首页|针刺联合康复训练对急性脑梗死患者神经及运动功能的改善作用

针刺联合康复训练对急性脑梗死患者神经及运动功能的改善作用

Improvement effect of acupuncture combined with rehabilitation training on neurological and motor functions in patients with acute cerebral infarction

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目的 探讨针刺联合早期康复训练对急性脑梗死患者临床疗效、中医证候积分、神经功能及运动功能的改善作用.方法 采用前瞻性研究方法,研究对象为金华市中心医院神经内科2019年6月至2022年6月收治的急性脑梗死患者76例,将研究对象通过随机数字表法分为观察组和对照组各38例.对照组干预方案为早期康复训练,观察组干预方案为针刺联合早期康复训练,比较两组患者临床疗效及治疗前后中医证候积分、神经功能及运动功能的差异.结果 观察组的治疗总有效率为89.47%(34/38),高于对照组的67.59%(25/38)(Z=2.41,P=0.016).治疗后,两组的半身不遂、口眼歪斜、言语蹇涩评分均比治疗前低,且观察组的下降程度更大(t=4.73,P<0.001;t=-10.58,P<0.001;t=6.42,P<0.001).治疗后,两组患者神经功能缺损量表评分均比治疗前低,且观察组的下降程度更大(t=-7.33,P<0.001).治疗后,两组患者的Fug-Meyer运动功能量表、Barthel指数评分均比治疗前高,且观察组的提高程度更大(t=3.72,P<0.001;t=-5.02,P<0.001).治疗后,两组患者核心肌群的徒手肌力评分均比治疗前高,且观察组的提高幅度更大(t=3.31,P<0.001).结论 针刺联合康复训练治疗急性脑梗死可提高临床疗效,改善患者中医证候积分,改善患者神经功能和运动功能,提高患者核心肌群肌力,值得临床进一步推广.
Objective To investigate the improvement effect of acupuncture combined with early rehabilitation training on clinical efficacy,traditional Chinese medicine syndrome score,and neurological and motor functions of patients with acute cerebral infarction.Methods A total of 76 patients with acute cerebral infarction who received treatment in the Department of Neurology at Jinhua Municipal Central Hospital from June 2019 to June 2022 were included in this prospective study.These patients were randomly divided into an observation group and a control group using the random number table method,with 38 patients in each group.The control group received early rehabilitation training,while the observation group received acupuncture combined with early rehabilitation training.The clinical efficacy was compared between the two groups.Pre-and post-treatment traditional Chinese medicine symptom scores and neurological and motor functions were compared between the two groups.Results The overall response rate in the observation group was 89.47%(34/38),which was significantly higher than 67.59%(25/38)in the control group(Z=2.41,P=0.016).After treatment,the scores of hemiplegia,mouth and eye deviation,and speech difficulty in both groups were significantly decreased compared with before treatment,and the observation group showed a greater degree of decline in these indices than the control group(t=4.73,P<0.001;t=-10.58,P<0.001;t=6.42,P<0.001).After treatment,the neurological deficit scale scores in each group were decreased compared with before treatment,and the observation group showed a greater degree of decline compared with the control group(t=-7.33,P<0.001).After treatment,the Fug-Meyer motor function scale and Barthel index scores in each group were significantly increased compared with before treatment,and the observation group showed a greater degree of increases compared with the control group(t=3.72,P<0.001;t=-5.02,P<0.001).After treatment,the bare hand muscle strength scores of the core muscles in both groups of patients were increased compared with before treatment,and the observation group showed a greater improvement compared with the control group(t=3.31,P<0.001).Conclusion Acupuncture combined with rehabilitation training can enhance clinical efficacy,improve traditional Chinese medicine syndrome scores,enhance neurological and motor functions,and strengthen core muscle strength in patients with acute cerebral infarction.This treatment approach is worthy of being further promoted in clinical practice.

Brain infarctionAcupuncture pointsRehabilitationExercise therapyMotor activityMuscle strengthTreatment outcomeControlled cinical trial

周桂妃、余静、李倩

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金华市中心医院康复科,金华 321000

金华市中心医院神经内科,金华 321000

脑梗死 针刺穴位 康复 运动疗法 运动活动 肌力 治疗结果 临床对照试验

2024

中国基层医药
中华医学会,安徽医科大学

中国基层医药

影响因子:1.003
ISSN:1008-6706
年,卷(期):2024.31(1)
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