世界中医药

目的：探讨针药结合康复训练的方法对中风偏瘫痉挛状态的康复疗效及安全性。方法：将80例中风偏瘫患者按照抽签方法随机地均分为对照组与治疗组，各为40例。对照组仅给予康复训练治疗，治疗组在此基础上给予针药二法治疗。比较2组临床治疗疗效、治疗前后改良Ashworth分级情况、Fugl-Meyer评分、Barthel指数评分及不良反应发生情况。结果：1）对照组临床治疗总有效率为77.50%（31/40）明显小于治疗组（100.00%）（P<0.05）。2）2组治疗后Ashworth分级情况改善明显优于治疗前，其差异具有统计学意义（P<0.05），且治疗组治疗后的Ashworth分级情况改善程度优于对照组治疗后，其差异具有统计学意义（P<0.05）。3）对照组治疗前后Fugl-Meyer评分分别为（36.78±9.59）分、（53.29±12.77）分，治疗组分别为（37.39±10.02）分、（69.05±19.38）分，2组治疗前Fugl-Meyer评分差异无统计学意义（P>0.05），但治疗后治疗组Fugl-Meyer评分明显高于对照组，其差异具有统计学意义（P<0.01）；对照组治疗前Barthel指数评分为（32.00±5.62）分与治疗组（33.27±6.08）分相比，差异无统计学意义（P>0.05），但治疗组治疗后Barthel指数评分（73.29±18.86）分明显高于对照组（57.77±14.51）分，其差异具有统计学意义（P<0.01），且治疗组治疗后Barthel指数评分显著大于对照组治疗后（P<0.05）；4）2组治疗过程中均未出现任何不良反应。结论：针药结合康复训练的方法对中风偏瘫痉挛状态的康复疗效显著，安全性高，值得在临床上加以推广并应用。

English Summary:

To explore the efficacy and safety of combined treatment of acupuncture，medicine and rehabilitation training in spasticity for stroke hemiplegia rehabilitation.Methods：Eighty cases of stroke patients with hemiplegia were randomly divided into control group (n=40) and observation group (n=40).The control group only gave patients rehabilitation training treatment，and observation group applied acupuncture and medicine besides the same treatment as the control group.The clinical curative effect，Ashworth grading before and after treatment，Fugl - Meyer scores，the Barthel index score and adverse reactions occurrence of two groups were compared.Results：1) The total effective rate of the control group was 77.50%，which was significantly less than the observation group (100.00%) (P<0.05); 2) modified Ashworth grading situation were greatly improved after treatment in both groups，and the differences were statistically significant (P<0.05)，observation group showed better Ashworth grading improvement compared with the control group (P<0.05); 3) the Fugl - Meyer score of the control group before and after treatment were respectively 36.78±9.59 and 53.29±12.77; Fugl - Meyer score of the observation group before and after treatment were respectively 37.39±10.02 and 69.05±19.38; there was no statistical significant difference between the two groups before the treatment in terms of the Fugl - Meyer score，but the difference after the treatment was statistically significant (P<0.05，P<0.01); Barthel index score of the control group before and after treatment were respectively 32.00±5.62 and 57.77 ± 14.51 points，and those of the observation group were respectively 33.27± 6.08 and 73.29 ± 18.86.After treatment，the Barthel index score between the two groups had statistical significant difference (P<0.05，P<0.01); 4)neither group occurred adverse reaction.Conclusion：Combined therapy of acupuncture，medicine and rehabilitation training treating spasticity for stroke hemiplegia rehabilitation shows distinct curative effect with high safety，and it is worth in clinical promotion and application.

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