蜡疗联合循经中药穴位湿热敷在中风后肢体偏瘫患者中的应用

周逸波; 张洁; 梅娜; 黄嫦玉; 姚瑶

doi:10.16766/j.cnki.issn.1674-4152.003933

蜡疗联合循经中药穴位湿热敷在中风后肢体偏瘫患者中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003933

周逸波^1, ,,
张洁¹,
梅娜¹,
黄嫦玉¹,
姚瑶²

1.
浙江省立同德医院康复科，浙江杭州 310012
2.
浙江省立同德医院神经内科

基金项目:

浙江省中医药科技计划项目 2021ZB056

详细信息

通讯作者:
周逸波，E-mail：zhouyibotd@163.com

中图分类号: R244.9R255.2
计量
- 文章访问数: 5
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- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-10-20
- 网络出版日期: 2025-05-14

The application of wax therapy combined with Chinese herbal acupuncture point wet hot compress for patients with hemiplegia after stroke

1.
Department of Rehabilitation, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang 310012, China

摘要

摘要: 目的中医适宜技术在中风后肢体偏瘫康复治疗中备受重视，本研究旨在探讨蜡疗联合循经中药穴位湿热敷对此类患者的干预效果。方法严格纳入2022年6月—2024年5月浙江省立同德医院康复医学中心收治的中风后肢体偏瘫患者共130例，采用随机数表法分成对照组和干预组，每组65例。在常规治疗和护理前提下，对照组给予中药穴位湿热敷，干预组给予蜡疗联合循经中药穴位湿热敷，均干预和观察9周，比较组间改良Ashworth量表、简化Fuel-Meyer量表(FMA)、患肢疼痛视觉模拟评分(VAS)、改良Barthel指数(MBI)和血液流变学指标[高切全血黏度、血浆黏度和纤维蛋白原(FIB)]。结果与干预前比较，2组干预后改良Ashworth分级、患肢VAS评分、血液流变学指标均下降(P<0.05)，患肢FMA评分、MBI评分均升高(P<0.05)；与对照组比较，干预组干预后改良Ashoworth分级、患肢VAS评分、血液流变学指标差异均有统计学意义(P<0.05)，患肢FMA评分[(59.46±5.23)分vs.(50.62±4.91)分]、MBI评分[(56.06±4.21)分vs.(50.21±4.03)分]均升高，差异有统计学意义(F=3.372，P=0.018；F=10.238，P<0.001)。结论蜡疗联合循经中药穴位湿热敷能明显降低中风后偏瘫患者患肢肌张力和疼痛感，改善血液流变学和肢体运动功能，提高生活自理能力，是一种有效的中医适宜技术康复方案。
- 中风后肢体偏瘫 /
- 中医适宜技术 /
- 蜡疗 /
- 中药穴位湿热敷 /
- 肢体功能
Abstract: Objective Appropriate techniques of traditional Chinese medicine (TCM) have received much attention in the rehabilitation treatment of hemiplegia after stroke. The purpose of this study was to investigate the intervention effect of wax therapy combined with wet and hot compress of traditional Chinese medicine on such patients. Methods A total of 130 patients with hemiplegia after stroke admitted to the Rehabilitation Medical Center of Tongde Hospital of Zhejiang Province from June 2022 to May 2024 were strictly included and divided into control group and intervention group with 65 cases in each group by random number table method. Under the premise of conventional treatment and nursing, the control group was given traditional Chinese medicine acupoint wet and hot compress, and the intervention group was given wax therapy combined with traditional Chinese medicine acupoint wet and hot compress. Both groups were intervened and observed for 9 weeks The modified Ashworth scale, simplified Fuel-Meyer assessment (FMA), visual analogue scale (VAS), modified Barthel index (MBI), and hemorheological indicators [high cut whole blood viscosity, plasma viscosity, and fibrinogen (FIB)] were compared between groups. Results Compared with before intervention, the modified Ashworth scale, VAS score, and hemorheology indexes of the affected limb were decreased in both groups after intervention (P<0.05), while the FMA score and MBI score of the affected limb were increased (P<0.05). Compared with the control group, the modified Ashworth grade, VAS score of the affected limb and hemorheology indexes in the intervention group were lower after intervention (P<0.05). The FMA score [(59.46±5.23) points vs.(50.62±4.91) points] and MBI score of the affected limb [(56.06±4.21) points vs. (50.21±4.03) points] were higher, and the difference was statistically significant (F=3.372, P=0.018; F=10.238, P<0.001). Conclusion Wax therapy combined with hot and wet compress of Chinese herbal acupuncture points can obviously reduce the muscle tension and pain of the affected limbs of hemiplegia patients after stroke, improve the hemorheology and limb motor function, and improve the self-care ability, which is an effective technical rehabilitation program of traditional Chinese medicine
- Hemiplegia after stroke /
- Appropriate technology of traditional chinese medicine /
- Wax therapy /
- Chinese medicine acupoint wet hot compress /
- Limb function

