本文選題：中風(fēng) + 屈伸肌交替刺激法�。� 參考：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察電針結(jié)合屈伸肌交替低頻穴位電刺激治療和電針治療對(duì)中風(fēng)后下肢功能障礙患者步行能力的影響,優(yōu)化臨床治療方案,提高臨床療效。方法:將60例符合中風(fēng)偏癱下肢功能障礙納入標(biāo)準(zhǔn)的患者隨機(jī)分為對(duì)照組與試驗(yàn)組,每組30例。兩組患者均接受針灸科常規(guī)治療。對(duì)照組接受常規(guī)電針治療,選取患側(cè)陽陵泉、足三里、懸鐘與丘墟,采用頻率為2Hz的連續(xù)波,每日治療2次,每次30分鐘,治療6天,休息1天,共治療4周;試驗(yàn)組在電針治療基礎(chǔ)上接受屈伸肌交替低頻穴位電刺激治療,選取患側(cè)陽陵泉、懸鐘;承山、昆侖,采用斷續(xù)波,斷續(xù)比(1:1),頻率為50Hz,每次治療20分鐘。每日1次,治療6天,休息1天,共治療4周。采用RM Gait步態(tài).分析系統(tǒng)(步長(zhǎng)、步速、步頻及患側(cè)單支撐相),運(yùn)動(dòng)功能評(píng)定表(Fugl-Meyer量表),日常生活活動(dòng)表Barthel指數(shù),Tinnetti平衡步態(tài)評(píng)分進(jìn)行療效判定。利用SPSS 20.0統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行處理與分析。結(jié)果:1.治療后對(duì)照組與試驗(yàn)組患者患側(cè)步長(zhǎng)、步速、步頻與患側(cè)單支撐相占整個(gè)步態(tài)周期百分比較療前明顯增加,兩組患者療后療前組內(nèi)差異具有統(tǒng)計(jì)學(xué)意義(P0.01),試驗(yàn)組患者患側(cè)步長(zhǎng)、步速、步頻與患側(cè)單支撐相占整個(gè)步態(tài)周期百分比較對(duì)照組顯著增加,兩組患者療后組間差異具有統(tǒng)計(jì)學(xué)意義(P0.05),電針結(jié)合屈伸肌交替低頻電刺激治療優(yōu)于電針治療。2.治療后對(duì)照組與試驗(yàn)組患者的下肢Fulg-Meyer評(píng)分較治療前均增加,兩組患者療后療前組內(nèi)差異具有統(tǒng)計(jì)學(xué)意義(P0.01),治療后試驗(yàn)組患者下肢Fulg-Meyer評(píng)分較對(duì)照組顯著增高,兩組患者療后組間差異具有統(tǒng)計(jì)學(xué)意義(P0.05),電針結(jié)合屈伸肌交替低頻電刺激治療優(yōu)于電針治療。3.治療后對(duì)照組與試驗(yàn)組患者的Barthel指數(shù)、Tinnetti平衡步態(tài)評(píng)分較治療前均增加,兩組患者療后療前組內(nèi)差異具有統(tǒng)計(jì)學(xué)意義(P0.01),試驗(yàn)組患者Barthel指數(shù)、Tinnetti平衡步態(tài)評(píng)分較對(duì)照組顯著增高,兩組患者療后組間差異具有統(tǒng)計(jì)學(xué)意義(P0.05),電針結(jié)合屈伸肌交替低頻電刺激治療優(yōu)于電針治療。結(jié)論:1.電針結(jié)合屈伸肌交替低頻穴位電刺激治療與電針治療均能改善中風(fēng)偏癱患者下肢功能障礙,提高中風(fēng)偏癱患者步行能力。2.電針結(jié)合屈伸肌交替低頻穴位電刺激對(duì)改善中風(fēng)后下肢功能障礙療效優(yōu)于常規(guī)電針治療。
[Abstract]:Objective: to observe the effect of electroacupuncture combined with alternative low frequency electric stimulation of flexion and extensor muscle and electroacupuncture on walking ability of patients with lower limb dysfunction after apoplexy. Methods: 60 patients with stroke hemiplegic lower limb dysfunction were randomly divided into control group and experimental group with 30 cases in each group. Both groups received routine acupuncture therapy. The control group was treated with conventional electroacupuncture. Yanglingquan, Zusanli, suspension bell and Qiu market of the affected side were treated with continuous wave with frequency of 2Hz twice a day for 30 minutes for 6 days, rest for 1 day, for a total of 4 weeks. On the basis of electroacupuncture treatment, the experimental group was treated with alternating low frequency acupoint electric stimulation of flexion and extensor muscle, selected Yanglingquan, suspension bell, Chengshan, Kunlun, using intermittent wave, intermittent ratio of 1: 1 to 1: 1, frequency of 50 Hz, for 20 minutes each time. Once a day, 6 days, rest 1 day, a total of 4 weeks. RM Gait gait was used. The analysis system (step size, step speed, gait frequency and single support phase of the affected side), motor function evaluation table (Fugl-Meyer scale), daily life activity scale (Barthel index) and Tinnetti balance gait score (TINETI) were used to evaluate the curative effect. The data are processed and analyzed by SPSS 20.0 software. The result is 1: 1. After treatment, the step length, step speed, gait frequency and the percentage of the whole gait cycle of the patients in the control group and the experimental group were significantly increased compared with those in the control group and the experimental group. The difference between the two groups before and after treatment was statistically significant (P 0.01), and the step length of the affected side in the test group was significantly higher than that in the control group. The percentage of walking speed, gait frequency and single support of the affected side in the whole gait cycle was significantly higher than that in the control group. The difference between the two groups after treatment was statistically significant (P 0.05). Electroacupuncture combined with alternative low frequency electric stimulation of flexion and extensor muscle was superior to electroacupuncture treatment. After treatment, the lower limb Fulg-Meyer scores of the patients in the control group and the experimental group were increased compared with those before treatment. The difference between the two groups before and after treatment was statistically significant (P 0.01). After treatment, the Fulg-Meyer score of the lower limbs in the test group was significantly higher than that in the control group. The difference between the two groups after treatment was statistically significant (P 0.05). Electroacupuncture combined with alternative low frequency electric stimulation of flexion and extensor muscle was superior to electroacupuncture treatment. After treatment, the Barthel index and Tinnetti balance gait score of the patients in the control group and the experimental group were increased compared with those before treatment. The difference between the two groups before and after treatment was statistically significant (P 0.01). The Barthel index and the balance gait score of the patients in the test group were significantly higher than those in the control group. The difference between the two groups after treatment was statistically significant (P 0.05). Electroacupuncture combined with alternative low frequency electric stimulation of flexion and extensor muscle was superior to electroacupuncture. Conclusion 1. Electroacupuncture combined with alternating low frequency electric stimulation of flexion and extensor muscle and electroacupuncture treatment can improve lower limb dysfunction and improve walking ability of stroke hemiplegic patients. The effect of electroacupuncture combined with alternative low frequency electric stimulation of flexion and extensor on improving lower limb dysfunction after stroke was better than that of conventional electroacupuncture.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

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