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针刺与推拿分别联合康复训练对老年脑卒中后痉挛性偏瘫患者的疗效分析

王林香 丛文杰 傅莹 郑扬扬 吴春秀

王林香, 丛文杰, 傅莹, 郑扬扬, 吴春秀. 针刺与推拿分别联合康复训练对老年脑卒中后痉挛性偏瘫患者的疗效分析[J]. 中华全科医学, 2022, 20(10): 1760-1762. doi: 10.16766/j.cnki.issn.1674-4152.002697
引用本文: 王林香, 丛文杰, 傅莹, 郑扬扬, 吴春秀. 针刺与推拿分别联合康复训练对老年脑卒中后痉挛性偏瘫患者的疗效分析[J]. 中华全科医学, 2022, 20(10): 1760-1762. doi: 10.16766/j.cnki.issn.1674-4152.002697
WANG Lin-xiang, CONG Wen-jie, FU Ying, ZHENG Yang-yang, WU Chun-xiu. Effect of acupuncture and massage combined with rehabilitation training on elderly patients with spastic hemiplegia after stroke[J]. Chinese Journal of General Practice, 2022, 20(10): 1760-1762. doi: 10.16766/j.cnki.issn.1674-4152.002697
Citation: WANG Lin-xiang, CONG Wen-jie, FU Ying, ZHENG Yang-yang, WU Chun-xiu. Effect of acupuncture and massage combined with rehabilitation training on elderly patients with spastic hemiplegia after stroke[J]. Chinese Journal of General Practice, 2022, 20(10): 1760-1762. doi: 10.16766/j.cnki.issn.1674-4152.002697

针刺与推拿分别联合康复训练对老年脑卒中后痉挛性偏瘫患者的疗效分析

doi: 10.16766/j.cnki.issn.1674-4152.002697
基金项目: 

浙江省中医药科学研究基金项目 2019ZB048

详细信息
    通讯作者:

    王林香, E-mail: linxiangwang384@163.com

  • 中图分类号: R244.1R743.3

Effect of acupuncture and massage combined with rehabilitation training on elderly patients with spastic hemiplegia after stroke

  • 摘要:   目的  探究针刺、推拿分别联合康复训练对老年脑卒中后痉挛性偏瘫患者疗效及Ashworth、日常生活活动能力(ADL)、神经功能缺损量表(NDS)评分的影响。  方法  回顾性分析2018年10月—2020年8月温州医科大学附属第一医院收治100例脑卒中后痉挛性偏瘫患者,根据治疗方式不同分为针刺组(40例)、推拿组(30例)和康复组(30例)。其中康复组仅给予康复训练治疗,针刺组给予康复训练联合针刺治疗,推拿组给予康复训练联合推拿治疗。比较3组患者临床疗效及治疗前后上、下肢Ashworth、ADL和NDS评分变化情况。  结果  针刺组总有效率(92.50%,37/40)高于康复组(63.33%, 19/30,χ2=10.513,P<0.05);但康复组与推拿组(86.67%, 26/30)、推拿组与针刺组比较差异无统计学意义(均P>0.05)。治疗前,3组患者上、下肢Ashworth评分、ADL评分及NDS评分比较差异均无统计学意义(F=0.062、0.118、0.025、0.002,均P>0.05);相较于治疗前,3组治疗后上、下肢Ashworth及NDS评分均显著降低,ADL评分显著升高,且康复组、推拿组、针刺组依次更优(F=16.303、21.294、18.291、36.720,均P<0.05)。  结论  针刺和推拿分别联合康复训练治疗老年脑卒中后痉挛性偏瘫效果较好,且针刺联合康复训练疗效更佳,可有效缓解肢体痉挛,提高日常生活能力。

     

  • 表  1  3组老年脑卒中后痉挛性偏瘫患者临床总有效率比较

    Table  1.   Comparison of clinical total effective rate among three groups of elderly patients with spastic hemiplegia after stroke

    组别 例数 基本痊愈[例(%)] 显著进步[例(%)] 进步[例(%)] 无效[例(%)] 总有效率(%)
    康复组 30 1(3.33) 4(13.33) 14(46.67) 11(36.67) 63.33
    推拿组 30 7(23.33) 7(23.33) 12(40.00) 4(13.33) 86.67
    针刺组 40 10(25.00) 12(30.00) 15(37.50) 3(7.50) 92.50a
    注:3组总有效率比较,χ2=10.513,P=0.005。与康复组比较,aP<0.017,α校正=0.017。
    下载: 导出CSV

    表  2  3组老年脑卒中后痉挛性偏瘫患者上、下肢Ashworth评分比较(x ±s,分)

    Table  2.   Comparison of Ashworth scores of upper and lower limbs among three groups of elderly patients with spastic hemiplegia after stroke(x ±s, points)

    组别 例数 上肢Ashworth评分 下肢Ashworth评分
    治疗前 治疗后 治疗前 治疗后
    康复组 30 2.56±0.54 1.91±0.50a 1.93±0.49 1.35±0.34a
    推拿组 30 2.61±0.57 1.57±0.46ab 1.87±0.47 1.06±0.32ab
    针刺组 40 2.59±0.55 1.28±0.42abc 1.91±0.50 0.86±0.28abc
    F 0.062 16.303 0.118 21.294
    P 0.940 0.001 0.889 < 0.001
    注:与同组治疗前比较,aP<0.05;与治疗后康复组比较,bP<0.05;与治疗后推拿组比较,cP<0.05。
    下载: 导出CSV

    表  3  3组老年脑卒中后痉挛性偏瘫患者ADL评分比较(x ±s,分)

    Table  3.   Comparison of ADL scores among three groups of elderly patients with spastic hemiplegia after stroke(x ±s, points)

    组别 例数 治疗前 治疗后 t P
    康复组 30 55.65±7.98 70.24±8.86a 6.702 < 0.001
    推拿组 30 55.31±7.76 82.57±9.24ab 12.374 < 0.001
    针刺组 40 55.24±7.85 89.16±9.36abc 17.561 < 0.001
    F 0.025 36.720
    P 0.975 < 0.001
    注:与同组治疗前比较,aP<0.05;与治疗后康复组比较,bP<0.05;与治疗后推拿组比较,cP<0.05。
    下载: 导出CSV

    表  4  3组老年脑卒中后痉挛性偏瘫患者NDS评分比较(x ±s,分)

    Table  4.   Comparison of NDS scores among three groups of elderly patients with spastic hemiplegia after stroke(x ±s, points)

    组别 例数 治疗前 治疗后 t P
    康复组 30 27.99±8.67 22.12±7.12a 2.866 < 0.001
    推拿组 30 28.13±8.73 17.34±5.87ab 5.618 < 0.001
    针刺组 40 28.08±8.54 13.63±4.56abc 9.440 < 0.001
    F 0.002 18.291
    P 0.998 < 0.001
    注:与同组治疗前比较,aP<0.05;与治疗后康复组比较,bP<0.05;与治疗后推拿组比较,cP<0.05。
    下载: 导出CSV
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  • 收稿日期:  2021-08-16
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