调阴和阳针法联合Bobath疗法对中风后痉挛性瘫痪患者痉挛程度及运动功能的影响

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目的 探究调阴和阳针法联合Bobath疗法对中风后痉挛性瘫痪(spastic paralysis after stroke,SPAS)患者痉挛程度及运动功能的影响。方法 回顾性选取2024年2月至2026年2月就诊于我院的102例SPAS患者,按照治疗方案分为对照组、研究组,各51例。对照组采用Bobath疗法治疗,研究组采用调阴和阳针法联合Bobath疗法治疗,均治疗4周。比较两组临床疗效、治疗前后中医证候积分、肢体痉挛程度[改良Ashworth分级(MAS)]、相关量表[Fugl-Meyer运动功能量表(FMA)、功能独立性量表(FIM)、Berg平衡量表(BBS)、改良Barthel指数(MBI)]评分、不良反应发生情况。结果 研究组愈显率、总有效率均高于对照组(P<0.05);研究组治疗4周后半身不遂、头晕目眩、肢体麻木或手足拘急、舌强言謇、口舌歪斜积分低于对照组(P<0.05);研究组治疗4周后MAS评分低于对照组(P<0.05);研究组治疗4周后FMA、FIM、BBS、MBI评分高于对照组(P<0.05);两组均无严重不良反应发生。结论 采用调阴和阳针法联合Bobath疗法联合治疗SPAS患者可有效减轻临床症状及痉挛程度,提高疗效,且有利于促进患者运动功能、平衡能力及生活能力恢复,安全性良好。
论著

真武汤联合八段锦对老年冠心病患者心肺运动功能及生存质量的影响

Clinical effects of Zhenwu Decoction combined with Baduanjin Qigong on the cardiopulmonary function and quality of life in older adults with coronary heart disease

:1470-1475
 
目的 探讨真武汤联合八段锦在老年冠状动脉粥样硬化性心脏病(冠心病)患者中的应用效果。方法 将96例75岁以上冠心病患者按照随机数字表法分为对照组与干预组,每组各48例。在12周的临床研究期间,对照组用规范的冠心病二级预防药物治疗;干预组在规范的冠心病二级预防药物治疗基础上,增加真武汤以及八段锦运动处方。结果 治疗后干预组中医临床疗效(P=0.023)和中医证候积分(P<0.001)均优于对照组。两组患者的心肺运动试验指标均有改善,且干预组在升高峰值摄氧量(Peak VO2,P=0.005)、最大摄氧量(VO2max,P=0.001)、氧脉搏(VO2/HR,P=0.002)和无氧阈值时最大代谢当量(MET,P=0.001),以及降低无氧阈值(AT,P<0.001)和二氧化碳通气当量(VE/VCO2,P=0.020)方面比对照组更明显。两组患者在36项简明健康状态调查表(SF-36)评分的8个维度中评分均有所升高,其中在生理机能(P=0.001)、生理职能(P<0.001)、一般健康状况(P=0.018)、精力(P=0.007)、社会职能(P=0.010)、精神健康(P=0.004)方面,干预组效果优于对照组;而在躯体疼痛、情感职能维度改善方面,两组间结果相近,差异无统计学意义(P>0.05)。两组患者的匹兹堡睡眠质量指数(PSQI)均有所改善,且干预组效果优于对照组(P<0.001)。结论 真武汤联合八段锦能够进一步增强老年冠心病患者中医证候疗效,改善心肺运动试验Peak VO2、VO2max、VO2/HR、MET、AT、VE/VCO2等指标,并提高SF-36评分多个维度的生活质量及睡眠质量。
Objective To explore the therapeutic effects of Zhenwu Decoction combined with Baduanjin Qigong in older adults with coronary heart disease(CHD).Methods Ninety-six patients with CHD aged ≥75 years were randomly divided into a treatment group and a control group,with 48 patients in each group.Within the 12-week period,the control group received standard secondary prevention therapy for CHD,while the treatment group received Zhenwu Decoction and Baduanjin Qigong prescription,in addition to the standard treatment.Results After treatment,both groups showed improvement in the traditional Chinese medicine(TCM)clinical efficacy,TCM syndrome,SF-36 scores and Pittsburgh Sleep Quality Index(PSQI)scores;increase in Peak VO2,VO2max,VO2/HR,and metabolic equivalent(MET);and decrease in AT and VE/VCO2.However,the treatment group had a more pronounced improvement in the TCM clinical efficacy(P=0.023),TCM syndrome(P<0.001),PSQI scores(P<0.001),and cardiopulmonary exercise testing(CPET)indicators including Peak VO2(P=0.005),VO2max(P=0.001),VO2/HR(P=0.002),MET(P=0.001),AT(P<0.001)and VE/VCO2(P=0.020),compared to their control counterparts. For the SF-36 scores,in comparison to the control group,the treatment group presented better outcomes in enhancing physical functioning(P=0.001),role limitations due to physical health(P<0.001),general health(P=0.018),vitality(P=0.007),social functioning(P=0.010)and mental health(P=0.004),but not in pain or role limitations due to emotional problems.Conclusions The Zhenwu Decoction combined with Baduanjin Qigong can enhance the TCM syndrome,improve various CPET indicators such as Peak VO2、VO2max、VO2/HR、MET、AT and VE/VCO2,and elevate both quality of life and sleep quality among older adults with CHD.
临床诊疗

