中药熏蒸联合针灸对缺血性脑卒中后下肢肌张力增高患者肌痉挛、下肢关节活动度及步行功能的影响

Impacts of traditional Chinese medicine fumigation combined with acupuncture and moxibustion on muscle spasm,range of motion of lower limb joints,and walking function in patients with increased lower limb muscle tension after ischemic stroke

关键词:  中药熏蒸  针灸  缺血性脑卒中  下肢肌张力  肌痉挛  下肢关节活动度  步行功能

Key words:  traditional Chinese medicine fumigation  acupuncture and moxibustion  ischemic stroke  lower limb muscle tension  muscle spasms  range of motion of lower limb joints  walking function

摘要:

[目的] 通过中药熏蒸疗法联合针灸治疗的综合干预方案，探索中西医结合治疗对缺血性脑卒中后下肢肌张力增高患者肌痉挛、下肢关节活动度及步行功能的影响。[方法] 将收治的缺血性脑卒中后下肢肌张力增高的患者92例随机分为两组。对照组在西医常规治疗基础上采用针灸治疗，试验组在此基础上增加中药熏蒸治疗。于4周后对比分析两组患者疗效及改善情况。[结果] 试验组总有效率为84.78%，对照组为65.22%，两组比较，差异有统计学意义（P＜0.05）；治疗2、4周后，试验组患者Ashworth肌痉挛分级评分、Fugl-Meyer下肢运动功能（FMA）评分、Barthel指数量表评分与对照组比较，差异具有统计学意义（P＜0.05）；试验组患者踝关节、髋关节活动度大于对照组（P＜0.05）。[结论] 中药熏蒸疗法联合针灸治疗能够提高缺血性脑卒中后下肢肌张力增高患者疗效，有效缓解肌痉挛，改善下肢关节活动度及步行功能。

Abstract:

[Objective] To explore the impacts of integrated traditional Chinese and Western medicine treatment on muscle spasm，range of motion of lower limb joints，and walking function of patients with increased lower limb muscle tension after ischemic stroke through the comprehensive intervention scheme of traditional Chinese medicine fumigation combined with acupuncture and moxibustion treatment. [Methods] A total of 92 patients with increased lower limb muscle tone after ischemic stroke admitted to our hospital were randomly grouped into two groups. The control group adopted acupuncture and moxibustion treatment on the basis of conventional western medicine treatment，and the test group added traditional Chinese medicine fumigation treatment on this basis. After 4 weeks，the efficacy and improvement of patients in the two groups were compared and analyzed. [Results] The effective rate of the experimental group was higher than that of the control group (P<0.05);after 2 and 4 weeks of treatment，there were obvious differences in the Ashworth muscle spasm grading score，Fugl-Meyer motor function assessment(FMA) score，and Barthel index scale score between the experimental group and the control group (P<0.05);the ranges of motion of the ankle and hip joints in the experimental group were greater than those in the control group (P<0.05). [Conclusion] Traditional Chinese medicine fumigation combined with acupuncture and moxibustion treatment can improve the efficacy of patients with increased lower limb muscle tension after ischemic stroke，effectively relieve muscle spasm，and improve the range of motion of lower limb joints and walking function.