Abstract:Objective To observe the clinical effect of acupotomy therapy in the treatment of post-stroke spasm. Methods Seventy-nine patients with post-stroke spasm treated in Inpatient Ward and Outpatient Clinic of Acupuncture and Moxibustion in Wuxi Traditional Chinese Medicine Hospital from January 2016 to October 2017 were selected, and they were divided into two groups by random number table method, 40 patients of acupotomy group was given the treatment of acupotomy, 39 patients of control group were given rehabilitation therapy. The degree of limb spasm (modified Ashworth scale), the clinical spasticity index (CSI) and the conditions of motor function (simple Fugl-Meyer scale) of the two groups before and after treatment were observed. Results After treatment, the cure rate and total effective rate in the acupotomy group were all higher than those of the control group, the differences were statistically significant (P < 0.05). After treatment, the CSI scores of the two groups were lower than those before treatment, and the scores of simple Fugl-Meyer scale in the two groups were higher than those before treatment, and the CSI scores of the acupotomy group were lower than those of the control group, the scores of simple Fugl-Meyer scale of the acupotomy group were higher than those of the control group, the differences were all statistically significant (all P < 0.05). Conclusion Acupotomy therapy in the treatment of post-stroke spasm has definite clinical effects, which is worthy of clinical application.
丁敏 冯骅 靳长旭 何为奇 王惠国 徐蕾. 小针刀疗法治疗中风后痉挛状态的临床效果[J]. 中国医药导报, 2018, 15(3): 155-158.
DING Min FENG Hua JIN Changxu HE Weiqi WANG Huiguo XU Lei. Clinical effect of acupotomy therapy in the treatment of post-stroke spasm. 中国医药导报, 2018, 15(3): 155-158.
[1] GBD 2013 Mortality and Causes of Death Collaborators. Global,regional, and national age sex specific all cause and cause specific mortality for 240 causes of death, 1998-2013:a systematic analysis for the Global Burden of Disease Study 2013 [J]. Lancet,2015,385(9963):117-171.
[2] 叶晓勤,谢雁呜,季林红.中风后痉挛的中医针刺治疗思路与方法及在康复训练机器人的应用探讨[J].中华中医药学刊,2011,29(7):1506-1508.
[3] 罗晓萍.电针结合康复训练对偏瘫患者下肢运动功能的影响[J].四川中医,2014,32(4):159-161.
[4] 国家中医药管理脑病急症协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55.
[5] 中华医学会全国第四届脑血管病学术会议.各类脑血管病诊断要点[J].中华神经科杂志,1996,29(6):379.
[6] 中国针灸学会微创针刀专业委员会.针刀医学临床诊疗与操作规范[M].北京:中国中医药出版社,2012:127-129.
[7] 南登菎.康复医学[M].北京:人民卫生出版社,2008:235-295.
[8] Bakheit AM ,Maynard VA, Curnow J,et al. The relation between Ashworth scale scores and the excitability of the alpha motor neurones in patients with post-stroke muscle spasticity [J]. J Neurol Neurosurg Psychiatry,2003,74(5):646-648.
[9] Levin MF,Hui-Chart C. Are H and stretch reflexes in hemiparess reproducible and correlated with spasticity [J]. J Neuol,1993,240(2):63-71.
[10] Sullivan KJ,Tilson JK,Cen SY,et al. Fugl-Meyer assessment of sensorimotor function after stroke:standardized training procedure for clinical practice and clinical trials [J]. Stoke,2011,42(2):427-432.
[11] 王澍欣,张宾,徐展琼,等.麦粒灸配合靳三针疗法治疗中风后痉挛性偏瘫的临床研究[J].广州中医药大学学报,2014,31(4):548-552.
[12] 修宇,张松兴.郝学君针刺治疗中风痉挛性瘫痪的临床经验[J].中西医结合心脑血管病杂志,2016,14(4):923-926.
[13] 姜桂美,吴思平,贾超,等.不同刺激量针刺拮抗肌与主动肌治疗脑卒中后痉挛性偏瘫的临床疗效观察[J].针灸临床杂志,2008,24(11):1-3.
[14] Naghdi S,Ansari NN,Abolhasani H,et al. Electrophysiological valuation of the Modified Tardieu Scale(MTS)in assessing poststroke wrist flexor spasticity [J]. Neuro Rehabilitation,2014,34(1):177-184.
[15] Ward AB. A literature review of the pathophysiology and onset of post-stroke spasticity [J]. Eur J Neurol,2012,19(1):21-27.
[16] 王雪飞,赵因,王麟鹏.早期针刺夹脊穴治疗脑卒中后痉挛的机制探讨[J].吉林中医药,2015,35(4):421-424.
[17] 张彭跃,胡永善.运动训练对缺血性脑卒中后脑功能修复的研究进展[J].中国康复医学杂志,2013,28(1):78-82.
[18] 王治国,包志军,代永庆,等.脑外伤并发脑梗死30例诊治分析[J].陕西医学杂志,2015,44(5):634.
[19] Marra GA,D'Aleo G,Di Bella P,et al. Intrathecal baclofen therapy in patients with severe spasticity [J]. Acta Neurochir Suppl,2007,97(1):173-180.
[20] 陈南萍,钟勤,吴爱萍.针刀微创治疗脑瘫肢体畸形临床观察[J].中国针刀,2014,19(10):99-103.
[21] Bergfedt U,Jonsson T,Bergfeldt L,et al. Cortical activation changes and improved motor function in stroke patients after focal spasticity therapy an interventional study applying repeated fMRI [J]. BMC Neurol,2015,15:52.
[22] 郭天龙,刘景隆,郭宇.3种口服抗痉挛药物对脑卒中后肢体痉挛的疗效比较[J].中国康复理论与实践,2012, 18(5):453-455.
[23] 朱汉章.针刀医学原理[M].北京:人民卫生出版社,2002.
[24] 张天民,张强,曾垂秀,等.针刀刀具及其作用原理[J].中国医药导报,2016,13(27):163-166.
[25] 陈腾.小针刀配合药物注射治疗骨伤疾病的探讨[J].陕西中医学院学报,2013,36(6):79-80.
[26] 杨学义.针刀靶点法治疗膝骨关节炎的临床研究[J].贵阳中医学院学报,2014,36(3):79-80.
[27] 张天民,杜艳军.针刀医学发展简史[J].中国医药导报,2016,13(27):159-162.