【摘要】：目的：本研究旨在通過臨床試驗,觀察電針組及電針加康復訓練組治療的有效性,重點觀察踝關節(jié)背屈的關節(jié)活動度、脛前肌肌力、踝關節(jié)痙攣程度、平衡以及對Fugl-Meyer下肢功能評分改善情況,尋求一種治療腦卒中后踝背屈障礙的有效、可行的方案,并求證康復訓練在改善踝關節(jié)背屈功能中能否起到作用。 方法：將75例腦卒中偏癱后踝背屈障礙患者納入研究,隨機分為電針加康復訓練治療組和電針對照組。兩組均在神經(jīng)科常規(guī)及對癥治療基礎上進行電針治療,治療組在對照組基礎上加上康復訓練。每周治療5次,10次一療程,共兩個療程。然后對兩組治療前后踝關節(jié)背屈的關節(jié)活動度、脛前肌肌力、踝關節(jié)痙攣程度、平衡以及Fugl-Meyer下肢功能評分多方面的改善情況進行療效評價。 結果：兩種療法治療踝背屈障礙均有療效,總有效率差異有統(tǒng)計學意義(P0.05),臨床有效率治療組優(yōu)于對照組(P0.05),治療10次、治療20次踝關節(jié)關節(jié)活動度、脛前肌肌力、平衡及Fugl-Meyer下肢功能評分改善情況治療組均優(yōu)于對照組(P0.05),且治療組較對照組對踝關節(jié)痙攣程度的影響更小(P0.05)。 結論：電針加康復訓練和單純電針治療對腦卒中偏癱后踝背屈障礙均有療效,但電針加康復訓練臨床有效率更高,可更好的增加患者踝關節(jié)主動背屈的關節(jié)活動度、脛前肌肌力,減輕對踝關節(jié)痙攣程度的影響,能更好的改善患者平衡和Fugl-Meyer下肢功能評分,具有一定的深入研究及探討的價值。
[Abstract]:Objective: to observe the effectiveness of electroacupuncture group and electroacupuncture plus rehabilitation training group through clinical trial, and to observe the joint motion, tibialis anterior muscle strength and ankle spasm. The balance and the improvement of Fugl-Meyer 's lower limb function score were investigated to find an effective and feasible scheme for the treatment of malleolus dorsiflexion disorder after stroke, and to verify whether rehabilitation training can play a role in improving ankle dorsiflexion function. Methods: 75 patients with malleolus dorsiflexion disorder after stroke were randomly divided into electroacupuncture plus rehabilitation training treatment group and electroacupuncture control group. Both groups were treated with electroacupuncture on the basis of routine neurology and symptomatic treatment, and rehabilitation training was added to the treatment group on the basis of control group. Five times a week, 10 times a course of treatment, a total of two courses of treatment. Then the improvement of ankle flexion motion, tibialis anterior muscle strength, ankle spasm, balance and Fugl-Meyer lower limb function score before and after treatment were evaluated. Results: the two kinds of therapy were effective in treating ankle dorsiflexion disorder, the total effective rate was significantly different (P0.05). The clinical effective rate in the treatment group was better than that in the control group (P0.05), 10 times of treatment, 20 times of treatment of ankle joint activity, and the muscle strength of tibial anterior muscle, the clinical effective rate of treatment group was better than that of control group (P0.05). The improvement of balance and Fugl-Meyer lower limb function score in the treatment group was better than that in the control group (P0.05), and the effect of the treatment group on ankle spasticity was less than that in the control group (P0.05). Conclusion: electroacupuncture plus rehabilitation training and simple electroacupuncture therapy have curative effect on ankle dorsiflexion disorder after stroke, but the clinical effective rate of electroacupuncture plus rehabilitation training is higher, which can better increase the joint motion of ankle active dorsiflexion. The tibialis anterior muscle strength can reduce the influence of ankle spasticity and can improve the balance of patients and Fugl-Meyer lower limb function score. It has certain value of further study and discussion.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R246.6

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