经筋刺法结合加味芍药甘草汤治疗脑卒中后肢体痉挛的效果

doi:10.3969/j.issn.1006-9771.2018.03.015

Abstract

Abstract: 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.

Key words: stroke, spasticity, acupuncture at muscle tendon, Supplemented Peony-Licorice Decoction, rehabilitation

CLC Number:

R743.3

LIU Wei-ai, YUE Zeng-hui, FU Lei, DAI Si-jia, CHEN Jian-hong, HE Xin-min. Effect of Acupuncture at Muscle Tendon and Supplemented Peony-Licorice Decoction on Spasticity after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(3): 323-327.

References

[1] Sommerfeld DK, Gripenstedt U, Welmer AK.Spasticity after stroke: an overview of prevalence, test instruments, and treatments[J]. Am J Phys Med Rehabil, 2012, 91(9): 814-820.
[2] 陈瑛玲,陈立典. 脑卒中后肢体痉挛的康复研究进展[J]. 世界中医药, 2013, 8(1): 110-112.
[3] 尹姣姣,王敏华. 脑卒中患者偏瘫肢体痉挛的治疗进展[J]. 中华全科医学, 2015, 13(10): 1696-1698.
[4] 郑薏,柳维林,上官豪,等. 针灸治疗脑卒中患者肢体运动功能障碍疗效的Meta分析[J]. 中国康复医学杂志, 2016, 31(2): 217-221.
[5] 叶涛,朱路文,唐强. 针刺结合康复训练治疗脑卒中后肢体痉挛的meta分析[J]. 中国康复医学杂志, 2017, 32(3): 318-324.
[6] 徐磊,王敏,李飞,等. 针刺结合康复训练治疗中风后肢体痉挛疗效观察[J]. 中国针灸, 2017, 37(7): 696-700.
[7] 中华医学会神经病学分会. 2016版中国脑血管病诊治指南与共识[M]. 北京:人民卫生出版社, 2016: 12.
[8] 恽晓平. 康复疗法评定学[M]. 2版. 北京:华夏出版社, 2014: 1.
[9] 国家中医药管理局. 中医病证诊断疗效标准[S]. 南京:南京中医药大学出版社, 1994: 92.
[10] 马剑波,孙恺,马冲,等. 青年脑卒中研究进展[J]. 中华神经创伤外科电子杂志, 2016, 2(1): 45-50.
[11] 崔利华,山磊,杨宇琦. 首次脑卒中后6个月内肢体痉挛情况调查[J]. 中国康复理论与实践, 2014, 20(12): 1144-1146.
[12] 顾明慧,李建,朱毅. 脑卒中后肌痉挛的部分研究进展[J]. 中国康复, 2011, 26(5): 375-376.
[13] 马振合. 针药结合康复训练治疗中风痉挛性偏瘫的临床分析[J]. 中外医疗, 2017, 36(3): 19-21.
[14] 刘强,文毅,王铭菖. 针药结合康复训练对中风偏瘫的疗效及安全性[J]. 中国地方病防治杂志, 2016, 31(10): 1187.
[15] 唐跃富,杨荣光,罗清勇,等. 针药结合康复训练的方法对中风偏瘫痉挛状态的康复疗效及安全性评价[J]. 世界中医药, 2014, 9(9): 1218-1220.
[16] 岳增辉,袁建菱,姜京明. 针刺脑卒中后痉挛性瘫痪的临床研究[J]. 针灸临床杂志, 2004, 20(12): 9-11, 3.
[17] 岳增辉,刘伍立,章薇. 经筋刺法治疗脑卒中后痉挛状态及疗效评价研究[J]. 中国中医药信息杂志, 2001, 8(4): 85-86, 93.
[18] 张瑜. 经筋刺法治疗脑卒中后痉挛性瘫痪的系统评价与Meta分析[D]. 沈阳:辽宁中医药大学, 2016.
[19] 赵艳玲,李文纯,黄娟,等. 经筋刺法对脑卒中恢复期偏瘫手精细动作的影响[J].中国针灸, 2014, 34(2): 120-124.
[20] 王开龙,庞军,黄瑾明,等. 壮医经筋挑刺法治疗脑卒中偏瘫痉挛状态的效果[J]. 中国康复理论与实践, 2017, 23(1): 89-91.
[21] 陶文娟,马丽虹,李可建. 补阳还五汤治疗中风后遗症随机对照试验的系统评价研究[J]. 山东中医药大学学报, 2015, 39(2): 107-108, 124.
[22] 陈紫薇,谭子虎. 芍药甘草汤治疗中风后痉挛性偏瘫的系统评价[J]. 云南中医中药杂志, 2016, 37(2): 23-27.
[23] 樵成,郭延召,倪创社,等. 芍药甘草汤加味配合针刺治疗中风后肢体痉挛疼痛25例[J]. 河南中医, 2017, 37(7): 1174-1176.
[24] 崔晶晶,高俊虹,王玉敏,等. 针药结合增效机制研究的新思路探讨[J]. 针刺研究, 2010, 35(2): 146-150.
[25] 蔡昕宏. 针药结合治疗肝郁脾虚型失眠的临床研究[D]. 广州:广州中医药大学, 2013.

