Abstract:

Objective　To explore the effect of acupuncture and moxibustion based on the theory of meridians and tendons on limb spasticity after stroke. Methods　A total of 90 patients with post-stroke limb spasticity were selected from Baoji Traditional Chinese Medicine Hospital from May 2022 to May 2024. They were divided into two groups according to the random number table method. In 45 cases of the control group, the male to female ratio was 28:17, the age was (60.28±4.62) years old, and the Brunnstrom stroke classification included 16 patients with grade II, 20 patients with grade III, and 9 patients with grade IV. In 45 cases of the observation group, the male to female ratio was 26:19, the age was (61.43±4.57) years old, and the Brunnstrom stroke classification included 14 patients with grade II, 21 patients with grade III, and 10 patients with grade IV. The control group received routine rehabilitation therapy, and the observation group received routine rehabilitation therapy + acupuncture and moxibustion based on the theory of meridians and tendons. Both groups were treated for 1 month. The changes of cerebrospinal fluid γ-aminobutyric acid (GABA) and glutamic acid (GLU) levels, traditional Chinese medicine (TCM) syndrome score, free-hand muscle strength, motor function of limbs, neurological deficit, and quality of life were observed in the two groups. t test was used for statistical analysis. Results　After intervention, the GABA level in the observation group was higher than that in the control group [(1.75±0.48) mol/L vs. (1.49±0.43) mol/L], and the levels of GLU and GLU/GABA were lower than those in the control group [(2.07±0.22) mol/L vs. (2.38±0.34) mol/L, 1.38±0.39 vs. 1.65±0.43] (all P<0.05); the scores of TCM syndromes in the observation group were lower than those in the control group (all P<0.05); there were statistically significant differences in the motor function of upper limb [(26.37±3.72) points vs. (21.16±3.54) points], motor function of lower limb [(17.46±2.74) points vs. (14.36±2.62) points], muscle strength of free hand (3.36±0.59 vs. 2.61±0.53), and nerve function defect degree [(9.34±1.74) points vs. (13.83±1.25) points] between the observation group and the control group (all P<0.05); the quality of life scores of the observation group were higher than those of the control group (all P<0.05). Conclusion　Acupuncture and moxibustion based on the theory of meridians and tendons helps the patients with limb spasticity after stroke to improve the spasticity of limbs, improve the muscle strength of limbs, promote the recovery of motor function, improve the neurological deficit, promote the prognosis, and improve the quality of life.

Key words:

Limb spasticity after stroke, Theory of meridians and tendons, Acupuncture and moxibustion, Limb motor function, Neural function defect, Free-hand muscle strength

摘要：

目的　探讨脑卒中后肢体痉挛患者采取基于经筋理论针灸疗法干预的效果。方法　选取2022年5月至2024年5月于宝鸡市中医医院接受治疗的90例脑卒中后肢体痉挛患者作为研究对象，按随机数字表法分为两组。对照组45例，男女比为28∶17，年龄（60.28±4.62）岁；Brunnstrom脑卒中分级Ⅱ级16例，Ⅲ级20例，Ⅳ级9例。观察组45例，男女比为26∶19，年龄（61.43±4.57）岁；Brunnstrom脑卒中分级Ⅱ级14例，Ⅲ级21例，Ⅳ级10例。对照组实施常规康复治疗，观察组实施常规康复治疗+基于经筋理论的针灸疗法。两组均干预1个月。对比两组脑脊液γ氨基丁酸（GABA）、谷氨酸（GLU）水平，中医症候积分、徒手肌力、肢体运动功能、神经功能缺损、生活质量变化情况。采用t检验进行统计学分析。结果　干预后，观察组的GABA水平高于对照组［（1.75±0.48）mol/L比（1.49±0.43）mol/L］，GLU、GLU/GABA水平低于对照组［（2.07±0.22）mol/L比（2.38±0.34）mol/L、1.38±0.39比1.65±0.43］（均P<0.05）；观察组各项中医证候积分均低于对照组（均P<0.05）；观察组上肢运动功能［（26.37±3.72）分］、下肢运动功能［（17.46±2.74）分］、徒手肌力（3.36±0.59）和神经功能缺损程度［（9.34±1.74）分］与对照组［（21.16±3.54）分、（14.36±2.62）分、2.61±0.53、（13.83±1.25）分］比较，差异均有统计学意义（均P<0.05）；观察组生活质量各项评分均高于对照组（均P<0.05）。结论　基于经筋理论的针灸疗法可帮助脑卒中后肢体痉挛患者改善肢体痉挛状态，提高四肢肌力，促进运动功能恢复，改善神经功能缺损及预后，进而提高生活质量。

关键词:

脑卒中后肢体痉挛, 经筋理论, 针灸疗法, 肢体运动功能, 神经功能缺损, 徒手肌力