针刺结合Bobath 技术改善出血性卒中术后痉挛性瘫痪临床研究

Clinical Study on Acupuncture Combined with Bobath Technique for Improving Spastic Paralysis After Hemorrhagic Stroke Surgery

摘要:

目的：观察针刺结合Bobath技术改善出血性卒中术后痉挛性瘫痪的临床疗效。方法：选取2022年10月—2024年10月河南中医药大学第一附属医院收治的出血性卒中术后痉挛性瘫痪患者104例，按随机数字表法分为对照组和观察组各52例。对照组采用Bobath技术治疗，观察组在对照组基础上加用针刺治疗。7天为1个疗程，治疗4个疗程。评价2组临床疗效，比较2组治疗前后神经功能、肢体痉挛程度、肢体运动功能、生活质量及满意度。结果：观察组总有效率为96.15% （50/52），高于对照组82.69% （43/52）（P＜0.05）。治疗后，2组美国国立卫生研究院出血性卒中量表（NIHSS） 评分较治疗前降低，简化Fugl-Meyer量表（FMA） 评分较治疗前升高（P＜0.05）；且观察组NIHSS评分低于对照组，简化FMA评分高于对照组（P＜0.05）。治疗后，2组肢体痉挛程度较治疗前改善（P＜0.05），且观察组肢体痉挛改善程度优于对照组（P＜0.05）。治疗后，2组生活质量量表（SF-36） 各项评分较治疗前升高（P＜0.05），且观察组SF-36各项评分高于对照组（P＜0.05）。观察组满意度为98.08% （51/52），高于对照组84.62% （44/52）（P＜0.05）。结论：针刺结合Bobath技术应用于出血性卒中术后痉挛性瘫痪患者效果明显，可有效改善神经功能、肢体痉挛程度、肢体运动功能及生活质量，患者满意度高。

Abstract:

Abstract： Objective： To observe the clinical efficacy of acupuncture combined with Bobath technique in improving spastic paralysis after hemorrhagic stroke surgery. Methods： A total of 104 patients with spastic paralysis after hemorrhagic stroke surgery admitted to The First Affiliated Hospital of Henan University of Chinese Medicine from October 2022 to October 2024 were selected and randomly divided into a control group and an observation group according to a random number table method，with 52 cases in each group. The control group received Bobath technique treatment，while the observation group received additional acupuncture treatment based on the control group's regimen. Seven days constituted one treatment course，and both groups received four consecutive courses. Clinical efficacy was evaluated， and neurological function， limb spasticity degree， limb motor function， quality of life， and satisfaction were compared between the two groups before and after treatment. Results：The total effective rate was 96.15%（ 50/52） in the observation group， higher than that of 82.69% （43/52） in the control group （P＜0.05）. After treatment， the National Institutes of Health Stroke Scale （NIHSS） scores decreased in both groups compared to before treatment，while Fugl-Meyer Assessment （FMA） scores increased （P＜0.05）. The observation group showed lower NIHSS scores and higher FMA scores than the control group （P＜0.05）. After treatment，the degree of limb spasticity improved in both groups compared to before treatment （P＜0.05），and the improvement in the observation group was superior to that in the control group （P＜0.05）. After treatment， the scores of all dimensions of the 36-Item Short Form Health Survey （SF-36） increased in both groups compared to before treatment （P＜0.05），and the observation group showed higher scores in all SF-36 dimensions than the control group （P＜0.05）. The satisfaction rate was 98.08% （51/52） in the observation group，higher than that of 84.62%（ 44/52） in the control group（ P＜0.05）. Conclusion：Acupuncture combined with Bobath technique demonstrates significant effects in patients with spastic paralysis after hemorrhagic stroke surgery. It can effectively improve neurological function， limb spasticity degree， limb motor function， and quality of life，with higher patient satisfaction.