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邯郸市第一医院康复医学科,河北邯郸056004
贾晓沛,E-mail:w50rwe@163.com
收稿:2025-09-17,
修回:2025-12-29,
网络首发:2026-02-27,
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冯雅娟,贾晓沛,周丽军,等.手足十二针联合神经松动术对气虚血瘀型脑梗死偏瘫患者肢体运动功能的影响[J].针刺研究,XXXX,XX(XX):1-7.
FENG Ya-juan,JIA Xiao-pei,ZHOU Li-jun,et al.Effect of acupuncture of “twelve hand and foot acupoints” combined with neural mobilization on limb motor function in patients with cerebral infarction hemiplegia of qi-deficiency and blood-stasis type[J].Acupuncture Research,
冯雅娟,贾晓沛,周丽军,等.手足十二针联合神经松动术对气虚血瘀型脑梗死偏瘫患者肢体运动功能的影响[J].针刺研究,XXXX,XX(XX):1-7. DOI: 10.13702/j.1000-0607.20251006.
FENG Ya-juan,JIA Xiao-pei,ZHOU Li-jun,et al.Effect of acupuncture of “twelve hand and foot acupoints” combined with neural mobilization on limb motor function in patients with cerebral infarction hemiplegia of qi-deficiency and blood-stasis type[J].Acupuncture Research, DOI:10.13702/j.1000⁃0607.20251006.
目的
2
探讨手足十二针联合神经松动术对气虚血瘀型脑梗死(CI)偏瘫患者肢体运动功能、生活质量的影响。
方法
2
98例气虚血瘀型CI偏瘫患者按随机数字表法分为神经松动组(49例,脱落2例)和复合组(49例,脱落3例)。所有患者均进行基础治疗及康复锻炼,神经松动组加用神经松动术,1次/d,5 d/周,连续治疗4周。复合组在神经松动组基础上联合手足十二针(双侧内关、合谷、曲池、阳陵泉、足三里与三阴交)治疗,留针30 min,1次/d,5 d/周,连续治疗4周。采用中国卒中量表(CSS)评分评定神经功能缺损程度,比较两组治疗前后气虚血瘀证积分,采用Fugl-Meyer运动功能量表(FMA)评定肢体功能,血液流变检测仪测定血浆黏度及纤维蛋白原(Fib),采用脑卒中专用生活质量量表(SS-QOL)评定生活质量。
结果
2
治疗4周后,两组气虚血瘀证积分、CSS评分、血浆黏度及Fib均低于治疗前(
P
<
0.05),且复合组均低于神经松动组(
P
<
0.05);两组FMA评分、SS-QOL评分均高于治疗前(
P
<
0.05),且复合组均高于神经松动组(
P
<
0.05)。
结论
2
对气虚血瘀型CI偏瘫患者应用手足十二针联合神经松动术治疗,可有效调节血流变,明显改善症状、肢体运动功能,显著提高生活质量。
Objective
2
To observe the effect of acupuncture of “12 hand and foot acupoints” (in fact “12 acupoints at the hands and four limbs”) combined with neural mobilization intervention [a manual treatment method that directly applies force to some related nerve tissue through the placement and movement of multiple joints] on the limb motor function and quality of life in patients with cerebral infarction (CI) hemiplegia of
qi
-deficiency and blood-stasis type. Methods Ninety-eight patients with CI hemiplegia of
qi
-deficiency and blood-stasis type who were admitted to our hospital were randomly divided into a neural mobilization group (
n
=49) and a combination (acupuncture plus neural mobilization) group (
n
=49) using a random number table method. All patients underwent basic treatment and rehabilitation training,
and those of the neural mobilization group received various manipulations at different portions of the body related to the innervation of radial nerve, median nerve, ulnar nerve, sciatic nerve, common peroneal nerve, tibial nerve and femoral nerve through the placement and movement of multiple joints. The patients of the combination group received manual acupuncture stimulation of twelve acupoints (including bilateral Neiguan (PC6), Hegu (LI4), Quchi (LI11), Yanglingquan (GB34), Zusanli (ST36) and Sanyinjiao (SP6)) of the hand and limbs (with the acupuncture needles retained for 30 min in every session of treatment) on the basis of the neural mobilization. The treatment was conducted once daily, 5 days a week for 4 weeks. The score of
qi
-deficiency and blood-stasis syndrome was given according to “quantitative scoring scale for
qi
-deficiency and blood-stasis syndrome”. The limb motor function was assessed using Fugl-Meyer assessment scale (FMA). The blood plasma viscosity and fibrinogen levels were detected using a blood rheology analyzer. The score of quality of life was assessed using the stroke-specific quality of life scale (SS-QOL).
Results
2
After 4 weeks of treatment, the score of
qi-
deficiency and blood-stasis syndrome, CSS score, plasma viscosity and fibrinogen levels were significantly lower in both groups than pre-treatment (
P
<
0.05), and those of the combination group were obviously lower than those of the simple neural mobilization group (
P
<
0.05). The FMA scores of the upper and lower limbs and SS-QOL score were considerably increased in both groups compared with pre-treatment (
P
<
0.05,
P
<
0.01), and those of the combination group were strikingly higher than those of the neural mobilization group (
P
<
0.05). Conclusion Acupuncture of “twelve hand and foot acupoints” combined with neural mobilization can effectively regulate bloo
d rheology, improve symptoms and limb motor function, and raise the quality of life in patients with hemiplegia of qi-deficiency and blood-stasis type.
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