悬吊运动训练联合感觉统合训练对脑瘫患儿站立、步行运动功能的影响

:109-112
 
目的 将悬吊运动+感觉统合训练联合应用在脑瘫患儿的治疗当中,探讨该治疗方式对患儿运动功能(站立、步行)的影响。方法 将2021年3月—2022年3月作为时间区间,于该区间内摘选78例脑瘫患儿,将其随机分为A组和B组(n=39)。A组予以常规的运动训练,B组予以悬吊运动+感觉统合训练,对比分析2组患儿的粗大运动功能(站立、行走与跑跳能力)、平衡控制功能与步态参数。结果 2组患儿在治疗前的运动功能评分、平衡控制功能评分方面基本相同,经过治疗后,B组在站立、行走、跑跳方面的功能评分高于A组,在步态参数方面高于A组(P<0.05)。治疗之前的2组患儿在步态方面的各项参数大致相同,治疗后的B组在步长和步行速度方面出现了增长,步行宽度有了一定的减小(P<0.05)。结论 将悬吊运动+感觉统合训练联合应用在脑瘫患儿的治疗当中,不仅可以帮助患儿改善站立、步行以及跑跳的功能,同时也能强化患儿躯体的平衡控制功能,促进康复训练效果的有效提升,值得在临床上推广与应用。
临床诊疗

四通道FES对脑卒中患者下肢运动功能影响的随机对照研究

:97-100
 
目的 观察四通道FES对脑卒中患者下肢运动功能的影响,为其临床应用及推广提供依据。方法 将入组的49例脑卒中患者随机分为四通道FES组(17例)、单通道FES组(16例)和对照组(16例),三组患者均进行(除电刺激)综合康复训练,四通道FES组模仿正常人行走时肌肉收缩的时序刺激患侧下肢的股四头肌、胫骨前肌、腓肠肌及腘绳肌。单通道FES组患者仅在迈步时刺激患侧下肢的胫骨前肌,而股四头肌、腓肠肌、腘绳肌三块肌肉仅作安慰刺激。对照组患者在上述四块肌肉处做安慰刺激(即仅在这四处肌肉贴电极片,但没有电流)。治疗时间为每周5次,持续2周共10次,在治疗前、治疗后1周、治疗后2周分别进行患侧下肢运动功能评定及平衡功能评估。结果 组内前后比较:两组患者治疗前、治疗后一周、治疗后两周下肢功能(FMA)及平衡功能(Berg)逐步提高(P<0.05)。组间比较:治疗后一周三组差异无统计学意义(P>0.05);治疗后两周三组有统计学意义,经过两两比较发现,只有四通道组与对照组之间差异有统计学意义(P<0.05),其他两组之间均无统计学意义。结论 应用基于正常行走模式四通道FES治疗可以改善患者的下肢功能及平衡功能。
论著

