醒脑开窍针刺法联合重复经颅磁刺激治疗卒中后痉挛性偏瘫的疗效研究OA
Study on the efficacy of Xingnao Kaiqiao acupuncture therapy combined with repetitive transcranial magnetic stimulation in the treatment of post-stroke spastic hemiplegia
目的 探讨醒脑开窍针刺法联合重复经颅磁刺激(rTMS)治疗卒中后痉挛性偏瘫的疗效.方法 选取2022年6月至2025年6月于该院收治的120例卒中后痉挛性偏瘫患者作为研究对象.按照随机数字表法分为对照组和观察组,每组60例.对照组采用常规治疗,观察组在对照组基础上给予醒脑开窍针刺法联合rT-MS治疗,两组连续治疗4周.比较两组临床疗效、中医证候积分、神经功能[美国国立卫生研究院卒中量表(NIHSS)评分]、运动功能[Fugl-Meyer运动功能评定(FMA)量表评分]及肢体痉挛程度[临床痉挛指数(CSI)]、脑动脉平均血流速度、脑损伤相关因子及炎症因子[IL-13、神经元PAS结构域蛋白4(NPAS4)、胶质纤维酸性蛋白(GFAP)]及不良反应发生情况.结果 观察组总有效率高于对照组(96.67%vs.83.33%),差异有统计学意义(P<0.05).与治疗前比较,治疗后两组中医证候积分、NIHSS评分、CSI评分及IL-13、NPAS4、GFAP水平更低,且观察组低于对照组;而FMA-上肢、FMA-下肢评分和大脑前动脉、中动脉、后动脉 Vm 更高,且观察组高于对照组,差异有统计学意义(P<0.05).两组不良反应发生率比较(5.00%vs.8.33%),差异无统计学意义(P>0.05).结论 醒脑开窍针刺法联合rTMS治疗卒中后痉挛性偏瘫疗效更好.
Objective To investigate the efficacy of Xingnao Kaiqiao Acupuncture Therapy combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of spastic hemiplegia after stroke.Methods One hundred and twenty patients with post-stroke spastic hemiplegia admitted to the hospital be-tween June 2022 and June 2025 were selected as research subjects.They were divided into the control group and the observation group according to the random number table method,with 60 cases in each group.The control group received conventional treatment,while the observation group received Xingnao Kaiqiao acupunc-ture therapy combined with rTMS on the basis of the treatment of the control group.Both groups received continuous treatment for 4 weeks.The clinical efficacy,traditional Chinese medicine syndrome score,neurolog-ical function[National Institutes of Health Stroke Scale(NIHSS)score],motor function[Fugl-Meyer Motor Assessment(FMA)scale score],limb spasticity degree[Clinical Spasticity Index(CSI)],mean cerebral artery blood flow velocity,brain injury-related factors and inflammatory factors[IL-13,neuronal PAS domain protein 4(NPAS4),glial fibrillary acidic protein(GFAP)]and the incidence of adverse reactions were com-pared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(96.67%vs.83.33%),and the difference was statistically significant(P<0.05).Com-pared with those before treatment,after treatment,the traditional Chinese medicine syndrome scores,NIHSS scores,CSI scores,and levels of IL-13,NPAS4 and GFAP of both groups were lower,and those in the observa-tion group were lower than those in the control group;while FMA-upper limb scores,FMA-lower limb scores,and Vm of the anterior cerebral artery,middle cerebral artery and posterior cerebral artery were higher,and those in the observation group were higher than those in the control group,and the differences were statisti-cally significant(P<0.05).The difference in the incidence of adverse reactions between the two groups(5.00%vs.8.33%)was not statistically significant(P>0.05).Conclusion Xingnao Kaiqiao acupuncture ther-apy combined with rTMS has better therapeutic efficacy in the treatment of post-stroke spastic hemiplegia.
邢军;张怡;王海蓉
联勤保障部队第九八三医院康复医学科,天津 300142联勤保障部队第九八三医院康复医学科,天津 300142联勤保障部队第九八三医院康复医学科,天津 300142
医药卫生
卒中后痉挛性偏瘫重复经颅磁刺激醒脑开窍针刺法运动功能神经功能
post-stroke spastic hemiplegiarepetitive transcranial magnetic stimulationXingnao Kaiqiao acupuncture methodmotor functionneurological function
《重庆医学》 2026 (9)
1936-1941,6
天津市卫生健康委员会科技项目(TJWJ2023MS070).
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