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表 1 2组中风后肢体偏瘫患者一般资料比较

Table 1. Comparison of general data of patients with hemiplegia after stroke between the two groups

项目	对照组(n=65)	干预组(n=65)	统计量	P值
性别(男性/女性，例)	39/26	36/29	0.284^a	0.594
年龄(x±s，岁)	64.05±7.12	63.86±7.09	0.152^b	0.879
中风病程(x±s，月)	1.20±0.31	1.22±0.34	0.350^b	0.727
中风类型[例(%)]			0.128^a	0.720
出血性	27(41.54)	25(38.46)
缺血性	38(58.46)	40(61.54)
患侧[例(%)]			0.492^a	0.483
左侧	35(53.85)	31(47.69)
右侧	30(46.15)	34(52.31)
合并基础疾病[例(%)]
高血压	19(29.23)	23(35.38)	0.563^a	0.453
糖尿病	15(23.08)	12(18.46)	0.421^a	0.517
高脂血症	10(15.38)	13(20.00)	0.475^a	0.491
冠心病	9(13.85)	6(9.23)	0.678^a	0.410
注：^a为χ²值, ^b为t值。

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表 2 2组中风后肢体偏瘫患者Ashworth分级比较(例)

Table 2. Comparison of Ashworth classification of patients with hemiplegia after stroke between the two groups (casas)

组别	例数	时点	0级	1级	1+级	2级	3级	4级
对照组	65	干预前	0	5	10	27	21	2
		干预后	4	11	20	19	11	0
干预组	65	干预前	0	4	14	26	20	1
		干预后	7	19	24	12	3	0

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表 3 2组中风后肢体偏瘫患者患肢FMA评分比较(x±s，分)

Table 3. Comparison of FMA scores of patients with hemiplegia after stroke between the two groups (x±s, points)

组别	例数	上肢FMA		下肢FMA		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	65	21.71±3.86	31.25±4.37^b	13.06±3.12	19.37±3.46^b	34.77±5.58	50.62±4.91^b
干预组	65	22.04±5.12	36.40±4.62^b	12.97±3.15	23.06±3.94^b	35.01±5.01	59.46±5.23^b
统计量		0.471^a	3.430^c	0.236^a	3.286^c	0.258^a	3.372^c
P值		0.638	0.016	0.814	0.025	0.797	0.018
注：^a为t值，^c为F值；与同组干预前比较，^bP<0.05。

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表 4 2组中风后肢体偏瘫患者患肢VAS、MBI评分比较(x±s，分)

Table 4. Comparison of VAS and MBI scores of patients with hemiplegia after stroke between the two groups (x±s, points)

组别	例数	患肢VAS		MBI
组别	例数	干预前	干预后	干预前	干预后
对照组	65	3.18±0.31	1.70±0.23^b	38.77±3.62	50.21±4.03^b
干预组	65	3.20±0.28	1.13±0.15^b	39.10±3.65	56.06±4.21^b
统计量		0.386^a	7.102^c	0.518^a	10.238^c
P值		0.700	0.003	0.606	<0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP<0.05。

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表 5 2组中风后肢体偏瘫患者血液流变学指标比较(x±s)

Table 5. Comparison of hemorheological indexes between the two groups of patients with hemiplegia after stroke (x±s)

组别	例数	高切全血黏度(mPa·s)		血浆黏度(mPa·s)		FIB(g/L)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	65	5.96±0.76	5.12±0.71^b	1.81±0.44	1.38±0.31^b	3.77±0.58	2.90±0.51^b
干预组	65	6.02±0.81	4.60±0.62^b	1.79±0.46	1.15±0.25^b	3.81±0.61	2.48±0.42^b
统计量		0.436^a	7.472^c	0.253^a	9.287^c	0.383^a	7.238^c
P值		0.664	<0.001	0.800	<0.001	0.702	0.003
注：^a为t值，^c为F值；与同组干预前比较，^bP<0.05。

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