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《广州医药》编辑部
目的 观察急性期脑卒中患者早期针刺结合康复训练的临床疗效。方法 采用单盲、分层、区组随机设计分组,随机分成针康组与康复组。针康组35例,康复组35例,按5 d为一个疗程,共4个疗程。采用Fug-Meyer运动功能评分法(FMA)、巴氏指数(BI)、脑卒中专用生活质量量表(SS-QOL)对治疗前及治疗后4周末、出院后8周末及随访期3个月、6个月末的死亡率、残疾率、复发率评估,比较两组的疗效。结果 两组基线比较差异无统计学意义(P>0.05)。组间比较:4周末 FMA、BI评分两组相比差异均无统计学意义(P>0.05),8周末则具有统计学意义(P<0.01)。SS-QOL评分在第4周末和第8周末相比差异无统计学意义(P>0.05)。随访3个月、6个月末的死亡率、致残率和复发率差异均无统计学意义(P>0.05)。组间多重比较,两组4、8周末 FMA、 BI和SS-QOL评分较治疗前比较差异有统计学意义(P<0.01)。针刺康复组8周末疗效优于4周末(P<0.01),康复组8周末与4周末相比差异无统计学意义(P>0.05)。针刺康复组4、8周末SS-QOL评分显著高于治疗前(P<0.01),8周末与4周末相比差异无统计学意义(P>0.05),康复组各时间点SS-QOL评分两两比较差异有统计学意义(P<0.01)。结论 对急性脑卒中患者进行早期针刺结合康复训练,可明显改善其肢体运动功能和日常生活活动能力。
Objective To observe the clinical efficacy of early acupuncture combined with rehabilitation training in acute-phase stroke patients.Methods Single-blind,stratified,zone group randomized design grouping was adopted,and randomly divided into acupuncture rehabilitation group and rehabilitation group.There were 35 cases in the acupuncture rehabilitation group and 35 cases in the rehabilitation group,received 4 courses,5 days in each course.Fugl-Meyer Assessment(FMA),Barthel Index(BI),Stroke Specific Quality of Life Scale(SS-QOL) scores and mortality,disability and recurrence rates at the end of 3 and 6 months of follow-up were used to compare the efficacy of the two groups.Results Comparing the basic conditions of the two groups,the difference was not significant(P>0.05).Comparison between groups:differences FMA and BI scores between two groups at the end of 4 weekends were not significant(P>0.05),while differences were significant(P<0.01)at the end of 8 weekends.SS-QOL scores at the end of 4 weekends and the end of 8 weekends were not significant different between two groups(P>0.05).Mortality,disability and recurrence rates at the end of 3 and 6 months of follow-up were not significantly different(P>0.05).Multiple comparisons between groups:there were significant differences in FMA,BI and SS-QOL scores at the end of 4 and 8 weeks between the two groups compared with the pre-treatment period(P<0.01).The efficacy of the acupuncture rehabilitation group at the end of 8 weekends was significantly better than that at the end of 4 weekends(P<0.01),and there was no statistically significant difference between the rehabilitation group at the end of 8 weekends and that at the end of 4 weekends(P>0.05).The SS-QOL scores at the end of 4 and 8 weekends in the acupuncture rehabilitation group were significantly higher than those before treatment(P<0.01),and there was no statistically significant difference at the end of 8 weekends compared with that at the end of 4 weekends(P>0.05),and there was a statistically significant difference in the two-by-two comparisons of SS-QOL scores at each time point in the rehabilitation group(P<0.01).Conclusions Early acupuncture combined with rehabilitation training for acute stroke patients can significantly improve their extremities motor function and daily vitality.