目的 观察通督调神针法联合经筋结点放血治疗脑卒中后痉挛性瘫痪的临床疗效。方法 将60例脑卒中后痉挛性瘫痪的患者随机分为治疗组和对照组，各30例。对照组予以通督调神针法治疗，治疗组在通督调神针法的基础上予以经筋结点放血治疗。治疗前后分别采用美国国立卫生研究院卒中量表（National Institution Health Stroke Scale, NIHSS）评价神经功能缺损情况，采用改良Ashworth痉挛分级量表（modified Ashworth scale, MAS）评价肢体痉挛程度，采用简式Fugl-Meyer评定法（Fugl-Meyer assessment, FMA）评价脑卒中后运动功能障碍程度，并观察临床疗效。结果 与治疗前比较，两组患者治疗后NIHSS评分、MAS等级显著降低（P<0.05），FMA评分显著升高（P<0.05）；治疗组治疗后NIHSS评分、MAS等级降低程度显著大于对照组（P＜0.05），FMA评分升高程度明显大于对照组（P<0.05）。治疗组临床疗效显著优于对照组（P＜0.05）。结论 通督调神针法联合经筋结点放血可显著改善脑卒中后痉挛性瘫痪的痉挛状态及运动功能，且优于单纯通督调神针法治疗方案。
Objective To investigate the clinical effect of Tongdu Tiaoshen acupuncture combined with bloodletting therapy at meridian sinew nodal points in the treatment of post-stroke spastic paralysis. Methods A total of 60 patients with post-stroke spastic paralysis were randomly divided into treatment group and control group, with 30 patients in each group. The patients in the control group were given Tongdu Tiaoshen acupuncture, and those in the treatment group were given bloodletting therapy at meridian sinew nodal points in addition to the treatment in the control group. Before and after treatment, National Institutes of Health Stroke Scale (NIHSS) was used to evaluate neurological defects, modified Ashworth scale (MAS) was used to evaluate the spasticity of limbs, and Fugl-Meyer Assessment (FMA) was used to evaluate the degree of dyskinesia after stroke; clinical outcome was also observed after treatment. Results After treatment, both groups had significant reductions in NIHSS score and MAS grade (P<0.05) and a significant increase in FMA score (P<0.05), and compared with the control group, the treatment group had significantly greater reductions in NIHSS score and MAS grade (P<0.05) and a significantly higher FMA score (P<0.05). The treatment group had a significantly better clinical outcome than the control group (P<0.05). Conclusion Tongdu Tiaoshen acupuncture combined with bloodletting therapy at meridian sinew nodal points can significantly improve spasticity and motor function in patients with post-stroke spastic paralysis, with a better clinical effect than Tongdu Tiaoshen acupuncture alone.
代 飞,张君宇,蔡圣朝,杨 坤.通督调神针法联合经筋结点放血治疗脑卒中后痉挛性瘫痪30例[J].安徽中医药大学学报,2021,40(4):60-63复制