电针联合下肢机器人康复技术对脑卒中患者步行功能的影响^①

王 猛 ^② ,张志娟,汤雲婷

(河南大学第一附属医院康复医学科,河南 开封 475000)

摘要 目的:探究电针联合下肢机器人康复技术对脑卒中(CA)患者步行功能的影响。 方法:选取 120 例 CA 患者,按照随机数字表法分成 A 组和 B 组,每组各 60 例。 B 组接受下肢机器人康复技术治疗,A 组于 B 组基础上联合电针治疗。 对比两组治疗前后 Fugl-Meyer 运动功能测评量表(FMA)评分、Berg 平衡量表(BBS)评分、功能性步行分级(FAC)、神经递质指标水平、患肢皮肤交感神经反应(SSR)潜伏期、波幅。 结果:治疗后,A 组 FMA、BBS 评分以及血清神经递质指标水平高于 B 组(P<0.05);FAC 分级优于 B 组(P<0.05);SSR 潜伏期较 B 组长,SSR 波幅较 B 组低(P<0.05)。 结论:电针联合下肢机器人康复技术治疗 CA 患者,可有效调节神经递质,改善下肢运动功能。

关键词: 脑卒中;电针;下肢机器人康复技术;步行功能

中图分类号:R743 文献标志码:A 文章编号:1008-2409(2022)03-0040-05

Effects of electroacupuncture combined with lower limb robotic rehabilitation technology on walking function in cerebral apoplexy patients ^①

WANG Meng ^② , ZHANG Zhijuan, TANG Yunting. (Dept. of Rehabilitation Medicine, the 1 stAffiliated Hospital of Henan University, Kaifeng 475000, China)

Abstract Objective: To investigate the effect of electroacupuncture combined with lower limb robotic rehabilitation technology on the walking function of patients with cerebral apoplexy(CA). Methods: 120 CA patients were randomized two groups, each with 60 cases. Group B received lower limb robotic rehabilitation therapy, while Group A received electroacupuncture on the basis of Group B. The scores of Fugl-Meyer Motor Function Assessment ( FMA), Berg balance scale ( BBS), Functional ambulation category(FAC), levels of neurotransmitter indexes, and the sympathetic skin response(SSR)latency and amplitude of the affected limbs were compared between both groups. Results: After treatment, FMA and BBS scores and serum neurotransmitter index levels in Group A were higher than those in Group B(P<0.05); FAC classification was better than that in Group B(P<0.05); SSR latency was longer than that in Group B, and the SSR amplitude was lower than that in Group B(P<0.05). Conclusion: Electroacupuncture combined with lower extremity robotic rehabilitation therapy in the treatment of CA patients can effectively regulate neurotransmitters and improve lower extremity motor function.

Keywords: cerebral apoplexy(CA); electroacupuncture; lower limb robotic rehabilitation technology;walking function

参考文献:

[1] JOY M T,CARMICHAEL S T. Encouraging an excitable brain state:mechanisms of brain repair in stroke[J]. Nat Rev Neurosci,2021,22(1):38-53.

[2] LEE S,JIANG B,HEIT J J,et al.Cerebral perfusion in pediatric stroke:children are not little adults[J].Top Magn Reson Imaging,2021,30(5):245-252.

[3] 张伟,冯晓东,任彬彬,等.局部振动结合肌电生物反馈治疗对脑卒中后偏瘫患者步行能力的影响[J].中华物理医学与康复杂志,2019,41(11):850-852.

[4] 路芳,朱琳,宋为群.下肢康复机器人联合虚拟现实技术对脑卒中患者下肢功能的影响[J].中国康复医学杂志,2018,33(11):1301-1306.

[5] 胡靖然,陈小飞.虚拟现实技术联合下肢康复机器人训练对缺血性脑卒中患者下肢功能及平衡能力影响的研究[J].中国康复,2020,35(12):633-636.

[6] 吉贞料,王高岸,张长杰.头穴透刺联合持续经颅磁刺激治疗脑卒中后运动功能障碍疗效观察[J].现代中西医结合杂志,2021,30(8):830-833,860.

[7] 郝强,郝春华,庄贺,等.电针结合康复训练治疗脑卒中后足内翻临床观察[J].山东中医杂志,2020,39(9):957-960.

[8] 中华医学会神经病学分会,中华医学会神经病学分会神经康复学组,中华医学会神经病学分会脑血管病学组,等.中国脑卒中早期康复治疗指南[J].中华神经科杂志,2017,50(6):405-412.

[9] LI H Q,LONG D H,LI B,et al.A clinical study to assess the influence of acupuncture at "Wang′s Jiaji" acupoints on limb spasticity in patients in convalescent stage of ischemic stroke:study protocol for a randomized controlled trial[J].Trials,2019,20(1):419-424.

[10] 罗姣,黄程,李丹,等.高压氧联合早期康复治疗脑卒中的疗效及神经功能恢复的影响因素分析[J].解放军预防医学杂志,2019,37(4):75-76.

[11] 李丹丹,王明选,沈小程.分期电针联合头穴久留针治疗对急性缺血性脑卒中患者下肢运动功能的影响[J].四川中医,2021,39(1):191-193.

[12] 王小萌,吴全娥.芍甘木瓜汤对脑卒中后痉挛大鼠神经递质的影响[J].中国中医基础医学杂志,2019,25(3):311-313,329.

[13] 张东平,张波,郑磊,等.卒中患者手功能与桡动脉血供及交感神经皮肤反应的相关性分析[J].重庆医科大学学报,2020,45(1):139-141.

PDF下载：点击下载