轻点刺络法联合针刺对脑卒中偏身感觉障碍患者感觉功能和生活质量的影响
|
摘要
目的观察轻点刺络法联合针刺治疗脑卒中后偏身感觉障碍的疗效及对患者运动、平衡功能及生活质量的影响。方法将156例脑卒中偏身感觉障碍患者随机分为观察组和对照组,每组78例。对照组给予常规神经内科基础+康复治疗;观察组在对照组治疗基础上给予轻点刺络法+针刺疗法治疗,2组疗程均为8周。记录观察2组治疗前后Lindmark感觉功能评分、体感诱发电位(SEP)、改良Barthel指数(MBI)及简明健康量表(SF-36)评分变化情况,统计2组临床疗效。结果 2组治疗后Lindmark感觉功能评分中浅感觉(上臂、手掌、腿部、足底)评分、本体感觉(肩-肘、腕-手指、髋-膝)评分和总评分均显著升高(P均<0.05),且观察组各评分均显著高于对照组(P均<0.05)。2组治疗后体感诱发电位中各电位(P14、N20、P27、N35)的潜伏期均显著降低(P均<0.05),波幅均显著升高(P均<0.05);观察组各电位潜伏期均显著短于对照组(P均<0.05),各电位波幅均显著高于对照组(P均<0.05)。2组治疗后MBI分级、MBI总分均显著改善(P均<0.05),观察组改善情况显著优于对照组(P均<0.05);2组治疗后SF-36量表中生命活力(VT)、总体健康感(GH)、生理职能(RP)、生理功能(PF)、心理健康(MH)、社会功能(SF)评分均显著增高(P均<0.05),且观察组VT、GH、PF、SF评分均显著高于对照组(P均<0.05)。观察组总有效率显著高于对照组(P<0.05)。结论轻点刺络法结合针刺可明显缓解脑卒中偏身感觉障碍患者症状,促进神经传导功能恢复,提高日常生活活动能力与生存质量。
Objective It is to observe the curative effect of light pricking method combined with acupuncture on post-stroke hemianesthesia and its effect on the patients' action, balance function and quality of life. Methods A total of 156 stroke patients with hemianesthesia were randomly divided into observation group and control group, with 78 cases in each group. The control group was given the normal neurological basic therapy+rehabilitation, additionally, the observation group was treated with light pricking method combined with acupuncture on the basis of the control group, and the two groups were treated for 8 weeks. The changes of Lindmark sensory function score, somatosensory evoked potential(SEP), modified Barthel index(MBI) and concise health scale(SF-36) scores before and after treatment were observed. The clinical efficacy of the two groups was statistically analyzed. Results The scores of the shallow sense(upper arm, palm, leg, and vola) and the proprioception(shoulder-elbow, wrist-finger, hip-knee) scores and total scores in the Lindmark sensory function scores were significantly increased in the two groups(P<0.05), and the scores of the observation group were significantly higher than those of the control group(P<0.05). The latency of each potential(P14, N20, P27, N35) in the somatosensory evoked potentials of the two groups was significantly decreased(P<0.05), and the amplitudes were significantly increased(P<0.05). The latency of each potential in the observation group was significant shorter while the amplitude of each potential was significantly higher than those in the control group(P<0.05). The MBI grade and MBI scores of the two groups were significantly improved after treatment(P<0.05), the improvement of the observation group was significantly better than that of the control group(P<0.05). The scores of vitality(VT), general health(GH), role physical(RP), physiological function(PF), mental health(MH), and social function(SF) in SF-36 were significantly increased(P<0.05), and the scores of VT, GH, PF and SF were significantly higher in the observation group than those in the control group(P<0.05). The total effective rate of the observation group was significantly higher than that of the control group(P<0.05). Conclusion Light pricking method combined with acupuncture can significantly alleviate the symptoms, promote the recovery of nerve conduction function, and improve the ability of daily living and quality of life in the stroke patients with hemianesthesia.
Objective It is to observe the curative effect of light pricking method combined with acupuncture on post-stroke hemianesthesia and its effect on the patients' action, balance function and quality of life. Methods A total of 156 stroke patients with hemianesthesia were randomly divided into observation group and control group, with 78 cases in each group. The control group was given the normal neurological basic therapy+rehabilitation, additionally, the observation group was treated with light pricking method combined with acupuncture on the basis of the control group, and the two groups were treated for 8 weeks. The changes of Lindmark sensory function score, somatosensory evoked potential(SEP), modified Barthel index(MBI) and concise health scale(SF-36) scores before and after treatment were observed. The clinical efficacy of the two groups was statistically analyzed. Results The scores of the shallow sense(upper arm, palm, leg, and vola) and the proprioception(shoulder-elbow, wrist-finger, hip-knee) scores and total scores in the Lindmark sensory function scores were significantly increased in the two groups(P<0.05), and the scores of the observation group were significantly higher than those of the control group(P<0.05). The latency of each potential(P14, N20, P27, N35) in the somatosensory evoked potentials of the two groups was significantly decreased(P<0.05), and the amplitudes were significantly increased(P<0.05). The latency of each potential in the observation group was significant shorter while the amplitude of each potential was significantly higher than those in the control group(P<0.05). The MBI grade and MBI scores of the two groups were significantly improved after treatment(P<0.05), the improvement of the observation group was significantly better than that of the control group(P<0.05). The scores of vitality(VT), general health(GH), role physical(RP), physiological function(PF), mental health(MH), and social function(SF) in SF-36 were significantly increased(P<0.05), and the scores of VT, GH, PF and SF were significantly higher in the observation group than those in the control group(P<0.05). The total effective rate of the observation group was significantly higher than that of the control group(P<0.05). Conclusion Light pricking method combined with acupuncture can significantly alleviate the symptoms, promote the recovery of nerve conduction function, and improve the ability of daily living and quality of life in the stroke patients with hemianesthesia.
