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电针与运动疗法不同干预次序对卒中偏瘫患者疗效的影响申芳芳 吴 强 林忠荣 林 栋 黄冬娥 刘建忠 陈立典 张学君


  [摘 要] 目的:观察电针与运动疗法组合应用时不同干预次序对临床疗效的影响。方法:将卒中偏瘫患者按就诊顺序随机分为先电针后运动治疗组(A组)与先运动后电针治疗组(B组),记录并比较1个疗程(2周)前后患侧Fugl-Meyer评定、改良Barthel指数及体感诱发电位(SEP)波幅的变化情况。结果:A组治疗前后Fugl-Meyer评定分别为31.760±4.438、76.640±3.621,改良Barthel指数治疗前后分别为26.520±2.413、62.360±3.700;B组治疗前后Fugl-Meyer评定分别为32.480±5.903、65.640±5.212,改良Barthel指数治疗前后分别为28.000±3.383、54.480±5.205。同组治疗前后比较,差异均有统计学意义(均P0.05),两组SEP波幅差值比较无统计学意义(P>0.05)。结论:电针与运动疗法以任何次序组合均可改善卒中后偏瘫肢体的功能,但以先电针后运动治疗组疗效更佳。

  [关键词] 中风后遗症;偏瘫;电针;运动疗法;对比研究;干预次序

  Effects of different interference orders of electroacupuncture and exercise therapy on the therapeutic effect of hemiplegia after stroke

  SHEN Fang-fang1, 2, WU Qiang1, LIN Zhong-rong3, LIN Dong1, HUANG Dong-e4, LIU Jian-zhong3, CHEN Li-dian1, ZHANG Xue-jun1 (1. Department of Acupuncture and Massage, Fujian College of TCM, Fuzhou 350108, China; 2. Shandong Higher Training School of TCM; 3. Department of Neurology, Nanping Municipal Hospital; 4. Department of TCM Physiotherapy, Fuzhou General Hospital of Nanjing Military Area)

  ABSTRACT: Objective To observe effects of different interference orders of electroacupuncture and exercise therapy on the therapeutic effect of hemiplegia after stroke. Methods The patients of hemiplegia due to stroke were randomly divided into a group A and a group B. The group A were treated by exercise therapy after electroacupuncture (EA) and the group B by EA after exercise therapy. Fugl-Meyer evaluation (FME), modified Barthel index (MBI) and amplitude of somatosensory evoked potential (SEP) on the affected side before treatment and after one therapeutic course (2 weeks) were recorded and compared in the two groups. ResultsBefore and after treatment, FME were 31.760±4.438 and 76.640±3.621, and MBI were 26.520±2.413 and 62.360±3.700 in the group A; and FME were 32.480±5.903 and 65.640±5.212, and the MBI were 28.000±3.383 and 54.480±5.205 in the group B, respectively, with very significant differences in FME and MBI in the two groups (all P<0.01); and the different values before and after treatment in the two indexes in the group A were better than those in the group B (all P<0.05). There was a very significant difference in the amplitude of SEP before and after treatment in the group A (P<0.01) and no significant difference in the group B, and there was no significant difference between the two groups in the different value of the amplitude of SEP. Conclusion Combination of any orders of electroacupuncture and exercise therapy can improve limb function of the patient with hemiplegia after stroke, but the therapeutic effect of exercise therapy after EA is better.

  KEY WORDS: Poststroke Syndrome; Hemiplegia; Electroacupuncture; Exercise Therapy; Comparative Study; Intervention Order

  随着医学科技的进步,许多危重脑卒中患者的生命得以挽救,但随之而来的是大量患者遗留有运动功能障碍并成为后期康复的一大难题。

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