针刺数量对小儿脑瘫肌张力及粗大运动功能的影响

The effect of acupuncture quantity on muscle tension and gross motor function in children with cerebral palsy

:47-49
 
目的 初步探究针刺数量对小儿脑瘫肌张力及粗大运动功能的影响。方法 选取我院2017年1月—2019年11月接收的脑瘫患儿78例,以随机数表法分组,常规针刺组39例,采用一般治疗加常规针刺穴位;增穴针刺组39例,在常规针刺组治疗基础上增加13个穴位治疗。对比2组患儿三个疗程后的肌张力及粗大运动功能。结果 治疗三个疗程后,常规针刺组肌张力评分稍低于增穴针刺组,粗大运动功能量表(GMFM-88)评分稍低于增穴针刺组,但差异没有统计学意义(P>0.05)。结论 针刺疗法可以有效辅助脑瘫患儿治疗,但是增多穴位不一定能明显改善患儿肌张力和粗大运动功能。
Objective To explore the effect of acupuncture quantity on muscle tension and gross motor function in children with cerebral palsy. Methods From January 2017 to November 2019, 78 children with cerebral palsy who were treated in our hospital were collected. 78 children with cerebral palsy were randomly divided into two groups. The conventional acupuncture group (39 cases) were treated with general treatment and conventional acupuncture points. And the more-needle acupuncture group (39 cases) were treated with adding another 13 more acupuncture points. Muscle tension and gross motor function were compared between the two groups after three courses of treatment. Results After three courses of treatment, the muscle tension score of the conventional acupuncture group was slightly lower than that of the more-needle acupuncture group, and the gross motor function scale (GMFM-88) score was slightly lower than that of the more-needle acupuncture group, but the difference was not statistically significant (P>0.05). Conclusion Acupuncture therapy can effectively assist the treatment of children with cerebral palsy, but increasing acupoints may not improve the muscle tension and gross motor function of children with cerebral palsy.
论著

经皮穴位电刺激对脑卒中患者偏瘫下肢运动功能的影响

Effect of transcutaneous accupoint electrical stimulation on motor function recovery of the lower extremity of stroke patients

:19-22
 
目的 探讨经皮穴位电刺激对脑卒中偏瘫患者下肢功能的影响。方法 41例脑卒中患者随机分为TAES组和安慰刺激组,分别为21例和20例。两组常规治疗相同。TAES组采用KD-2A型经皮神经电刺激治疗仪治疗,刺激部位选择患侧下肢的4个穴位(足三里ST 36、太冲LV 13、阳陵泉GB 34、昆仑BI 60),频率100 Hz,脉宽0.2 ms,强度为患者最大耐受强度为限;安慰刺激组接受治疗的部位时间和疗程与TAES组相同,但每次治疗时没有电流输出。治疗前、治疗2周、治疗3周分别用综合痉挛量表(CSS)评定踝关节痉挛,Fugl-Meyer运动评定量表中下肢部分(FMA)评定下肢运动功能,Berg平衡量表(BBS)评定平衡功能。结果 组内比较:治疗2周和治疗3周后与治疗前比较两组CSS、FMA下肢部分、BBS评分差异有统计学意义(P<0.05);组间比较:治疗2周和3周后,TAES组CSS、FMA、BBS评分优于安慰刺激组,差异有统计学意义(P<0.05)。结论 TAES治疗能减轻脑卒中患者偏瘫下肢痉挛程度和提高平衡功能,改善下肢运动能力。
Objective To investigate the effect of transcutaneous accupoint electrical stimulation(TAES)in enhancing motor and functional recovery of the lower extremity in subjects with stroke. Methods 41 subjects with first stroke were randomly assigned into 2 groups:TAES group and placebo stimulation group.All subjects received the same standard rehabilitation.In the TAES group.Model KD-2A stimulator was applied with 0.2 ms pulses,at 100 Hz within the subject's tolerance level on the 4 acupuncture points(ST 36,LV 3,GB 34,and Bl 60)in the affected lower legs for 60 min,5 days a week for 3 weeks;The time and the course of treatment of the placebo stimulation group was as well as the TAES group's,but no current output for each treatment.All subjects in the 2 groups received standard rehabilitation program.Measurements including composite spasticity score(CSS)for the spasticity of the ankle planter flexors,Fugl-Meyer motor assessment(FMA)for the lower extremity,and Berg Balance Scale(BBS)for balance were recorded before treatment,after 2 and 3 weeks' treatment. Results After 2 and 3 weeks of treatment,the CSS score in the TAES group was significantly lower than the placebo stimulation group(P<0.05)and the FMA score and BBS score in the TAES group was significantly higher than the placebo stimulation group(P<0.05). Conclusion Transcutaneous accupoint electrical stimulation significantly decreased ankle plantar flexor spasticity and improve motor function of the affected lower extremity.
论著

