作者：韩伟，张虎，张春荣，于磊

单位：

101300北京市中医院顺义医院康复科

Units：

Department of Rehabilitation, Beijing Shunyi Hospital of Traditional Chinese Medicine, Beijing 101300, China

关键词：

脑梗死；偏瘫；手足十二针；强制性运动疗法；治疗结果；日常生活活动

Keywords：

Brain infarction; Hemiplegia; Hand and foot acupuncture with twelve needles; Compulsory exercise therapy; Treatment outcome; Activities of daily living

CLC：

R 743.33

DOI：

10.12114/j.issn.1008-5971.2024.00.080

Funds：

北京市科技计划课题任务（Z171100001017150）

摘要：

目的　探究手足十二针联合强制性运动疗法治疗脑梗死偏瘫的临床疗效及其对患者日常生活活动能 力的影响。方法　选取2022年2月—2023年2月北京市中医院顺义医院收治的脑梗死偏瘫患者120例，采用随机数字表 法将其分为对照组和观察组，每组60例。对照组患者接受强制性运动疗法，观察组患者在对照组基础上接受手足十二 针治疗，两组患者疗程均为4周。比较两组患者临床疗效及治疗前后Berg平衡量表（BBS）评分、Fugl-Meyer运动功 能评估量表（FMA）评分、神经营养因子〔神经生长因子（NGF）和脑源性神经营养因子（BDNF）〕、Barthel指数 （BI）。结果　治疗4周后，观察组患者临床疗效优于对照组（Z=2.237，P=0.025）。治疗后，两组患者BBS、FMA评 分分别高于本组治疗前，且观察组患者BBS、FMA评分高于对照组（P＜0.05）。治疗后，两组患者NGF、BDNF分别 高于本组治疗前，且观察组患者NGF、BDNF高于对照组（P＜0.05）。治疗后，两组患者BI分别高于本组治疗前，且 观察组患者BI高于对照组（P＜0.05）。结论　手足十二针联合强制性运动疗法能有效提高脑梗死偏瘫患者的临床疗 效、平衡能力及运动能力，促进脑神经功能恢复，进而提高患者的日常生活活动能力。

Abstract：

Objective To explore the clinical effect of hand and foot acupuncture with twelve needles combined with compulsory exercise therapy in the treatment of cerebral infarction patients with hemiplegia and their influence on the activities of daily living ability. Methods A total of 120 cerebral infarction patients with hemiplegia in Beijing Shunyi Hospital of Traditional Chinese Medicine from February 2022 to February 2023 were selected, and they were divided into control group and observation group according to random number table method, 60 cases in each group. The patients in the control group received compulsory exercise therapy, and the patients in the observation group received hand and foot acupuncture with twelve needles on the basis of the control group. The course of treatment in both groups was 4 weeks. The clinical efficacy, and Berg Balance Scale (BBS) score, Fugl-Meyer Motor Assessment (FMA) score, neurotrophic factors [nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) ] and Barthel Index (BI) before and after treatment were compared between the two groups. Results At 4 weeks after treatment, the clinical efficacy in the observation group was better than that in the control group (Z=2.237, P=0.025) . After treatment, the scores of BBS and FMA in the two groups were higher than those before treatment, respectively, and the scores of BBS and FMA in the observation group were higher than those in the control group (P < 0.05) . After treatment, the NGF and BDNF in the two groups were higher than those before treatment, respectively, and the NGF and BDNF in the observation group were higher than those in the control group (P < 0.05) . After treatment, the BI in the two groups was higher than that before treatment, respectively, and the BI in the observation group was higher than that in the control group (P < 0.05) . Conclusion Hand and foot acupuncture with twelve needles combined with compulsory exercise therapy can effectively improve the clinical efficacy, balance ability and motor ability of cerebral infarction patients with hemiplegia, promote the recovery of brain nerve function, and then improve the activities of daily living ability of patients.

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