头部电针结合屈伸肌交替经皮穴位电刺激治疗脑卒中偏瘫患者平衡及步行能力的临床研究

Clinical Study of Scalp Electro-Acupuncture Combined with Alternating Flexor-Extensor Transcutaneous Electrical Stimulation of Acupoints for Improving Balance and Walking Ability in Patients with Post-Stroke Hemiplegia

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中文摘要：目的:观察头部电针结合屈伸肌交替经皮穴位电刺激治疗脑卒中(CVA)偏瘫患者平衡及步行能力的临床疗效.方法:将60例符合纳入标准的CVA偏瘫患者作为本试验研究对象,运用随机数字表法将患者分为常规组与联合组.两组患者均给予CVA基础治疗;常规组额外给予患肢足三里、阳陵泉、阴陵泉、三阴交、丘墟及太冲进行电针治疗;联合组额外给予百会、病灶侧运动区和双侧平衡区进行电针治疗,同时给予患肢浮郄、殷门、血海及箕门进行屈伸肌交替经皮穴位电刺激治疗.治疗前后采用5次椅子坐立测试(5-TSST)、四阶段平衡测试(4-STB)、简明平衡评价系统测试(Brief-BESTest)、功能性步态评估(FGA)、脑卒中专用生存质量量表(SS-QOL)及表面肌电信号最大肌电幅值(MAX)对患者进行疗效评估.结果:两组患者5-TSST评分治疗后降低,4-STB评分、Brief-BESTest评分、FGA评分、SS-QOL评分及表面肌电信号MAX值治疗后均升高,治疗后两组患者各项评分组间比较差异有统计学意义(P＜0.01).结论:头部电针联合屈伸肌交替经皮穴位电刺激治疗能有效改善CVA偏瘫患者的平衡及步行能力,上下协同同步刺激疗效显著,值得临床推广.

外文摘要：Objective:To observe the clinical efficacy of scalp electro-acupuncture combined with alternating flexor-extensor transcutaneous electrical stimulation of acupoints for improving balance and walking ability in hemiplegic patients with cerebrovascular accident(CVA).Methods:60 cases of hemiplegic CVA patients,who met the inclusion criteria,were randomly divided into the conventional group and the combined group.Both groups were given basic treatment for stroke;the conventional group was additionally treated with electro-needling Zusanli(ST36),Yanglingquan(GB34),Yinlingquan(SP9),Sanyinjiao(SP6),Qiuxu(GB40)and Taichong(LR3)on affected limb;the combined group was additionally treated with scalp electro-needling Baihui(DU20),the affected motor area and bilateral balance area;meanwhile alternating flexor-extensor transcutaneous electrical stimulation of acupoints was applied to Fuxi(BL38),Yinmen(BL37),Xuehai(SP10),and Jimen(SP11)on the affected limb.5-Times Sit to Stand Test(5-TSST),4-Stage Balance Test(4-STB),Brief-Balance Evaluation Systems Test(Brief-BESTest),Functional Gait Assessment(FGA),Stroke-Specific Quality of Life(SS-QOL),and Surface Electromyography MAX Amplitude(MAX)were used to evaluate treatment efficacy in the two groups.Results:The score of 5-TSST was decreased(P＜0.01),the scores of 4-STB,Brief-BESTest,FGA and SS-QOL,as well as the value of MAX of surface electromyographic signals were increased after the treatment compared to those before the treatment in the two groups(P＜0.01);of which the improvements were more significant in the combined group than those in the conventional group(P＜0.01).Conclusion:Scalp electro-acupuncture combined with alternating flexor-extensor transcutaneous electrical stimulation of acupoints can effectively improve the balance and walking ability in hemiplegic patients with CVA,and the efficacy is remarkable by upper and lower synergistic and synchronized stimulation.The therapy is worthy to be promoted in clinical practice.

外文关键词：

StrokeHemiplegiaElectro-acupunctureAlternating flexor-extensor transcutaneous electrical stimulation of acupointsBalance and walking ability

作者：

张译尹、张健、王东岩、董旭、冯丽媛、霍宏、张虹岩

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作者单位：

黑龙江中医药大学,黑龙江哈尔滨 150040

黑龙江中医药大学附属第三医院,黑龙江哈尔滨 150060

黑龙江中医药大学附属第二医院,黑龙江哈尔滨 150001

关键词：

脑卒中偏瘫电针屈伸肌交替经皮穴位电刺激平衡及步行能力

基金：

国家自然科学基金面上项目哈尔滨市科技计划自筹经费项目黑龙江中医药大学科研项目

项目编号：

823746012022ZCZJNS062201203

出版年：

2024

DOI：

10.19917/j.cnki.1005-0779.024045

针灸临床杂志

中华中医药学会黑龙江中医药大学中国针灸学会临床分会

针灸临床杂志

CSTPCD

影响因子：1.242

ISSN：1005-0779

年,卷(期)：2024.40(3)

参考文献量32