针灸联合康复训练对早期偏瘫患者恢复下肢运动功能效果观察.docVIP

针灸联合康复训练对早期偏瘫患者恢复下肢运动功能效果观察 　　[摘要] 目的：探讨针灸联合康复训练对早期偏瘫患者恢复下肢运动功能的效果。方法：选择本院2009年9月~2011年3月收治的脑卒中偏瘫患者120例，随机分为研究组与对照组各60例，研究组患者在常规治疗的基础上给予针灸治疗及康复训练；对照组给予常规治疗。用Bmnnstmm分期、Fugl―Meyer（FMA）积分法及FCA综合功能评定法，评价患者治疗1、3个月时下肢体运动功能。结果：治疗1、3个月后研究组患者下肢Bmnnstmm分期、FMA积分、FCA行走功能评分均较综合治疗前明显改善，差异有统计学意义（P 　　[关键词] 针灸；康复训练；偏瘫；下肢运动功能 　　[中图分类号] R245 [文献标识码] A [文章编号] 1674-4721（2012）01（b）-108-02 　　 　　The effect observation of acupuncture combined with early rehabilitation training in the restore of lower limb motor function in hemiplegia patients 　　ZHOU Liangjun 　　Department of Acupuncture, Traditional Chinese Medicine of Xiangtan County in Hunan Province, Xiangtan 411228, China 　　[Abstract] Objective: To investigate the effect of acupuncture combined with early rehabilitation training in the restore of lower limb motor function in hemiplegia patients. Methods: One hundred and twenty cases of stroke patients in our hospital from September 2009 to March 2011 were randomly divided into study group and control group, each 60 cases, patients in study group were given acupuncture treatment and rehabilitation training on basis of conventional treatment; control group were given conventional therapy. Bmnnstmm stage, Fugl-Meyer (FMA) integration method and the FCA comprehensive functional assessment method were used to evaluate motor function after 1, 3 months treatment. Results: After 1, 3 months treatment, lower limb Bmnnstmm stage, FMA points, FCA walking function score of the study group were significantly improved compared with before (P0.05）。治疗1、3个月后研究组患者下肢Bmnnstmm分期、FMA积分、FCA行走功能评分均较治疗前明显改善，差异有统计学意义（P 　　3 讨论 　　脑卒中偏瘫患者，中枢神经系统受损，运动功能下降，若不进行系统的康复运动训练，将产生严重的后遗症，影响患者生活质量。临床研究表明中枢神经细胞受损后，邻近脑细胞受刺激后可分化代偿部分受损神经功能。 　　针灸治疗具有调和经脉疏通气血的作用，可以改善脑血管意外患者脑部血液循环，可增强脑皮质的电活动，此外局部不同针灸方法还可以增强或减弱肌张力，激活脑卒中偏瘫患肢感觉和运动能力，促进患肢恢复[3-4]。脑卒中后椎体束受损，中枢的上运动神经元不能将冲动下传至脊髓，再传到肌肉，由于下运动神经元是正常的，针刺信息主要靠脊髓的反射中枢将信息整合后传到肌肉，产生主动收缩，此时针灸可以通过脊髓的初级运动中枢兴奋瘫痪肌肉防止失用性萎缩，还可以通过反复刺激来兴奋大脑的高级运动中枢，帮助恢复和重建正常的反射弧。此外配合临床康复治疗可利用机体反射功能，调节