经皮穴位电刺激治疗对脑卒中患者上肢运动功能的影响

Effect of transcutaneous accupoint electrical stimulation on upper iimb function in stroke patients

:19-21
 
目的 探讨经皮穴位电刺激对脑卒中偏瘫患者上肢运动功能的影响。方法 37例脑卒中患者随机分为TAES组(n=19)和安慰刺激组(n=18)。两组常规治疗相同。TAES组采用KD-2A型经皮神经电刺激治疗仪治疗,刺激部位选择患侧上肢的4个穴位(肩髃、曲池、外关、合谷),频率100 Hz,脉宽0.2 ms,强度以患者最大耐受强度为限;每天治疗1次,每次60 min,连续3周共15次;安慰刺激组接受治疗的部位、时间和疗程与TAES组相同,但每次治疗时没有电流输出。治疗前、治疗第2周、治疗第3周分别用上肢Fugl-Meyer评分和改良Barthel指数评分(MBI)评定上肢运动功能及日常生活活动能力。结果 治疗前,两组患者间的一般情况、FMA-UE 评分和MBI评分的比较差异无统计学意义(P>0.05)。经过治疗,两组患者的FMA-UE和MBI评分与治疗前比较均有改善(P<0.05);TAES组FMA-UE和MBI评分的改善较安慰刺激组明显(P<0.05)。结论 TAES治疗能够提高脑卒中患者上肢运动功能,提高生活自理能力。
Objective To investigate the effect of transcutaneous accupoint electrical stimulation (TAES) in enhancing upper limb function in subjects with stroke. Methods 37 subjects with first stroke were randomly assigned into 2 groups:TAES group(n=19) and placebo stimulation group(n=18). All subjects received the same standard rehabilitation. In the TAES group, Model KD-2A stimulator was applied with 0.2 ms pulses, at 100 Hz within the subject's tolerance level on the 4 acupuncture points (LI15, L I11, LI4, and SJ5) in the affected upper limb for 60 min, 5 days a week for 3 weeks; The time and the course of treatment of the placebo stimulation group were as well as the TAES group's, but no current output for each treatment. All subjects in the 2 groups received standard rehabilitation program. Measurements including Fugl-Meyer motor assessment (FMA-UE) and modified Barthel index(MBI) on affected side were recorded before treatment after 2 and 3 weeks' treatments. Results After 3 weeks treatments,the function scores on affected side of the two groups were improved significantly(P<0.05). And function scores of the TAES group were significantly improved than those of the placebo group (P<0.05). Conclusion Transcutaneous accupoint electrical stimulation significantly may improve the recovery of upper limb function.
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