针刺同步运动疗法改善脑卒中患者下肢感觉及运动功能的效果研究

关键词：针刺  运动疗法  脑卒中  下肢  运动功能  感觉功能

Keywords:acupuncture  exercise therapy  stroke  lower limb  motor function  sensory function

摘要：

      摘要 目的：观察针刺同步运动疗法对脑卒中患者下肢感觉及运动功能的影响，旨在为脑卒中康复方案的优化提供依据。 方法：选取2022年3—7月在山东中医药大学附属医院住院脑卒中患者70例，将患者随机分为同步组和对照组，每组各35例。对照组采用传统针刺和运动疗法分时序康复模式，同步组采用针刺同步运动疗法康复模式。分别于治疗前后采用改良版诺丁汉感觉功能评价量表（reNSA）、Fugl-Meyer感觉功能量表、下肢Fugl-Meyer运动功能评定（FMA）、Berg评分、改良Barthel量表（MBI）和改良Ashworth痉挛评定分级（MAS）评定并比较2组疗效。 结果：治疗后2组在reNSA浅感觉、reNSA深感觉、reNSA复合感觉和Fugl感觉评分4个指标均显著升高（P<0.05）。同步组的深、浅感觉得分显著高于对照组，而2组在复合感觉和Fugl感觉得分间差异无显著性意义（P>0.05）。治疗后2组患者FMA-UE、Berg评分和MBI均显著升高（P<0.05），且同步组的FMA-UE、Berg评分和MBI得分也显著高于对照组（P<0.05）。治疗后2组MAS评分构成均显著改善，治疗前后2组间差异无显著性意义（χ2=2.469， P=0.650；χ2=1.651，P=0.648）。 结论：针刺同步运动疗法能有效改善脑卒中下肢感觉、运动和平衡功能，效果优于传统针刺和运动疗法分时序康复模式。

Abstract:

      Abstract Objective：To observe the effect of acupuncture synchronized exercise therapy on sensory and motor functions of lower limbs in stroke patients， and to provide scientific basis for the optimization of rehabilitation program for stroke patients. Method：Seventy stroke patients hospitalized in the Rehabilitation Department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from March 2022 to July 2022 were selected and randomly divided into synchronous group and control group， 35 patients in each group. The patients in the synchronous group received routine exercise therapy and synchronized acupuncture treatment， while the patients in the control group received acupuncture and subsequent exercise therapy continuously. Before and after treatment， the revised Nottingham sensory assessment scale （reNSA）， Fugl-Meyer sensory rating scale， Fugl-Meyer motor function assessment （FMA）， Berg rating scale， modified Barthel index rating scale （MBI） and modified Ashworth spasm rating scale （MAS） were used to evaluate the curative effects. Result：After treatment， the scores of reNSA deep sensation， reNSA compound sensation and Fugl sensation in two groups were significantly increased （P<0.05）. The scores of deep and shallow sensation in the synchronous group were significantly higher than those in the control group， while there was no significant difference between the two groups in the scores of compound sensation and Fugl sensation （P>0.05）. After treatment， the FMA-UE score， Berg score and MBI score in the two groups were significantly increased （P<0.05）， and the FMA-UE score， Berg score and MBI score of the synchronous group were also significantly higher than those of the control group （P<0.05）. The composition of MAS scores in both groups also improved significantly after treatment， but there was no significant difference between the two groups before or after treatment（χ2=2.469，P=0.650； χ2=1.651，P=0.648）. Conclusion：Acupuncture synchronized exercise therapy can effectively improve the sensory and motor functions of the lower limbs after stroke， and its effect is better than that of exercise therapy and acupuncture sequential therapy.