针刺结合本体感觉神经肌肉促进技术治疗脑卒中后上肢痉挛性偏瘫疗效观察

目的 观察针刺结合本体感觉神经肌肉促进技术（proprioceptive neuromuscular facilitation，PNF）治疗脑卒中后上肢痉挛性偏瘫的临床疗效。方法 40例脑卒中后痉挛性偏瘫患者被随机分为观察组和对照组各20例。观察组接受针刺与PNF治疗，对照组接受针刺治疗。于治疗前和治疗4周后，分别观察两组患者改良Ashworth痉挛量表（modified Ashworth scale，MAS）分级、Fugl-Meyer 运动功能（Fugl-meyer motor assessment，FMA）评分、改良Barthel指数（modified Barthel index，MBI）评分。结果 与治疗前比较，治疗后两组患者上肢MAS分级明显降低，FMA评分及MBI评分均显著提高，差异均有统计学意义（P＜0.05）。治疗后，观察组FMA评分和MBI评分升高值显著大于对照组，差异均有统计学意义（P＜0.05）；观察组基于MAS分级的疗效优于对照组（P＜0.05）。结论 针刺结合PNF治疗脑卒中后上肢痉挛疗效确切，效果优于单纯针刺治疗。

Clinical Effect of Acupuncture Combined with Proprioceptive Neuromuscular Facilitation in Treatment of Upper Limb Spastic Hemiplegia After Stroke

Objective To evaluate the clinical effect of acupuncture combined with proprioceptive neuromuscular facilitation (PNF) in the treatment of upper limb spastic hemiplegia after stroke. Methods A total of 40 patients with spastic hemiplegia after stroke were randomly divided into observation group and control group, with 20 patients in each group. The patients in the observation group were treated with acupuncture and PNF, while those in the control group were treated with acupuncture alone. The two groups were compared in terms of modified Ashworth Spasm Scale (MAS), Fugl-Meyer Assessment (FMA) score, and modified Barthel Index (MBI) before treatment and after 4 weeks of treatment. Results Both groups had a significant reduction in the MAS grade of upper limbs and significant increases in FMA and MBI scores after treatment (P<0.05). Compared with the control group after treatment, the observation group had significantly greater increases in FMA and MBI scores (P<0.05) and a significantly better outcome based on the MAS grade (P<0.05). Conclusion Acupuncture combined with PNF has good efficacy in the treatment of upper limb spastic hemiplegia after stroke, with a better clinical effect than acupuncture alone.