关键词:

脑卒中, 下肢痉挛, 经筋理论, 针刀, 头针, 痉挛程度

Abstract:

Objective　To analyze the effect of acupotomy under the guidance of meridian tendon theory combined with scalp acupuncture in the treatment of lower limb spasm after stroke and its influences on spasm degree and balance function. Methods　A total of 80 patients with lower limb spasm after stroke admitted to Xi'an International Medical Center Hospital from February 2021 to June 2024 were prospectively selected, and were divided into 2 groups with 40 cases in each group according to the random number table method. There were 20 males and 20 females in the control group, aged (49.20±4.17) years, the spasticity time of lower limb was (10.21±2.63) d, and the hemiplegia site was on the left side in 18 cases and right side in 22 cases. There were 23 males and 17 females in the observation group, aged (49.81±4.37) years, the spasticity time of lower limb was (10.65±3.02) d, and the hemiplegia site was on the left side in 20 cases and right side 20 cases. The control group was treated with scalp acupuncture (once a day, 6 times a week), and the observation group was treated with scalp acupuncture combined with acupotomy under the guidance of meridian tendon theory (3 times a week). Both groups were treated for 4 weeks. The therapeutic effect, adverse reactions, spasticity, balance function, activities of daily living, lower limb motor function, and three-dimensional gait analysis were compared between the two groups. χ² test, rank sum test, and t test were used for statistical analysis. Results　The effective rate of the observation group was 95.00% (38/40), which was higher than that of the control group [77.50% (31/40)] (χ²=5.165, P=0.023). After 4 weeks of treatment, the grade of spasticity in the observation group was better than that in the control group (P<0.05); the modified Barthel index (MBI) [(52.63±3.78) points], Fugl-Meyer Lower Limb Motor Function Rating Scale (FMA-LE) score [(23.20±2.98) points], and Berg Balance Scale (BBS) score [(46.25±5.04) points] in the observation group were higher than those in the control group [(46.21±3.42) points, (20.45±2.68) points, and (41.08±4.59) points] (t=7.965, 4.340, and 4.797, all P<0.05); the step frequency [(73.20±4.99) steps/min] and step speed [(0.61±0.07) m/s] in the observation group were higher than those in the control group [(70.02±4.24) steps/min and (0.52±0.06) m/s] (t=3.071 and 6.174, both P<0.05); the maximum dorsiflexion angle of the affected ankle [(14.02±1.62)°] and the maximum plantar flexion angle of the affected ankle [(20.02±2.74)°] in the observation group were higher than those in the control group [(11.84±1.27)° and (17.21±2.27)°] (t=6.698 and 4.995, both P<0.05). No aggravation occurred in both groups during treatment, and no adverse reactions such as needle fainting, subcutaneous hematoma, or congestion occurred. Conclusion　Acupotomy under the guidance of meridian tendon theory combined with scalp acupuncture has significant therapeutic effect in the treatment of lower limb spasm after stroke, which can reduce the degree of spasm, and improve the gait kinematics parameters, step frequency and pace, and lower limb motor function.

Key words:

Stroke, Spasm of lower limb, Meridian tendon theory, Acupotomy, Scalp acupuncture, Degree of spasm