目的 观察中医针药结合治疗脑卒中后肢体痉挛的临床疗效。方法 2016年4月至2017年10月,90例脑卒中后肢体痉挛患者随机分为基础康复组(n=30)、巴氯芬组(n=30)和针药结合组(n=30)。三组均予脑卒中内科常规治疗和康复训练,针药结合组加经筋针刺和加味芍药甘草汤口服,巴氯芬组加巴氯芬口服。治疗前和治疗4周后采用改良Ashworth量表(MAS)、简式Fugl-Meyer评定量表(FMA)和改良Barthel指数(MBI)进行评定,并比较三组临床疗效。结果 基础康复组总有效率53.3%,巴氯芬组66.7%,针药结合组86.7%。三组治疗后MAS、FMA及MBI评分均较治疗前显著改善(t>6.500, P<0.001),针药结合组评分最优(F>12.332, P<0.001)。治疗过程中未见不良反应事件发生。结论 结合中医针刺和中药能更好缓解脑卒中后偏瘫患者肌张力,改善运动功能,提高日常生活活动能力。
Objective To observe the effect of traditional Chinese acupuncture-medcine on limb spasticity after stroke. Methods From April, 2016 to October, 2017, 90 patients with limb spasticity after stroke were randomly divided into basic rehabilitation group (n=30), baclofen group (n=30) and acupuncture-medicine group (n=30). All the groups accepted basic medical therapy and rehabilitation training, while the acupuncture-medicine group accepted acupuncture at muscle tendon and Supplemented Peony-Licorice Decoction orally, and the baclofen group accepted baclofen orally. They were assessed with modified Ashworth Scale (MAS), simplified Fugl-Meyer Assessment (FMA) and modified Barthel index (MBI) before and four weeks after treatment, and the clinical effective rates were compared. Results The total effective rate of the basic rehabilitation group was 53.3%, and it was 66.7% in the baclofen group, and 86.7% in the acupuncture-medicine group. The scores of MAS, FMA and MBI significantly improved in all the groups after treatment (t>6.500, P<0.001), and improved the most in the acupuncture-medicine group (F>12.332, P<0.001). No adverse event was found during the treatment.Conclusion The integration of acupuncture and Chinese medicine in rehabilitation can further relieve the spasticity in patients after stroke, and improve the motor function and activities of daily living.
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