發(fā)布時(shí)間：2019-03-11 11:58

【摘要】：目的:通過觀察低頻電刺激結(jié)合電針治療法與單純電針治療法兩種方式對(duì)中風(fēng)后弛緩癱患者上肢功能障礙對(duì)比,評(píng)價(jià)兩種方法在治療結(jié)果上的差異,進(jìn)一步研究低頻穴位電刺激對(duì)改善中風(fēng)后上肢弛緩癱的作用,以提高臨床治療效果,優(yōu)化中風(fēng)后上肢弛緩癱治療方案。方法:將符合納入標(biāo)準(zhǔn)的60例上肢弛緩癱患者隨機(jī)分為低頻結(jié)合電針組(治療組)、電針組(對(duì)照組),每組30例。對(duì)所有納入患著給予神經(jīng)內(nèi)科基礎(chǔ)治療,康復(fù)訓(xùn)練。電針組每日一次治療,每次30分鐘,低頻電針組每日各一次治療,時(shí)間分別為30分鐘。療程:每周治療7天,一天一次,四周為一個(gè)療程。治療前及治療一個(gè)療程后(28次)分別記錄上肢關(guān)節(jié)活動(dòng)度(ROM)、日常生活活動(dòng)能力量表(MBI)、徒手肌力測(cè)定(MMT)及簡(jiǎn)化Fugl-Meyer運(yùn)動(dòng)功能評(píng)分法(上肢部分)。本課題采用SPSS20.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1.低頻電針組和電針組經(jīng)治療后Fugl-meyer(上肢)評(píng)分與療前相比均有明顯提高,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),說明兩種治療方法均可以提高上肢運(yùn)動(dòng)功能,兩組患者組間比較,差異具有統(tǒng)計(jì)學(xué)意義(p0.01),低頻電針組優(yōu)于電針組。2.低頻電針組和電針組經(jīng)治療后Barthel ADL評(píng)分與療前相比均有明顯提高,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),說明兩種治療方法均可以提高日常生活活動(dòng)能力,兩組患者組間比較,差異具有統(tǒng)計(jì)學(xué)意義(p0.01),低頻電針組優(yōu)于電針組。3.低頻電針組和電針組經(jīng)治療后徒手肌力測(cè)定(MMT)評(píng)分與療前相比均有明顯提高,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),說明兩種治療方法均可以提高上肢肌力,兩組患者組間比較,差異具有統(tǒng)計(jì)學(xué)意義(p0.01),低頻電針組優(yōu)于電針組。4.低頻電針組和電針組經(jīng)治療后上肢關(guān)節(jié)活動(dòng)度(ROM)與療前相比均有明顯提高,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),說明兩種治療方法均可以提高上肢關(guān)節(jié)活動(dòng)度,兩組患者組間比較,差異具有統(tǒng)計(jì)學(xué)意義(p0.01),低頻電針組優(yōu)于電針組。結(jié)論:1.電針治療和低頻電刺激結(jié)合電針治療均可以改善中風(fēng)后上肢弛緩癱的肌力、日常生活能力、上肢運(yùn)動(dòng)功能及肩關(guān)節(jié)活動(dòng)度;2.低頻電刺激結(jié)合電針療法對(duì)于改善中風(fēng)后弛緩癱患者上肢功能重建作用明顯顯,優(yōu)于單純電針組。
[Abstract]:Objective: to compare the effects of low frequency electrical stimulation combined with electroacupuncture therapy and electroacupuncture therapy on upper limb dysfunction in patients with poststroke achalasia, and to evaluate the difference between the two methods in the treatment of upper limb dysfunction. To further study the effect of low-frequency acupoint electrical stimulation on the improvement of upper limb achalasia after apoplexy in order to improve the clinical treatment effect and optimize the treatment scheme of upper limb achalasia after apoplexy. Methods: sixty patients with upper limb achalasia were randomly divided into low frequency combined acupuncture group (treatment group) and electro acupuncture group (control group) with 30 cases in each group. All included patients were given basic treatment of neurology and rehabilitation training. The electric acupuncture group was treated once a day for 30 minutes, and the low frequency acupuncture group was treated once a day for 30 minutes. Course of treatment: 7 days a week, once a day, four weeks for a course. Before and after one course of treatment (28 times), the (ROM), activity of daily living scale (MBI),) was recorded to measure (MMT) and simplified Fugl-Meyer motor function scale (upper limb part) was used to measure the muscle strength of bare hands. This topic uses the SPSS20.0 statistical software to carry on the statistical analysis. Results: 1. The scores of Fugl-meyer (upper limb) in the low frequency acupuncture group and electroacupuncture group after treatment were significantly higher than those before treatment (P0.01), indicating that the two treatment methods could improve the motor function of the upper limbs, and there was a significant difference between the two groups (P0.01). The difference between the two groups was statistically significant (p0.01), and the low frequency electric acupuncture group was better than the electric acupuncture group. 2. After treatment, the Barthel ADL scores of the low frequency acupuncture group and the electroacupuncture group were significantly higher than those before the treatment (P0.01), indicating that the two treatment methods could improve the activity of daily living, and the two groups were compared between the two groups, and the difference between the two groups was statistically significant (P0.01). The difference was statistically significant (p0.01), and the low frequency electric acupuncture group was better than the electric acupuncture group. 3. After treatment, the (MMT) score of bare hand muscle strength in low frequency acupuncture group and electro acupuncture group was significantly higher than that before treatment (P0.01), indicating that both treatment methods can improve the muscle strength of upper limb. The difference between the two groups was statistically significant (p0.01). The low-frequency electroacupuncture group was superior to the electro-acupuncture group. The (ROM) of upper limb joint in low-frequency acupuncture group and electro-acupuncture group was significantly higher than that before treatment (P0.01), indicating that the two treatment methods can improve the movement of upper limb joint, and there is a significant difference between the two groups before and after treatment (P0.01), which indicates that the two methods can improve the activity of upper limb joint. The difference between the two groups was statistically significant (p0.01), and the low-frequency electroacupuncture group was superior to the electro-acupuncture group. Conclusions: 1. Electro-acupuncture therapy and low-frequency electrical stimulation combined with electro-acupuncture treatment can improve muscle strength, ability of daily living, upper limb motor function and shoulder joint activity in upper limb relaxation and paraplegia after apoplexy. Low-frequency electrical stimulation combined with electro-acupuncture therapy can improve the function reconstruction of upper limb in patients with post-stroke achalasia, which is better than that of simple electroacupuncture group.
【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)】：R246.6

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