| 摘要: |
| 目的 观察应用超声弹性成像技术评价股四头肌神经入肌点针刺法治疗脑卒中后痉挛性偏瘫患者的临床疗效。方法 选取脑卒中偏瘫后下肢痉挛患者44例，随机分为治疗组和对照组各22例，两组均给予相同的基础治疗，对照组采用传统的循经取穴针刺治疗，治疗组采用股四头肌神经入肌点针刺疗法。2组患者分别于治疗前与治疗4个疗程后采用改良Ashworth分级、临床痉挛指数（CSI）、Berg平衡量表（BBS）评定，同时以剪切波超声弹性成像技术检测对照组及病例组患者治疗前后下肢股外侧肌、股内侧肌、股直肌及股二头肌，记录并比较组织弹性图和杨氏模量值，对结果进行统计分析。结果：2组患者BBS的评分均较治疗前明显提高（P﹤0.01），治疗组与对照组比较有统计学意义（P﹤0.05），2组下肢改良Ashworth及CSI评分均较治疗前明显下降（P﹤0.01），治疗组与对照组比较有统计学意义（P﹤0.05）；治疗前观察组患者患侧与正常对照组相应一侧下肢相关肌肉的杨氏模量比较有显著差异(均P<0.01)，观察组患者患侧治疗后股外侧肌、股内侧肌、股直肌及股二头肌杨氏模量值比治疗前下降(均P<0.05)，治疗组患侧下肢比对照组相应侧下肢下降的更明显(均P<0.01)。结论：股四头肌神经入肌点针刺法能够明显缓解脑卒中后偏瘫侧痉挛下肢的肌张力，提高脑卒中患者日常生活活动能力，其疗效优于传统针刺方法。 |
| 关键词: 针刺神经入肌点 超声弹性成像 杨氏模量 评价 痉挛 脑卒中 |
| DOI： |
| 投稿时间：2018-09-03修订日期：2018-11-20 |
| 基金项目:浙江省医药卫生科技计划项目（2017KY707）；浙江省医药卫生科技计划项目（2014KYA224）；浙江省台州市科技计划项目（14SF03）；温州医科大学高等教育教学改革项目（YBJG201621） |
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| Application of the ultrasound elastography in Assessing the Efficacy of acupuncture nerve entering points on musculi quadriceps femoris for spastic hemiplegia patients |
| fan liu-bo |
| (Taizhou Hospital Affiliated to Wenzhou Medical University) |
| Abstract: |
| ?Objective To observe the effects of acupuncture nerve entering points on musculi quadriceps femoris in lower limb spasticity after stroke with ultrasound elastography.Method 44 patients with who suffers spastic hemiplegia were divided into two groups. There were 22 patients in observation group which were treated by acupuncture nerve entering points on musculi quadriceps femoris, and 22 patients in control group which were treated only by the traditional acupuncture. Modified Ashworth Scale(MAS), clinic spasticity index （CSI）, Berg balance scale(BBS) and analysis of the tissue elastic graph and young''s modulus value were used as outcome measure pre- treatment and post- treatment after 4 weeks by two appointed raters. Result After treatment for 4 week . BBS scores in both groups were significantly increased , and the lower extremity modified ashworth scores and CSI in both groups were decreased significantly as compared with those before treatment (p﹤0.01).more observation in observation group (p﹤0.05). Longitudinal Young’s modulus values of the vastus lateralis, vastus medialis, rectus femoris and biceps femoris of therapy group were lower with before treatment during knee maximum isometric voluntary contraction (P<0.05), and observation group are more apparently than control group(P<0.01). Conclusion The method of acupuncture nerve entering points on musculi quadriceps femoris can effectively improve stroke patients lower limb function and promote the recovery of patients. The recuperative effect of opposing needling is superior to either only traditional acupuncture treatment. |
| Key words: cupuncture nerve entering points ultrasound elastography Young’s modulus evaluation Spasm stroke |