引文
[1] 孟凡祥.某医院脑卒中患者发病影响因素调查[J].解放军预防医学杂志,2016,34(2):272
[2] 滕秀英,王晨燃.不同频率电针治疗脑卒中后偏身感觉障碍疗效观察[J].上海针灸杂志,2017,36(7):781-784
[3] 杨杰妹,潘成艳,叶爱素,等.延续性护理对脑卒中患者生活质量及心理状况的影响[J].中华现代护理杂志,2016,22(10):1430-1432
[4] 卫生部疾病控制司,中华医学会神经病学分会.中国脑血管病防治指南[J].中国现代神经疾病杂志,2007,7(2):200-201
[5] 国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56
[6] 中华医学会神经病学分会神经康复学组.中国脑卒中康复治疗指南(2011完全版)[J/CD].中国医学前沿杂志:电子版,2012,4(6):55-76
[7] 闵瑜,吴媛媛,燕铁斌.改良Barthel指数(简体中文版)量表评定脑卒中患者日常生活活动能力的效度和信度研究[J].中华物理医学与康复杂志,2008,30(3):185-188
[8] 王红妹,李鲁,沈毅.中文版SF-36量表用于杭州市区居民生命质量研究[J].中华预防医学杂志,2001,35(6):428-430
[9] 宋婧源.体感诱发电位在脑卒中患者中应用价值的研究进展[J].实用心脑肺血管病杂志,2017,25(12):1-4
[10] 丁琴.脑卒中后感觉障碍的康复训练[J].中国冶金工业医学杂志,2015,32(1):114-115
[11] 徐明红,胡月,索宜美,等.中药洗敷结合康复训练治疗脑卒中后偏侧感觉障碍的临床研究[J].中西医结合护理(中英文),2016,2(4):68-70
[12] 朱栋华,赵杨,范刚启.头针、体针联合治疗卒中研究现状[J].河北中医,2014,36(5):783-785
[13] 胡恒,汪国兴,韩永升,等.头项部电针治疗脑梗死的临床研究[J].中医药临床杂志,2015,27(7):913-917
[14] 陈艳萍.针刺配合刺络拔罐治疗脑卒中后偏身感觉障碍临床研究[J].河南中医,2017,37(1):87-89
[15] 于海燕,徐凤超,朱薇,等.针刺联合星蒌承气汤对脑卒中大鼠血液流变学的影响[J].中国中医急症,2016,25(5):849-851
[16] 王良谷,孙涛,徐海强.刺络疗法在临床中的应用[J].锦州医科大学学报,2013,34(4):64
[2] 滕秀英,王晨燃.不同频率电针治疗脑卒中后偏身感觉障碍疗效观察[J].上海针灸杂志,2017,36(7):781-784
[3] 杨杰妹,潘成艳,叶爱素,等.延续性护理对脑卒中患者生活质量及心理状况的影响[J].中华现代护理杂志,2016,22(10):1430-1432
[4] 卫生部疾病控制司,中华医学会神经病学分会.中国脑血管病防治指南[J].中国现代神经疾病杂志,2007,7(2):200-201
[5] 国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56
[6] 中华医学会神经病学分会神经康复学组.中国脑卒中康复治疗指南(2011完全版)[J/CD].中国医学前沿杂志:电子版,2012,4(6):55-76
[7] 闵瑜,吴媛媛,燕铁斌.改良Barthel指数(简体中文版)量表评定脑卒中患者日常生活活动能力的效度和信度研究[J].中华物理医学与康复杂志,2008,30(3):185-188
[8] 王红妹,李鲁,沈毅.中文版SF-36量表用于杭州市区居民生命质量研究[J].中华预防医学杂志,2001,35(6):428-430
[9] 宋婧源.体感诱发电位在脑卒中患者中应用价值的研究进展[J].实用心脑肺血管病杂志,2017,25(12):1-4
[10] 丁琴.脑卒中后感觉障碍的康复训练[J].中国冶金工业医学杂志,2015,32(1):114-115
[11] 徐明红,胡月,索宜美,等.中药洗敷结合康复训练治疗脑卒中后偏侧感觉障碍的临床研究[J].中西医结合护理(中英文),2016,2(4):68-70
[12] 朱栋华,赵杨,范刚启.头针、体针联合治疗卒中研究现状[J].河北中医,2014,36(5):783-785
[13] 胡恒,汪国兴,韩永升,等.头项部电针治疗脑梗死的临床研究[J].中医药临床杂志,2015,27(7):913-917
[14] 陈艳萍.针刺配合刺络拔罐治疗脑卒中后偏身感觉障碍临床研究[J].河南中医,2017,37(1):87-89
[15] 于海燕,徐凤超,朱薇,等.针刺联合星蒌承气汤对脑卒中大鼠血液流变学的影响[J].中国中医急症,2016,25(5):849-851
[16] 王良谷,孙涛,徐海强.刺络疗法在临床中的应用[J].锦州医科大学学报,2013,34(4):64