作者：许莹娟，曹斌，赵玉茜，高洋，刘雪生，王京芳

单位：

100144北京市，首都医科大学附属北京康复医院康复中心 通信作者：曹斌，E-mail：13520565169@126.com

Units：

Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing 100144, China Corresponding author: CAO Bin, E-mail: 13520565169@126.com

关键词：

脑梗死; 偏瘫; 神经松动术; 头体针; 巨刺疗法; 治疗结果;

Keywords：

Brain infarction; Hemiplegia; Nerve mobilization; Head-body acupuncture; Giant needling; Treatmentoutcome

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.091

Funds：

北京市残疾人联合会项目（1941GNOAFWGK0275）；首都医科大学附属北京康复医院科技发展专项（2019-074）

摘要：

目的 探讨神经松动术联合头体针巨刺疗法治疗脑梗死偏瘫患者的临床疗效。方法 选取2018年6月至2020年6月首都医科大学附属北京康复医院收治的脑梗死偏瘫患者130例作为研究对象,采用随机数字表法将患者分为三组,分别为对照1组(n=43)、对照2组(n=43)和联合组(n=44)。三组患者均接受常规药物治疗及对症处理,对照1组在常规药物治疗基础上给予神经松动术,对照2组在常规药物治疗基础上给予头体针巨刺疗法,联合组在常规药物治疗基础上给予神经松动术联合头体针巨刺疗法,均持续治疗4周。比较三组患者治疗前,治疗2、4周后FuglMeyer运动功能量表(FMA)下肢功能评分、美国国立卫生研究院卒中量表(NIHSS)评分、Berg平衡量表(BBS)评分和患侧上肢正中神经F波波幅、阈值。结果 对照1组和对照2组均有2例中途自行退出本研究,联合组有2例中途自行退出本研究和1例被剔除本研究,最终纳入患者123例,每组41例。治疗2周后和治疗4周后三组患者FMA下肢功能评分、BBS评分、正中神经F波波幅较治疗前升高,NIHSS评分、正中神经F波阈值较治疗前下降;治疗4周后三组患者FMA下肢功能评分、BBS评分、正中神经F波波幅较治疗2周后升高,NIHSS评分、正中神经F波阈值较治疗2周后下降(P<0.05)。治疗2周后和治疗4周后,联合组患者FMA下肢功能评分、BBS评分高于对照1组和对照2组,NIHSS评分低于对照1组和对照2组;治疗2周后,联合组患者正中神经F波波幅高于对照1组和对照2组,正中神经F波阈值低于对照1组和对照2组(P<0.05)。结论 神经松动术联合头体针巨刺疗法可有效减轻脑梗死偏瘫患者肢体障碍程度,促进神经功能的修复和提高肢体平衡功能,值得借鉴。

Abstract：

【Abstract】 Objective To explore the clinical effect of nerve mobilization combined with head-body acupuncture inthe treatment of hemiplegia after cerebral infarction. Methods A total of 130 patients with hemiplegia after cerebral infarctionwho were admitted to Beijing Rehabilitation Hospital of Capital Medical University from June 2018 to June 2020 were selected,and they were divided into 3 groups by random number table method, namely the control group 1(n=43) , control groups 2 (n=43)and combined group (n=44) . All three groups received conventional drug treatment and symptomatic treatment, control group 1was given nerve mobilization on the basis of conventional drug treatment, control group 2 was given head-body acupuncture on thebasis of conventional drug treatment, and the combined group was given nerve mobilization combined with head-body acupunctureon the basis of conventional drug treatment. The treatment of three groups lasted for 4 weeks. The Fugl-Meyer Motor Assessment(FMA) of lower extremity function scores, National Institute of Health Stroke Scale (NIHSS) scores, Berg Balance Scale (BBS)scores and ipsilateral median nerve F-wave amplitude and threshold were compared among the three groups before treatment andafter 2 weeks and 4 weeks of treatment. Results Two cases of control group 1, two cases of control group 2 and three cases ofcombined group were exited during the study. Eventually, there were 123 cases completed the study (41 cases in each group) .After 2 weeks and 4 weeks of treatment, the FMA of lower extremity function scores, BBS scores, and median nerve F-wave amplitudeof the three groups were higher than those before treatment, and the NIHSS scores and median nerve F-wave threshold were lowerthan those before treatment (P < 0.05) . After 4 weeks of treatment, the FMA of lower extremity function scores, BBS scores, andmedian nerve F-wave amplitude of the three groups were higher than those after 2 weeks of treatment, while the NIHSS scores andmedian nerve F-wave threshold decreased compared with those after 2 weeks of treatment (P < 0.05) . After 2 weeks and 4 weeks oftreatment, the FMA of lower extremity function scores and BBS scores in the combined group were higher than those in the controlgroup 1 and control group 2, and the NIHSS scores were lower than those in the control group 1 and control group 2 (P < 0.05) . After2 weeks of treatment, the median nerve F-wave amplitude in the combined group were higher than those in the control group 1 andcontrol group 2, and the median nerve F-wave threshold was lower than those in the control group 1 and control group 2 (P < 0.05) .Conclusion Nerve mobilization combined with head-body acupuncture can reduce the degree of limb impairment of patients withhemiplegia after cerebral infarction, promote the repair of nerve function, and improve the balance function of limbs, which is worthyof reference.

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