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| 针刺联合分带行走训练治疗脑卒中下肢本体感觉及平衡功能障碍的临床疗效观察 |
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韩倪1, 王春方2,3, 陈佳琪1, 崔汶轩1, 郑羿婕4, 张颖2,3
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1.天津中医药大学研究生院, 天津 301617;2.天津市人民医院, 南开大学第一附属医院康复科, 天津 300121;3.天津市康复医学研究所, 天津 300121;4.天津体育学院运动健康学院, 天津 301617
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| 摘要: |
| [目的] 探讨针刺联合分带行走训练治疗脑卒中患者下肢本体感觉和平衡功能障碍的临床疗效。[方法] 选取2023年12月—2024年12月于天津市人民医院康复科就诊的60例脑卒中患者为研究对象，随机分为对照组（30例，脱落1例，共29例）与试验组（30例）。对照组患者进行针刺+基础治疗，试验组在对照组治疗的基础上，进行分带行走训练，共治疗20 d，比较两组患者治疗前后Fugl-Meyer评定量表下肢部分（FMA）、改良Barthel指数评定量表（MBI）、起立-行走测试（TUGT）、10 m步行测试（10MWT）、Berg平衡量表（BBS）、动态平衡平均轨迹偏差（ATE）及测试执行时间（TTE）、膝踝关节本体感觉位置觉（PRPP）及运动觉（TDPM）变化。[结果] 治疗后，与对照组相比，试验组FMA（P=0.020）、MBI（P=0.005）、BBS（P=0.040）评分显著升高，TUGT（P=0.004）、10MWT（P=0.002）、ATE（P=0.033）、TTE（P=0.013）完成时间显著下降，PRPP（膝关节P=0.001，踝关节P=0.012）、TDPM（膝关节P<0.001 ，踝关节P<0.001）误差角度显著减小。[结论] 针刺联合分带行走训练对脑卒中下肢本体感觉、平衡功能障碍具有更优的治疗效果，可以有效提高患者下肢功能水平，提升康复治疗效果。 |
| 关键词: 针刺 分带行走训练 分带跑步机 本体感觉 脑卒中 |
| DOI：10.11656/j.issn.1672-1519.2026.05.06 |
| 分类号:R247.9 |
| 基金项目:天津市自然科学基金重点项目（22JCZDJC00060）。 |
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| Clinical observation on the efficacy of acupuncture combined with split-belt treadmill training in treating lower limb proprioceptive and balance dysfunction in stroke patients |
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HAN Ni1, WANG Chunfang2,3, CHEN Jiaqi1, CUI Wenxuan1, ZHENG Yijie4, ZHANG Ying2,3
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1.Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;2.Department of Rehabilitation, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin 300121, China;3.Tianjin Institute of Rehabilitation, Tianjin 300121, China;4.Institute of Sport, Exercise & Health, Tianjin University of Sport, Tianjin 301617, China
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| Abstract: |
| [Objective] To explore the clinical efficacy of acupuncture combined with split-belt treadmill training in treating lower limb proprioception and balance dysfunction in stroke patients. [Methods] Sixty patients with chronic stroke who visited the Rehabilitation Department of Tianjin Union Medical Center from December 2023 to December 2024 were selected as the research subjects and randomly divided into the experimental group（30 cases） and the control group（30 cases，with 1 dropout，29 cases）. Patients in the control group received acupuncture and basic treatment，while those in the experimental group received split-belt treadmill training on top of the treatment given to the control group. Both groups were treated for 20 days. Changes in the lower limb section of the Fugl-Meyer Assessment（FMA），Modified Barthel Index（MBI），Timed Up and Go Test（TUGT），10-Meter Walk Test（10MWT），Berg Balance Scale（BBS），average trajectory error（ATE） and test execution time（TTE） of dynamic balance，and proprioceptive position sense（PRPP） and kinesthetic sense（TDPM） of the knee and ankle joints were compared before and after treatment in both groups. [Results] After treatment，compared with the control group，the FMA（P=0.020），MBI（P=0.005），and BBS（P=0.040） scores of the experimental group significantly increased；the completion times of TUGT（P=0.004），10MWT（P=0.002），ATE（P=0.033），and TTE（P=0.013） significantly decreased；and the error angles of PRPP（knee joint P=0.001，ankle joint P=0.012） and TDPM（knee joint P<0.001，ankle joint P<0.001） significantly decreased. [Conclusion] Acupuncture combined with split-belt treadmill training has a better therapeutic effect on lower limb proprioception and balance dysfunction after stroke，which can effectively improve the lower limb function level of patients and enhance the rehabilitation treatment effect. |
| Key words: acupuncture split-belt treadmill training split-belt treadmill proprioception stroke |
