肌筋膜松解手法联合针刺对脑卒中后下肢痉挛的疗效观察

Clinical effect of myofascial release combined with acupuncture in treatment of lower limb spasticity after stroke

摘要:

目的 观察肌筋膜松解手法联合针刺对脑卒中后下肢痉挛的疗效。方法 纳入脑卒中后下肢痉挛患者45例，随机分为对照组（22例）和试验组（23例）。2组均给予针刺治疗，试验组在此基础上增加肌筋膜松解手法治疗。为期6周的治疗后，比较2组临床康复疗效，观察相关指标变化。采用改良Ashworth量表（modified Ashworth scale，MAS）评定屈膝肌群肌张力大小，降低即为治疗有效。采用Fugl-Meyer下肢运动功能评定量表（Fugl-Meyer assessment of lower extremity，FMA-LE）评定下肢运动功能；采用临床痉挛指数（clinic spasticity index，CSI）评定痉挛程度；检测血清同型半胱氨酸（homocysteine，Hcy）水平。结果 治疗后试验组有效率明显高于对照组（P<0.05）；2组屈膝肌群MAS得分、血清Hcy水平显著降低，FMA-LE评分、CSI评分显著增高（P<0.05）；试验组患者MAS得分、血清Hcy水平均低于对照组，FMA-LE评分、CSI均高于对照组（P<0.05）。结论 肌筋膜松解手法联合针刺可有效降低脑卒中下肢痉挛患者肌张力，减轻痉挛程度，改善下肢运动功能，降低血清Hcy水平。

Abstract:

Objective To investigate the clinical effect of myofascial release combined with acupuncture in the treatment of lower limb spasticity after stroke.Methods A totalof 45 patients with lower limb spasticity after stroke were enrolled and randomly divided into control group with 22 patients and experimental group with 23 patients. The patients in the control group were given acupuncture alone，and those in the experimental group were given myofascial release combined with acupuncture. After 6 weeks of treatment，the two groups were compared in terms of the clinical effect of rehabilitation and the changes in related indicators. Modified Ashworth Scale（MAS） was used to evaluate the muscle tension of knee flexor muscles，and the treatment was considered effective if there was a reduction in MAS score. Fugl-Meyer Assessment of Lower Extremity（FAM-LE） was used to evaluate the motor function of lower limbs，Clinical Spasticity Index（CSI） was used to evaluate the degree of spasticity，and the serum level of homocysteine（Hcy） was measured.Results After treatment，the experimental group had a significantly higher response rate than the control group（P<0.05），and both groups had a significant reduction in the serum level of Hcy and significant increases in FMA-LE and CSI scores（P<0.05）. Compared with the control group，the experimental group had significantly lower MAS score and serum Hcy level and significantly higher FMA-LE and CSI scores（P<0.05）.Conclusion For patients with lower limb spasticity after stroke，myofascial release combined with acupuncture can effectively reduce muscle tension，alleviate spasticity，improve the motor function of lower limbs，and reduce serum Hcy level.