针刺联合镜像疗法治疗脑卒中患者上肢运动功能障碍临床疗效观察

目的 观察针刺联合镜像疗法治疗脑卒中患者上肢运动功能障碍的临床疗效。方法 将90例脑卒中上肢运动功能障碍患者按随机数字表法分为对照1组（30例，给予针刺治疗）、对照2组（30例，给予镜像疗法治疗）和观察组（30例，给予针刺联合镜像疗法治疗），疗程均为2周。比较3组患者治疗前后Fugl-Meyer评估量表上肢板块（Fugl-Meyer assessment upper extremity，FMA-UE）评分，Wolf运动功能测试（Wolf motor function test，WMFT）量表评分，改良Barthel指数（modified Barthel index，MBI），国际功能、残疾和健康分类（international classification of functioning，disability and health，ICF）评分及伸腕主动运动范围（active range of motion，AROM）和基于FMA-UE评分判定临床疗效。结果 观察组临床疗效优于对照1组和对照2组（P＜0.05）；治疗后3组患者FMA-UE评分、WMFT评分、MBI均较治疗前显著增加（P＜0.05），ICF评分显著减少（P＜0.05），且观察组FMA-UE评分、WMFT评分、MBI增加程度，ICF评分减少程度显著大于对照1组和对照2组（P＜0.05）；治疗后观察组患者伸腕AROM显著大于对照1组和对照2组（P＜0.05）。结论 针刺联合镜像疗法能有效改善脑卒中患者上肢运动功能障碍。

Clinical Effect of Acupuncture Combined with Mirror Therapy in Treatment of Upper Limb Dyskinesia in Patients with Stroke

Objective To investigate the clinical effect of acupuncture combined with mirror therapy in the treatment of upper limb dyskinesia in patients with stroke. Methods A total of 90 stroke patients with upper limb dyskinesia were divided into control group 1 (treated with acupuncture), control group 2 (treated with mirror therapy),and observation group (treated with acupuncture and mirror therapy) using a random number table,with 30 patient in each group,and the course of treatment was 2 weeks for all groups.The three groups were compared in terms of Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score,Wolf Motor Function Test(WMFT) score,modified Barthel Index(MBI),International Classification of Functioning, Disability and Health(ICF) score,active range of motion(AROM) for wrist extension,and clinical outcome based on FMA-UE score. Results The observation group had a significantly better clinical outcome than control groups 1 and 2 (P<0.05). After treatment,all three groups had significant increases in FMA-UE score,WMFT score,and MBI (P<0.05) and a significant reduction in ICF score (P<0.05),and compared with control groups 1 and 2,the observation group had significantly greater increases in FMA-UE score, WMFT score,and MBI and a significantly greater reduction in ICF score (P<0.05).After treatment, the observation group had a significantly greater AROM for wrist extension compared with the control groups 1 and 2 (P<0.05). Conclusion Acupuncture combined with mirror therapy can effectively improve the motor function of upper limbs in patients with stroke.