中国针灸

目的：比较经筋针刺联合康复训练与常规针刺联合康复训练治疗脑卒中后痉挛性瘫痪的临床疗效。方法：将60例脑卒中后痉挛性瘫痪患者随机分为观察组和对照组，各30例。两组患者均接受常规康复训练，观察组采用经筋针刺治疗，针刺上肢肩、肘、腕和下肢髋、膝、踝处经筋结点；对照组采用常规针刺治疗，穴取患侧肩髃、曲池、合谷、髀关、风市、太冲等。两组均每日1次，每周5 d，共治疗4周。分别于治疗前后观察两组患者临床痉挛指数（CSI）、改良Ashworth量表、改良Barthel指数（MBI）和Fugl-Meyer运动功能评估量表（FMA）评分，并比较两组患者起效时间。结果：治疗后，两组患者CSI、改良Ashworth量表评分较治疗前降低（P<0.001）,MBI、FMA评分较治疗前升高（P<0.001）；观察组患者CSI、改良Ashworth量表评分低于对照组（P<0.05）,MBI评分高于对照组（P<0.05），两组患者FMA评分比较差异无统计学意义（P>0.05）。观察组起效时间早于对照组（P<0.05）。结论：经筋针刺联合康复训练和常规针刺联合康复训练均可有效治疗脑卒中后痉挛性瘫痪，经筋针刺联合康复训练疗效更明显，起效更快。

Objective To compare the clinical efficacy of jingjin needling combined with rehabilitation training and conventional acupuncture combined with rehabilitation training for post-stroke spastic paralysis. Methods A total of 60 patients with post-stroke spastic paralysis were randomly divided into an observation group and a control group, 30 cases in each one. Both groups received conventional rehabilitation training. In the observation group, jingjin needling was applied at tendon blockage points of the shoulder, elbow, wrist, hip, knee, and ankle. In the control group, conventional acupuncture was applied at Jianyu(LI15), Quchi(LI11), Hegu(LI4), Biguan(ST31), Fengshi(GB31), Taichong(LR3), etc. on the affected side.Treatment was given once daily, 5 days a week for 4 weeks in both groups. The scores of clinical spasticity index(CSI),modified Ashworth scale, modified Barthel index(MBI), and Fugl-Meyer assessment scale(FMA) were evaluated before and after treatment, and the onset time was compared between the two groups. Results After treatment, the scores of CSI and modified Ashworth scale were decreased compared with those before treatment(P<0.001), while the scores of MBI and FMA were increased compared with those before treatment(P<0.001) in the two groups. After treatment, the scores of CSI and modified Ashworth scale in the observation group were lower than those in the control group(P<0.05), the MBI score in the observation group was higher than that in the control group(P<0.05). There was no statistically significant difference in FMA scores between the two groups(P>0.05). The onset time of the observation group was earlier than that in the control group(P<0.05). Conclusion Both jingjin needling combined with rehabilitation training and conventional acupuncture combined with rehabilitation training can effectively treat post-stroke spastic paralysis, jingjin needling combined with rehabilitation training exhibits better therapeutic effect and rapider onset.