温通穴位灸刮疗法联合康复疗法治疗脑卒中后上肢痉挛性瘫痪临床研究OA

Objective:To observe the efficacy of warming and unblocking acupoint moxibustion-scraping therapy combined with rehabilitation therapy for patients with post-stroke upper limb spastic paralysis.Methods:A total of 138 patients with post-stroke upper limb spastic paralysis admitted to the Department of Rehabilitation,Jinhua Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University,from November 2023 to March 2025,were enrolled and randomly divided into a control group and an observation group using a random number table method,with 69 cases in each group.The control group received conventional rehabilitation therapy,while the observation group received warming and unblocking acupoint moxibustion-scraping therapy on the basis of the conventional rehabilitation therapy.Both groups were treated for eight weeks.Before and after treatment,the spasticity[Clinical Spasticity Index(CSI)scores],motor function[Wolf Motor Function Test(WMFT)scores,Fugl-Meyer Assessment of Upper Extremity(FMA-UE)scores],and muscle strength[Manual Muscle Testing(MMT)scores]of patients were assessed.Surface electromyographic(sEMG)signals of the forearm extensor muscles,deltoid,and triceps brachii were recorded.The clinical efficacy of the two groups was compared.Results:After eight weeks of treatment,the total effective rate in the observation group was significantly higher than that in the control group(P＜0.05).The CSI scores in both groups showed a decreasing trend over the treatment duration.Within each group,there were statistically significant differences in CSI scores across the four time points(before treatment,and at two,four,and eight weeks of treatment)(P＜0.05).In both groups,CSI scores at two,four,and eight weeks after treatment were significantly decreased compared with those before treatment(P＜0.05);scores at four weeks after treatment were lower than those at two weeks after treatment(P＜0.05);and scores at eight weeks after treatment were lower than those at four weeks after treatment(P＜0.05).At two,four,and eight weeks after treatment,the CSI scores in the observation group were significantly lower than those in the control group at the corresponding time points(P＜0.05).Similarly,the FMA-UE scores,MMT scores,and sEMG signals of the forearm extensor muscles,deltoid,and triceps brachii in both groups showed increasing trends over time.Within each group,significant differences were observed across the four time points for all five indicators(P＜0.05).Compared with those before treatment,all five indicators in both groups increased significantly at two,four,and eight weeks after treatment(P＜0.05);values at four weeks after treatment were higher than those at two weeks after treatment(P＜0.05);and values at eight weeks after treatment were higher than those at four weeks after treatment(P＜0.05).The observation group demonstrated significantly higher values for all five indicators than the control group at two,four,and eight weeks after treatment(P＜0.05).Conclusion:The combination of warming and unblocking acupoint moxibustion-scraping therapy and rehabilitation therapy for post-stroke upper limb spastic paralysis can further alleviate spasticity,promote the recovery of motor function and muscle strength,enhance muscle contraction efficiency and coordination,and thereby facilitate the overall functional recovery of the affected upper limb.