头针联合上肢功能性电刺激对脑卒中后上肢运动功能影响的随机对照研究

关键词：脑卒中  头针  上肢  功能性电刺激

Keywords:stroke  scalp acupuncture  upper limb  functional electrical stimulation

摘要：

      摘要 目的：探讨头针联合功能性电刺激（FES）对脑卒中患者上肢运动功能的影响。 方法：本研究采取单盲随机对照研究，纳入符合标准的脑卒中上肢功能障碍患者60例，使用信封法随机分为头针联合FES组、FES组和常规康复组，每组各20例。给予5次/周，连续4周的干预。比较三组在干预第2周、第4周，及治疗结束后的第4周随访时的上肢运动功能变化情况。采用Fugl-Meyer运动功能评定量表-上肢部分（FMA-UE）、Wolf运动功能评价量表及Brunnstrom分期进行干预效果的评价。 结果：①三组一般资料及结局指标治疗前对比均无显著性差异（P＞0.05）；②治疗4周后及出院4周进行随访时，FMA-UE评分：头针联合FES组较FES组、常规康复组在FMA-UE评分明显提升，差异具有显著性意义（P＜0.05）；③三组间Wolf评分及Brunnstrom分期在干预后及随访中均无显著性差异（P＞0.05）。 结论：头针联合上肢FES治疗可以提高脑卒中患者的上肢运动功能。

Abstract:

      Abstract Objective： To explore the effects of scalp acupuncture combined with functional electrical stimulation （FES） on upper limb motor function in stroke patients. Method： This study adopted a single blind randomized controlled study，including 60 stroke patients with upper limb dysfunction who met the criteria. They were randomly divided into a scalp acupuncture combined with FES group，FES group，and conventional rehabilitation group using the envelope method， with 20 cases in each group. 5 interventions were given per week for 4 consecutive weeks. The changes in upper limb motor function were compared among three groups during the second and fourth weeks of intervention， as well as the fourth week of follow-up after treatment. The intervention effect was evaluated using the Fugl-Meyer Motor Function Evaluation Scale Upper Limb Part （FMA-UE），Wolf Motor Function Evaluation Scale， and Brunnstrom staging. Result： ①There was no statistically significant difference in general information and outcome indicators among the three groups before treatment （P>0.05）； ②After 4 weeks of treatment and 4 weeks of follow-up after discharge， the FMA-UE score was significantly improved in the scalp acupuncture combined with FES group compared to the FES group and conventional rehabilitation group， with a statistically significant difference （P<0.05） There were no statistically significant differences in Wolf scores and Brunnstrom staging among the three groups after intervention and during follow-up （P>0.05）. Conclusion： The combination of scalp acupuncture and upper limb FES treatment can improve the upper limb motor function of stroke patients.