透刺联合悬吊训练对卒中后偏瘫患者下肢运动功能和平衡功能的影响OA
The impact of penetrating needling combined with sling exercise therapy on lower limb motor and balance function in post-stroke hemiplegic patients
目的:观察透刺联合悬吊训练(SET)对卒中后偏瘫患者下肢运动功能、平衡能力及痉挛程度的影响和疗效.方法:将卒中后偏瘫患者随机分为对照组(33例,脱落1例)和透刺组(33例,脱落1例),两组均予以内科常规治疗、康复训练和常规针刺基础治疗,对照组患者在基础治疗上予以SET治疗,透刺组患者在基础治疗上予以SET联合透刺治疗,透刺选取曲泉透膝阳关,阳陵泉透阴陵泉,跗阳透交信,丘墟透照海.分别于治疗前后采用Fugl-Meyer下肢运动功能量表(FMA-L)评估下肢运动功能,Berg平衡量表(BBS)评估平衡功能,改良 Ashworth量表(MAS)评估下肢痉挛程度,步态分析测力台系统进行步态数据分析.结果:治疗后,两组患者FMA-L、BBS评分提高(P<0.05),MAS评分降低(P<0.05),睁眼球长度、睁眼椭圆面积、闭眼球长度、闭眼椭圆面积、健侧负荷、内外侧负荷差距下降(P<0.05),步频、步速、患侧负荷增加(P<0.05),且透刺组均优于对照组(P<0.05).结论:透刺联合SET有助于平衡卒中后偏瘫患者健、患侧足底的内外侧负荷,使重心趋向中心,提高站立稳定性,改善运动功能、平衡功能,缓解痉挛.
Objective To observe the effects of penetrating needling combined with sling exercise therapy(SET)on lower limb motor function,balance,and spasticity in patients with post-stroke hemiplegia.Methods Patients with post-stroke hemiplegia were randomly divided into a control group(33 cases,1 dropout)and a penetrating needling group(33 cases,1 dropout).All participants received standard medical treatment,rehabilitation training,and routine acupuncture as baseline therapy.The control group received additional SET,while the penetrating needling group received additional SET combined with penetrating needling therapy.The penetrating needling technique was applied from Ququan(LR8)to Xiyangguan(GB33),from Yanglingquan(GB34)to Yinlingquan(SP9),from Fuyang(BL59)to Jiaoxin(KI8),and from Qiuxu(GB40)to Zhaohai(KI6).Outcome measures,including the Fugl-Meyer assessment of lower extremity motor function(FMA-L),Berg balance scale(BBS),modified Ashworth scale(MAS),and gait analysis data(assessed using a force plate system),were evaluated before and after treatment.Results After treatment,both groups showed significant improvements:increased FMA-L and BBS scores,decreased MAS scores,reduced postural sway parameters(eyes-open ball length,eyes-open ellipse area,eyes-closed ball length,and eyes-closed ellipse area),decreased load on the healthy side and medial-lateral load asymmetry,and increased step frequency,step speed,and load on the affected side(all P<0.05).The penetrating needling group demonstrated superior improvements in all measures compared to the control group(P<0.05).Conclusion The combination of penetrating needling and SET helps balance the medial-lateral plantar load distribution between the healthy and affected sides in post-stroke hemiplegic patients,shifts the center of gravity toward the midline,enhances standing stability,improves motor and balance functions,and alleviates spasticity.
李冰枝;罗金发;陈董董;刘华胜;李梦醒;朱宗俊;肖洪波
安徽中医药大学第一临床医学院,合肥 230038安徽中医药大学第一附属医院康复科,合肥 230031安徽中医药大学第一附属医院康复科,合肥 230031安徽中医药大学第一附属医院康复科,合肥 230031安徽中医药大学针灸推拿学院,合肥 230012安徽中医药大学第一附属医院康复科,合肥 230031安徽中医药大学第一附属医院康复科,合肥 230031
卒中后偏瘫透刺悬吊训练平衡功能步态分析
Post-stroke hemiplegiaPenetrating needlingSling exercise therapyBalance functionGait analysis
《针刺研究》 2026 (6)
749-757,9
国家中医康复中心建设项目(No.国中医药医政函[2023]255号)国家自然科学基金青年项目(No.82305361)安徽省卫健委科研项目(No.AHWJ2023A10070)
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