摘要
目的 探讨针灸联合偏瘫肢体综合训练对脑卒中后偏瘫并腰椎间盘突出症(LDH)患者患肢运动功能及生存质量的影响.方法 选取2019 年6 月至2021 年6 月收治的脑卒中后偏瘫并LDH患者68 例,采用随机数字表法分为观察组和对照组各34 例.2 组均给予常规治疗及偏瘫肢体综合训练,观察组在偏瘫肢体综合训练前采用针灸进行治疗.比较2 组治疗前后患肢运动功能[脑卒中康复运动功能评定量表(STREAM)]、痉挛程度[改良的Ashworth量表法(MAS)]、神经功能缺损[美国国立卫生研究院卒中量表(NIHSS)]、生活自理能力[日常生活活动能力评定(ADL)]、疼痛程度[视觉模拟评分法(VAS)]、腰椎功能[日本骨科协会评估治疗分数量表(JOA)]、腰背肌力学[屈伸松弛比(FRR)、肌张力、压痛阈]、足底压力、生活质量[脑卒中生活质量量表(SS-QOL)].结果 治疗后,2 组STREAM各项评分、JOA各项评分、压痛阈、SS-QOL评分、患足静态压力占比、患足中部动态压力峰值均较治疗前升高,且观察组高于对照组(P＜0.05).治疗后,2 组MAS评分、NIHSS评分、ADL各项评分、VAS评分、健足中部动态压力峰值、FRR、肌张力均较治疗前显著下降,且观察组低于对照组(P＜0.05).结论 针灸联合偏瘫肢体综合训练用于脑卒中后偏瘫并LDH患者治疗,可显著改善患者患肢运动功能,缓解痉挛、疼痛和神经功能缺损程度,同时改善腰椎功能、腰背肌力学和足底压力相关指标,促进患者生活自理能力恢复,提升生活质量.
Abstract
Objective To explore the effect of acupuncture and moxibustion combined with comprehensive training of hemiplegic limbs on motor function of affected limbs and quality of life in patients with post-stroke hemiplegia complicated with lumbar disc herniation(LDH).Methods A total of 68 patients with post-stroke hemiplegia and LDH treated from June 2019 to June 2021 were selected and divided into observation group(n=34)and control group(n=34)by random number table method.The two groups were given conventional treatment and comprehensive training of hemiplegic limbs,and the observa-tion group was treated with acupuncture and moxibustion before comprehensive training of hemiplegic limbs.The motor func-tion[stroke rehabilitation assessment of movement(STREAM)],spasticity degree[modified ashworth scale(MAS)],nerve function deficit[National Institutes of Health Stroke Scale(NIHSS)],self-care ability[activity of daily living(ADL)]and pain degree[visual analogue scale(VAS)],lumbar function[Japanese Orthopaedic Association(JOA)Scores],lumbar and dorsal myodynamics[flexural relaxation ratio(FRR),muscle tone,tenderness threshold],plantar pressure,quality of life[stroke-specific quality of life scale(SS-QOL)]were compared between the two groups before and after treatment.Results After treatment,the scores of items of STREAM,scores of items of JOA,tenderness threshold,proportion of static pressure of affected foot,peak dynamic pressure in the middle of affected foot and SS-QOL score of the two groups were signifi-cantly increased compared with those before treatment,and the above indexes were significantly higher in the observation group than in the control group(P＜0.05).After treatment,the MAS score,NHISS score,scores of items of ADL,VAS score,FRR,muscle tension and peak dynamic pressure in the middle of healthy foot in the two groups were significantly decreased compared with those before treatment,and the above indexes were significantly lower in the observation group than in the control group(P＜0.05).Conclusion Acupuncture and moxibustion combined with comprehensive training of hemiplegic limbs for patients with post-stroke hemiplegia complicated with LDH can significantly improve the motor function of affected limbs,relieve the spasm,pain and neurological deficits,and can also improve the lumbar function and the relevant indicators of lumbar back myodynamics and plantar pressure,promote the recovery of self-care ability and enhance the quality of life.
基金项目
安徽第十三批"115"产业创新团队项目(皖人才办[2020]4号)
维普
万方数据