| 赵鹭,陈蓉蓉,林树梁.拮抗肌群针刺疗法联合功能性电刺激对脑卒中偏瘫患者运动功能的影响[J].浙江中西医结合杂志,2025,35(3): |
| 拮抗肌群针刺疗法联合功能性电刺激对脑卒中偏瘫患者运动功能的影响 |
| Effects of acupuncture therapy for antagonistic muscle groups combined with functional electrical stimulation on motor function in hemiplegic patients with stroke |
| 投稿时间：2024-08-10 修订日期：2024-12-21 |
| DOI： |
| 中文关键词: 拮抗肌群针刺疗法 功能性电刺激 脑卒中偏瘫 运动功能 平衡功能 |
| 英文关键词:Acupuncture therapy of antagonistic muscle groups Functional electrical stimulation Stroke hemiparesis Motor function Balance function |
| 基金项目:浙江省基础公益项目(LTGY23H180020) |
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| 中文摘要: |
| 目的 观察拮抗肌群针刺疗法联合功能性电刺激(FES)对脑卒中偏瘫患者运动功能的影响。方法 病例选取时间2022年2月-2024年4月,研究人群为就诊于我院针灸理疗科及康复科的80例脑卒中偏瘫患者,采用简单随机法分为两组。FES组在常规康复治疗基础上给予FES治疗,针刺疗法组在FES组基础上给予拮抗肌群针刺疗法治疗。比较两组脑血流动力学、步态重建参数、重心移动轨迹椭圆面积及简化Fugl-Meyer(FMA)评分、Barthel(BI)指数、Berg平衡量表(BBS)评分、功能性步行分级(FAC)的差异。结果 治疗前比较,两组脑血流动力学无差异(P>0.05)。治疗前后比较,两组治疗4、8周最大峰值流速升高,阻力指数(RI)、搏动指数(PI)下降(P<0.05)。治疗4、8周比较,针刺疗法组最大峰值流速高于FES组,RI、PI低于FES组(P<0.05)。治疗前比较,两组FMA评分、BI指数、BBS评分、FAC分级无差异(P>0.05)。治疗前后比较,两组治疗4、8周FMA评分、BI指数、BBS评分、FAC分级升高(P<0.05)。治疗4、8周比较,针刺疗法组FMA评分、BI指数、BBS评分、FAC分级高于FES组(P<0.05)。治疗前比较,两组步态重建参数无差异(P>0.05)。治疗前后比较,两组治疗4、8周步速、步长、步幅升高(P<0.05)。治疗4、8周比较,针刺疗法组步速、步长、步幅高于FES组(P<0.05)。治疗前比较,两组重心移动轨迹椭圆面积无差异(P>0.05)。治疗前后比较,两组治疗4、8周闭眼时与睁眼时重心移动轨迹椭圆面积降低(P<0.05)。治疗4、8周比较,针刺疗法组闭眼时与睁眼时重心移动轨迹椭圆面积低于FES组(P<0.05)。结论 拮抗肌群针刺疗法联合功能性电刺激可改善脑卒中偏瘫患者运动功能,促进平衡功能的恢复,提高独立性。 |
| 英文摘要: |
| Objective To observe the effect of antagonistic muscle group acupuncture therapy combined with functional electrical stimulation (FES) on motor function in hemiplegic patients with stroke.Methods The cases were selected from February 2022 to April 2024, and the study population was 80 stroke hemiplegia patients who attended the acupuncture and physiotherapy department and the rehabilitation department of our hospital, and were divided into two groups by simple randomisation method.The FES group was given FES treatment based on the conventional rehabilitation treatment, and the acupuncture therapy group was given antagonist muscle group acupuncture therapy treatment based on the FES group. The differences in cerebral haemodynamics, gait reconstruction parameters, ellipse area of the centre of gravity movement trajectory and simplified Fugl-Meyer (FMA) score, Barthel (BI) index, Berg Balance Scale (BBS) score and Functional Ambulation Classification (FAC) were compared between the two groups.Results There was no difference in cerebral haemodynamics between the two groups when compared before treatment (P>0.05). Comparing before and after treatment, the maximum peak flow rate of the two groups increased at 4 and 8 weeks of treatment, and the resistance index (RI) and pulsatility index (PI) decreased (P<0.05). Comparing 4 and 8 weeks of treatment, the maximum peak flow rate of the acupuncture therapy group was higher than that of the FES group, and the RI and PI were lower than that of the FES group (P<0.05). Comparing before treatment, there was no difference in FMA score, BI index, BBS score and FAC grading between the two groups (P>0.05). Comparing before and after treatment, FMA score, BI index, BBS score, and FAC grading were elevated in the two groups at 4 and 8 weeks of treatment (P<0.05). Comparing 4 and 8 weeks of treatment, FMA score, BI index, BBS score, and FAC grading were higher in the acupuncture therapy group than in the FES group (P<0.05). Comparing before treatment, there was no difference in gait reconstruction parameters between the two groups (P>0.05). Comparing before and after treatment, step speed, step length, and step length were elevated in both groups at 4 and 8 weeks of treatment (P<0.05). Comparing 4 and 8 weeks of treatment, step speed, step length and stride length were higher in the acupuncture therapy group than in the FES group (P<0.05). Comparing before treatment, there was no difference in the elliptical area of the centre of gravity movement trajectory between the two groups (P>0.05). Comparing before and after treatment, the elliptical area of the centre of gravity movement trajectory decreased when the eyes were closed versus when the eyes were open in the two groups at 4 and 8 weeks of treatment (P<0.05). When comparing 4 and 8 weeks of treatment, the elliptical area of the centre of gravity movement trajectory at eye closure versus eye opening was lower in the acupuncture therapy group than in the FES group (P<0.05).Conclusion Antagonist muscle group acupuncture therapy combined with functional electrical stimulation improves motor function, facilitates recovery of balance function, and enhances independence in hemiplegic patients with stroke. |
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