目的 分析运动针法联合功能性电刺激治疗中风后手功能障碍的有效性、安全性.方法 选取2021年12月—2023年8月贵州医科大学附属医院收治的90例中风后手功能障碍患者作为研究对象,用随机数表法分为A组(运动针刺疗法)、B组(功能性电刺激疗法)、C组(运动针刺+功能性电刺激疗法),各30例,3组患者均进行常规药物和康复训练,连续治疗4周.治疗过程中记录首次出现主动伸腕及主动伸指动作的时间,比较3组患者的主动腕背伸关节活动度、主动食指背伸关节活动度、手握力、Brunstrom运动功能分期、上肢远端运动功能(Fugl-Meyer Assessment Scale,FMA)评分、简易上肢机能评分(Simple Test for Evaluating Hand Function,STEF)、改良Barthel指数(Modified Barthel Index,BI)及不良反应发生率.结果 治疗后,A组13例(43.3%),B组10例(33.3%),C组24例(80.0%)出现了主动腕背伸动作;A组10例(33.3%),B组9例(30.0%)、C组20例(66.7%)出现了主动食指背伸动作.C组出现主动伸腕动作、主动伸指动作的时间短于A组和B组,差异有统计学意义(P均<0.05);治疗后,C组腕背伸主动关节活动度、食指背伸主动关节活动度、手握力大于A组、B组,Brunstrom运动功能分期、FMA评分、BI指数、STEF评分高于A组、B组,差异有统计学意义(P均<0.05).治疗期间,3组患者均未发生严重不良反应.结论 运动针法联合功能性电刺激可更早促进中风患者出现主动腕背伸及手指背伸动作,增加腕背伸、食指背伸活动度,提升患侧握力,提高Brunstrom运动功能分期,提高手部运动功能及日常生活活动能力,且临床安全性较好.
Clinical Study of Acupuncture Combined with Functional Electrical Stimu-lation on Hand Dysfunction after Stroke
Objective To analyze the efficacy and safety of acupuncture combined with functional electrical stimula-tion in the treatment of hand dysfunction after stroke.Methods A total of 90 patients with post-stroke hand dysfunc-tion admitted to the Affiliated Hospital of Guizhou Medical University from December 2021 to August 2023 were se-lected as the study objects and divided into group A(exercise acupuncture therapy),group B(functional electrical stimulation therapy)and group C(dynamic acupuncture + functional electrical stimulation therapy)by random number table method,with 30 cases in each group.All patients in the 3 groups were treated with conventional drugs and reha-bilitation training for 4 weeks.The time of first active wrist extension and active finger extension were recorded during treatment.The active wrist dorsal extension joint mobility,active index finger dorsal extension joint mobility,hand grip strength,Brunstrom motor function stage,upper limb distal Fugl-Meyer Assessment Scale(FMA),simple test for evaluating hand function(STEF),modified Barthel index(BI)and incidence of adverse reactions were compared among the three groups.Results After treatment,13 cases(43.3%)in group A,10 cases(33.3%)in group B,and 24 cases(80.0%)in group C developed active dorsal wrist extension;active back extension of index finger occurred in 10 cases(33.3%)in group A,9 cases(30.0%)in group B and 20 cases(66.7%)in group C.The time of active wrist exten-sion and active finger extension in group C were shorter than that in group A and group B,and the differences were statistically significant(all P<0.05);after treatment,the active joint motion of wrist extension,active joint motion of in-dex finger extension and hand grip strength in group C were higher than those in groups A and B,and the Brunstrom motor function stage,FMA score,BI index and STEF score were higher than those in groups A and B,and the differ-ences were statistically significant(all P<0.05).During treatment,there were no serious adverse reactions occurred in the 3 groups.Conclusion Exercise acupuncture combined with functional electrical stimulation can promote active wrist extension and finger dorsiflexion earlier in stroke patients,increase the wrist dorsiflexion and index finger dorsi-flexion activity,improve the affected side grip strength,improve Brunstrom motor function stage,and improve hand motor function and daily living ability,with good clinical safety.
NETL
NSTL
万方数据
维普
