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李瑞青,刘承梅,席建明,冯红霞,刘飞来,冯晓东.督脉电针治疗脑卒中后上肢痉挛的临床疗效和表面肌电图特征研究[J].中国康复医学杂志,2019,(10):1157~1161
督脉电针治疗脑卒中后上肢痉挛的临床疗效和表面肌电图特征研究    点此下载全文
李瑞青  刘承梅  席建明  冯红霞  刘飞来  冯晓东
河南中医药大学第一附属医院康复中心,郑州,450000
基金项目:国家自然科学基金青年基金项目(81503630);国家中医药管理局国家中医临床研究基地业务建设科研专项(JDZX2015314);河南省中医临床学科领军人才培育计划资助项目(2100202)
DOI:
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摘要:
      摘要 目的:研究督脉电针治疗脑卒中后上肢痉挛的临床疗效和表面肌电图特征。 方法:入组的90例脑卒中偏瘫患者,根据随机数字表法,随机分为康复组、电针组、督脉电针组,康复组给予常规康复治疗,电针组在常规康复治疗的基础上给予常规电针,督脉电针组在常规康复治疗的基础上给予督脉电针治疗,30min/次,1次/天,5次/周,共8周。分别在治疗前后进行患侧上肢肱二头肌、肱三头肌表面肌电图测试、改良Ashworth肌张力评定、Fugl-Meyer上肢运动功能评定,改良Barthel指数评定。 结果:治疗后3组患者上肱二头肌、肱三头肌RMS值、改良Ashworth肌张力评估较治疗前均有所降低(P<0.05)、Fugl-Meyer上肢运动功能评分、改良Barthel指数评分均较治疗前有所增加(P<0.05),差异具有显著性意义;电针组、督脉电针组较康复组RMS(root mean square)值和改良Ashworth(MAS)均有所有所降低(P<0.05),Fugl-Meyer和改良 Barthel 指数评分均有所增加(P<0.05);督脉电针组较电针组RMS值和MAS均有所有所降低(P<0.05)、Fugl-Meyer和改良Barthel指数评分均有所增加(P<0.05);3组协同收缩率在治疗前后以及治疗后3组之间的比较均无明显差异(P>0.05)。 结论:督脉电针可明显降低脑卒中后偏瘫患者肱二头肌、肱三头肌RMS值,对两者之间的协同收缩率影响不明显,同时显著改善患者患侧上肢肘关节的痉挛程度、运动功能以及日常生活自理能力。
关键词:脑卒中  痉挛  日常生活活动  表面肌电图
Effects of electro-acupuncture at Du meridian in stroke patients with upper-extremity spasticity and its character of sEMG    Download Fulltext
The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou,450000
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Abstract:
      Abstract Objective:To study the clinical and sEMG effect of electro-acupuncture at Du meridian in stroke patients with upper-extremity spasticity. Method:Ninety patients were randomly assigned by random number table into rehabilitation (C) group, electro-acupunctrure (EAP) group and electro-acupunctrure at Du meridian (DMEAP) group. Rehabilitation therapy was used in the three groups. At the same time, electro-acupunctrure was applied in EAP group, DMEAP group was treated with electro-acupunctrure at Du meridian. The indexes were observed before and after treatment, including RMS and co-contraction ratio of sEMG of biceps and triceps , modified Ashworth scale (MAS), simple Fugl-Meyer assessment of upper-extremity (FMA), and modified Barthel index (MBI). Result:In the three groups, RMS and MAS were both lower after treatment than before (P<0.05), FMA, MBI were upper (P<0.05). RMS and MAS in EAP and DMEAP groups were decreased compared with C group, but FMA and MBI were increased (P<0.05) .There was no significant difference of co-contraction ratio of biceps and triceps after and before treatment at the three groups(P>0.05). Conclusion:RMS of biceps and tricep decreased at stroke patients with limb spasticity, movement function and daily activity improved, but no difference about co-contraction ratio.
Keywords:stroke  spasticity  daily activity  surface electromyography
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