Abstract:

Objective　To explore the effect of acupuncture along the meridians based on yin and yang balance theory for patients with spastic hemiplegia after ischemic stroke. Methods　A total of 90 patients with spastic hemiplegia after ischemic stroke who were admitted to Zhumadian Hospital of Traditional Chinese Medicine from April 2020 to April 2022 were selected for the random control trial, including 48 males and 42 females. They were 42-75 (58.25±10.10) years old. They were divided into a control group and an observation group by the random number table method. Both groups were treated with conventional western medicine, while the observation group also received acupuncture along the meridians based on yin and yang balance theory. The Ashworth classifications before and after the treatment, clinical effects, incidences of adverse reactions, degrees of neurological deficit, limb motor function, and self-care abilities were compared between these two groups. t and χ² tests were applied. Results　After the treatment, the proportions of the patients of Ashworth grade 0, 1-1+, 2-3, and 4 were 35.56% (16/45), 40.00% (18/45), 22.22% (10/45), and 2.22% (1/45) in the observation group, and were 15.56% (7/45), 31.11% (14/45), 40.00% (18/45), and 13.33% (6/45) in the control group, respectively, with statistical differences between before and after the treatment in both groups (Z=6.207, P=0.010; Z=4.935, P=0.038) and between the two groups after the treatment (Z=4.712, P=0.041). After the treatment, the obviously effective, effective, and ineffective rates were 57.78% (26/45), 35.56% (16/45), and 6.67% (3/45) in the observation group, and were 33.33% (15/45), 44.44% (20/45), and 22.22% (10/45) in the control group, respectively, with a statistical difference in the distribution of clinical efficacy between the two groups (Z=5.421, P=0.020). The total effective rate in the observation group was higher than that in the control group [93.33% (42/45) vs. 77.78% (35/45); χ²=4.406, P=0.036]. After the treatment, the scores of National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer, and Barthel Index (BI) were (8.71±1.89), (68.22±8.92), and (70.11±8.67) in the observation group, and were (10.13±2.02), (58.71±8.35), and (60.58±8.43) in the control group; the NIHSS score in the observation group was lower than that in the control group (t=3.443, P=0.001), and the Fugl-Meyer and BI scores were higher than those in the control group (t=5.221 and 5.287, both P<0.001). The incidences of adverse reactions in the observation group and control group were 8.89% (4/45) and 4.44% (2/45), respectively, with no statistical difference (correction χ²=0.179, P=0.673). Conclusion　Acupuncture along the meridians based on yin and yang balance theory in the treatment of patients with spastic hemiplegia after ischemic stroke can reduce their symptoms and neurological deficit degree, enhance the curative effect, and improve their limb motor function and ability of daily life.

Key words:

Spastic hemiplegia, Ischemic stroke, Yin-yang balance theory, Acupuncture along the meridians

摘要：

目的　基于阴阳调衡理论探讨循经针刺在缺血性脑卒中后痉挛性偏瘫患者中的作用。方法　选取驻马店市中医院2020年4月至2022年4月收治的90例缺血性脑卒中后痉挛性偏瘫患者进行随机对照试验，其中男48例、女42例，年龄42～75（58.25±10.10）岁。依照随机数字表将患者分对照组与观察组，对照组实施常规西医治疗，观察组在对照组的基础上予以基于阴阳调衡理论循经针刺。采用t检验、χ²检验进行统计分析。结果　治疗后观察组Ashworth分级0级、1～1+级、2～3级、4级分别为35.56%（16/45）、40.00%（18/45）、22.22%（10/45）、2.22%（1/45），对照组分别为15.56%（7/45）、31.11%（14/45）、40.00%（18/45）、13.33%（6/45），与本组治疗前比较差异均有统计学意义（Z=6.207，P=0.010；Z=4.935，P=0.038），治疗后两组间比较差异有统计学意义（Z=4.712，P=0.041）；治疗后观察组显效、有效、无效分别为57.78%（26/45）、35.56%（16/45）、6.67%（3/45），对照组分别为33.33%（15/45）、44.44%（20/45）、22.22%（10/45），两组临床疗效分布比较差异均有统计学意义（Z=5.421，P=0.020）；观察组总有效率为93.33%（42/45），较对照组的77.78%（35/45）高（χ²=4.406，P=0.036）；治疗后观察组NIHSS、Fugl-Meyer和BI评分为（8.71±1.89）分、（68.22±8.92）分、（70.11±8.67）分，对照组分别为（10.13±2.02）分、（58.71±8.35）分、（60.58±8.43）分，观察组治疗后NIHSS评分低于对照组（t=3.443，P=0.001），观察组治疗后Fugl-Meyer和BI评分均高于对照组（t=5.221、5.287，均P<0.001）；观察组与对照组不良反应发生率分别为8.89%（4/45）、4.44%（2/45），两组差异无统计学意义（校正χ²=0.179，P=0.673）。结论　基于阴阳调衡理论的循经针刺在缺血性脑卒中后痉挛性偏瘫中应用可减轻症状和神经功能缺损程度，还可增强疗效、改善肢体运动功能和日常生活能力。

关键词:

痉挛性偏瘫, 缺血性脑卒中, 阴阳调衡理论, 循经针刺