Effect of Acupuncture at Muscle Tendon and Supplemented Peony-Licorice Decoction on Spasticity after Stroke

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0

[1]	LUO Lihua, WANG Yusheng, LI Jianfeng, DONG Jige. Effect of early postoperative comprehensive rehabilitation on children and youth with supracondylar fracture of humerus complicated with ulnar nerve injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 105-110.
[2]	WANG Zihao, LI Xinhua, JIANG Huiping, GUO Sainan, LIANG Qiuman, SHI Tingqi. Short-term knee function after total knee arthroplasty and related factors [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 111-118.
[3]	LIN Na, GAO Hanlu, LU Huiping, CHEN Yanqing, ZHENG Junfan, CHEN Shurong. Effect of virtual reality on upper limb function after stroke: a study of diffusion tensor imaging [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 61-67.
[4]	WANG Haoyi, SHI Yawei, LU Jun, XU Guangxu. Impact of subjective vertical perception impairment on function in stroke patients: a retrospective study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 68-73.
[5]	CHEN Junwen, CHEN Qian, CHEN Cheng, LI Shuyue, LIU Lingling, WU Cunshu, GONG Xiang, LU Jun, XU Guangxu. Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 74-80.
[6]	HU Yonglin, MA Ying, DOU Chao, LU Anmin, JIANG Xiaoge, SONG Xinjian, XIAO Yuhua. Effect of neural mobilization based on shoulder control training on shoulder pain and upper limb function in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 81-86.
[7]	WANG He, HAN Liang, KAN Mengfan, YU Shaohong. Efficacy of electrical stimulation on shoulder-hand syndrome after stroke: a systematic review and meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1048-1056.
[8]	SHI Jiawei, LI Lingyu, YANG Haojie, WANG Qinlu, ZOU Haiou. Effect of preoperative prerehabilitation training on total knee arthroplasty: a systematic review of systematic reviews [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1057-1064.
[9]	CAI Huanian, FEI Sixian, ZHANG Yichen, SUN Qing, GUO Shuai, SONG Tao. Motion assistance analysis for robot-assisted tele-rehabilitation based on bilateral admittance control [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1104-1109.
[10]	SUN Tengfang, REN Mengting, YANG Lin, WANG Yaoting, WANG Hongyu, YAN Xingzhou. Effect of hyperbaric oxygen therapy combined with repetitive peripheral magnetic stimulation on ankle motor function and balance of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 875-881.
[11]	WANG Ya'nan, LIU Xihua. Correlation and predictive effect of subjective and objective balance function measurements in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 890-895.
[12]	WANG Haiyun, WANG Yin, ZHOU Xinjie, HE Aiqun. Effect of transcranial direct current stimulation combined with acupuncture on central and upper limb function in stroke patients based on central-peripheral-central theory [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 919-925.
[13]	CHEN Yiting, WANG Qian, CUI Shenhong, LI Yingcai, ZHANG Siyu, WEI Yanxu, REN Hui, LENG Jun, CHEN Bin. Effect of bilateral sequential repetitive transcranial magnetic stimulation on motor function of upper limbs in stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 926-932.
[14]	LI Zhenya, SUN Jie, GUO Pengfei, WANG Guangming. Correlation between changes of swallowing function in oral and pharyngeal phases, and aspiration in stroke patients based on videofluroscopic swallowing study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 933-939.
[15]	LIU Yang, ZHANG Peng, HUANG Ying, CHEN Han, XU Chen, LI Min. Path analysis of mediating effect of perceived stress affecting impact of event in rehabilitation patients with traumatic injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 954-960.