醒脑开窍针刺法联合中枢性促进技术对脑卒中后患者的疗效观察

目的探究醒脑开窍针刺法联合中枢性促进(Brunnstrom)技术应用于脑卒中后患者的疗效,观察其对认知功能,日常生活能力及肢体功能的影响。方法选取2018年10月—2019年10月辽宁中医药大学附属营口医院康复科收治的脑卒中后行康复治疗的患者86例,随机分为治疗组和对照组,每组各43例。对照组予以基础康复训练和醒脑开窍针刺法,治疗组在对照组的基础上联用Brunnstrom技术,疗程均为1个月。治疗期间,对照组剔除1例,治疗组剔除2例。治疗前后,两组均接受美国国立卫生研究院脑卒中量表(NIHSS)评分判定疗效;接受简易智能精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)北京版等2项认知功能评分;改良Barthel指数(MBI)日常生活能力评分和Fugl-Meyer运动功能(FMA)、上肢动作研究量表(ARAT)、Berg平衡量表(BBS)等3项肢体功能评分;并记录治疗期间不良反应。结果治疗组总有效率95.12%(39/41),高于对照组总有效率78.57%(33/42)(P<0.05);治疗后两组患者MMSE、MoCA、MBI评分均高于治疗前(P<0.05),且治疗组MMSE、MoCA、MBI评分均高于对照组(P<0.05);治疗后两组患者FMA、ARAT、BBS评分均高于治疗前(P<0.05),且治疗组FMA、ARAT、BBS评分均高于对照组(P<0.05);治疗期间对照组不良反应发生率16.67%(7/42),治疗组不良反应发生率21.95%(9/41),两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论醒脑开窍针刺法联合Brunnstrom技术治疗脑卒中后患者,能够提高疗效,明显改善其认知功能、日常生活能力和肢体功能。值得临床进一步推广应用。

Therapeutic Effect of Xingnao Kaiqiao Acupuncture Combined with Brunnstrom Promoting Technique on Patients after Stroke

Objective To investigate the curative effect of the Xingnao Kaiqiao acupuncture combined with the central promoting(Brunnstrom)technique on patients after stroke and observe its effects on cognitive function,ability of daily living and limb function.Methods From October 2018 to October 2019,86 patients undergoing rehabilitation after stroke admitted to the Rehabilitation Department of Yingkou Hospital Affiliated to Liaoning University of Traditional Chinese Medicine were randomly divided into observation group and control group,with 43 cases in each group.The control group was given basic rehabilitation training and the Xingnao Kaiqiao acupuncture,while the observation group was combined with the Brunnstrom technology on the basis of the control group,and the course of treatment was 1 month.During the treatment,1 case was excluded from the control group and 2 cases were excluded from the observation group.Before and after treatment,both groups were accepted the national institutes of health stroke scale(NIHSS)to judge curative effect.Both groups were accepted two cognitive function scores of the mini-mental state examination(MMSE),montreal cognitive assessment(MoCA),and the daily life ability score of modified barthel index(MBI),and the limb function scores of the Fugl-Meyer assessment-upper extremity(FMA),the action research arm test(ARAT),the Berg balance scale(BBS).The adverse reactions were recorded during treatment.Results The total effective rate in the observation group(95.12%)was higher than that in the control group(78.57%)(P<0.05).After treatment,the scores of MMSE,MoCA and MBI of the two groups were all higher than those before treatment(P<0.05).The MMSE,MoCA and MBI scores of the observation group were all higher than those of the control group(P<0.05).After treatment,the FMA,ARAT and BBS scores of the two groups were all higher than those before treatment in the same group(P<0.05).And the FMA,ARAT and BBS scores of the observation group were all higher than those of the control group(P<0.05).during treatment,the incidence of adverse reactions in the control group was 16.67%(7/42),and the incidence of adverse reactions in the treatment group was21.95%(9/41).There was no significant difference in the incidence of adverse reactions between the two groups.Significance(P>0.05).Conclusion The Xingnao Kaiqiao acupuncture combined with Brunnstrom technology can improve the curative effect of patients after stroke,and significantly improve their cognitive function,ability of daily living and limb function.It is worthy of further clinical application.