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不同针刺方法对中风患者手痉挛影响的对比研究


□ 王利春 王志勇 康西忠 贾丽娟

  文章编号:0255-2930(2008)07-0503-03
  中图分类号:R 246.6 文献标志码:A
  
  [摘 要] 目的:观察内关穴不同针刺手法治疗中风患者手部痉挛的疗效。方法:将172例患者随机分为单纯针刺组(36例)、慢速捻针组(34例)、快速捻针组(30例)、单纯提插组(35例)和提插捻转组(37例)。均取内关穴,每天针刺2次,每次5分钟,并配合康复训练。以修订的Ashworth量表和Fugl-Meyer(FMA)手功能评分评定疗效。结果:手痉挛即刻有效率和治疗8周后有效率单纯针刺组分别为66.7%、55.6%,慢速捻针组为82.4%、85.3%,快速捻针组为96.7%、90.0%,单纯提插组为80.0%、82.9%,提插捻转组为94.6%、91.9%,快速捻针组与提插捻转组疗效优于其他3组(P<0.01)。治疗后Ashworth量表分级和FMA评分提插捻转组、快速捻针组均优于其余3组(P<0.05,P<0.01),且提插捻针组和快速捻针组之间差异无显著性意义(P>0.05)。结论:针刺内关穴有非常肯定的即刻效应,提插捻转手法与快速捻转手法对痉挛的抑制效果最佳。
  [关键词] 穴,内关;中风后遗症/针灸疗法;肌痉挛/针灸疗法;针刺方向
  
  Comparative study on effects of different acupuncturemanipulationmethods at Neiguan (PC 6) on hand spasm in the patient of stroke
  WANG Li-chun, WANG Zhi-yong, KANG Xi-zhong, JIA Li-juan (Department of Neurology, Affiliated Hospital of Integrated Chinesemedicine and Westernmedicine of Hebei University ofmedical Sciences, Cangzhou 061001, China)
  ABSTRACT:Objective To observe therapeutic effects of different needlingmethods at Neiguan (PC 6) on hand spasm in the patient of stroke.methods One hundred and seventy-two cases were randomly divided into a simple acupuncture group (n=36), a slowly twirling needle group (n=34), a rapidly twirling needle group (n=30), a simple lifting-thrusting group (n=35) and a lifting-thrusting-twirling needle group (n=37).Acupuncture was gi-ven at Neiguan (PC 6), twice each day, 5min each time, and in combination with rehabilitation exercise.modified Ashworth scale and Fugl-Meyer (FMA) hand function score were used for assessment of therapeutic effects.ResultsThe transient effective rate and the effective rate after treatment for 8 weeks for hand spasm were 66.7% and 55.6% in the simple acupuncture group, 82.4% and 85.3% in the slowly twirling needle group,96.7% and 90.0% in the rapidly twirling needle group, 80.0% and 82.9% in the simple lifting-thrusting group and 94.6% and 91.9% in the lifting-thrusting-twirling needle group, the rapidly twirling needle group and the lifting-thrusting-twirling needle group being better than other 3 groups (P<0.01).After treatment, the grades for Ashworth scale and FMA scores in the lifting-thrusting-twirling needle group and the rapidly twirling needle group were better than those in other 3 groups (P<0.05, P<0.01), with no significant difference between the two groups (P>0.05).Conclusion Acupuncture at Neiguan (PC 6) has a very definite transient effect, and the lifting-thrusting-twirling needlingmanipulation and the rapidly twirling needlingmanipulation have the best inhibitive effect on spasm.
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