腹针治疗中风恢复期下肢运动障碍的临床观察

【作者】 李文敬；

【导师】 张学丽；

【作者基本信息】 北京中医药大学 ， 针灸推拿学， 2012， 硕士

【摘要】 本论文为腹针治疗中风恢复期下肢运动障碍的临床观察,分为文献综述与临床研究两部分。其中文献综述包括祖国医学对中风病的认识、现代医学对脑卒中的认识、腹针疗法概述及临床应用。临床研究部分包括腹针治疗中风恢复期下肢运动障碍的临床资料、研究方法、结果、结论及讨论。目的：通过观察腹针结合体针与单纯体针治疗中风恢复期下肢运动障碍的临床疗效,探讨腹针结合体针对中风恢复期下肢运动障碍的临床价值。方法：随机将中风恢复期下肢明显运动障碍患者40例分为治疗组和对照组。治疗组20例,用腹针结合体针疗法,腹针选穴取引气归元(中脘、下脘、气海、关元)、患侧的滑肉门、上风湿点、外陵、下风湿点,体针选穴及操作同对照组；对照组20例,主选百会、风府、患侧的肩髃、曲池、外关、合谷、环跳、阳陵泉、足三里、三阴交、太冲等穴位,配合辨证选穴治疗。2组均每日治疗1次,每周治疗5次,周末休息,共治疗4周。分别在治疗前和治疗4周结束后用Fugl-Meyer运动量表(FMA)和改良Barthel指数法(MB I)评定患者下肢运动功能的变化。结果：经28天治疗后,两组患者FMA和MB I评分均有显著提高(P均<0.01)。两组间的FMA和MBI评分比较差异有显著性,P均<0.05,治疗组优于对照组。两组内不同年龄段患者在治疗后,治疗组FMA和MBI评分比较无显著性差异P均>0.05；对照组FMA评分比较无显著性差异,P>0.05,但MB I评分比较有显著性差异,P<0.05,年龄越小,MBI评分改善越明显。两组间比较,45—62岁患者的FMA和MBI评分比较无显著性差异,P均>0.05；63—80岁患者的FMA和MBI评分比较差异有显著性,P均<0.05,治疗组优于对照组。说明治疗组对各年龄段中风患者的下肢运动功能均有明显的改善作用。结论：腹针结合体针与单纯体针疗法均能够改善中风恢复期下肢明显运动障碍者的运动功能,腹针与体针具有良好的协同作用,疗效不受年龄因素影响。更多还原

【Abstract】 This thesis is Clinical Observation of Abdominal Acupuncture combined with conventional Acupuncture on Lower Limb Disorder of Stroke Patients. It is divided into two parts, Literature review and Clinical study. Literature review includes the understanding of Chinese and Western medicine on stroke, which is about the treatment of stroke and awareness of abdominal acupuncture. Clinical study includes clinical data, research methodology, results, and discussion about stroke clinical observation of abdominal acupuncture combined with conventional acupuncture.Objective:To assess the therapeutic effect of abdominal acupuncture com bined with conventional acupuncture on lower limb disorder of stroke patients.Methods:A total of40stroke patients with lower limb disorder were randomly divided into control group (n=20) and treatment group (n20). Acupuncture was applied to acupoints of conventional acupuncture including Baihui (DU20), Fengfu (DU16), Jianyu (L115), Quchi (L111), Hegu (L14), Waiguan (SJ5), Huantiao (GB30), Yanglingquan (GB334), Zusanli (GB36), Sanyinjiao (SP6), Taichong (LR3), with adjunct points added according to the dialectical results. The treatment group was treated with both method of abdominal acupuncture and conventional acupuncture. The acupoints of conventional acupuncture is the same with control group. The prescription of abdominal acupuncture was YinQiGuiYuan (Zhongwan (CV12), Xiawan (CV10), Qihai (CV6), Guanyuan (CV4)), Fusiguan (Huaroumen (ST24), Wailing (ST26)), Shangfengshidian and Xiafengshidian corresponding to the affected limb. The treatment was conducted once daily,5sessions a week without Saturday and Sunday, and for4weeks. The FMA and MBI scores were counted before and at28days after treatment.Results:Both group showed a significant improvement on the FMA and MBI score and had statistically significant difference between them (P>0.05). The treatment group is better than the control group. Otherwise, we have also observed that the treatment group is effective for patients in different ages.Conclusion:Abdominal acupuncture combined with body acupuncture can significantly improve the lower limb motor function of stroke patients, and has a good synergistic effect.更多还原