针刺联合应象刺血治疗脑卒中后上肢痉挛性瘫痪临床观察

目的 观察针刺联合应象刺血治疗脑卒中后上肢痉挛性瘫痪的临床疗效。方法 将40例脑卒中后上肢痉挛性瘫痪患者随机分为两组，治疗组22例，对照组18例。治疗组采用应象刺血和常规针刺治疗，对照组采用巴氯芬治疗，1个月为1个疗程。观察治疗前后上肢肌张力的变化、运动功能的变化和日常生活活动能力的变化，1个疗程后观察临床疗效。结果 与治疗前比较，两组治疗后Fugl-Meyer量表（Fugl-Meyer assessment, FMA）、日常生活活动能力（activities of daily living, ADL)评分均显著升高（P<0.05）；治疗组治疗后FMA、ADL评分改善程度明显优于对照组（P<0.05）。与治疗前比较，两组治疗后肌张力均有所改善，但差异均无统计学意义（P＞0.05）。两组治疗后肌张力变化比较，差异无统计学意义（P＞0.05）。结论 针刺联合应象刺血可缓解脑卒中后上肢痉挛性瘫痪状态，不良反应小。

Clinical Efficacy of Acupuncture Combined with Bloodletting in Treatment of Post-stroke Upper Limb Spastic Paralysis

Objective To observe the clinical efficacy of acupuncture combined with bloodletting in the treatment of post-stroke upper limb spastic paralysis. Methods A total of 40 patients with post-stroke upper limb spastic paralysis were randomly divided into two groups: treatment group (n=22) and control group (n=18). The treatment group was administered bloodletting and conventional acupuncture, and the control group was treated with baclofen. One month was considered one course of treatment. The changes in upper limb muscle tone, motor function, and activities of daily living (ADL) after treatment were assessed. The clinical outcomes were evaluated after one course of treatment. Results After treatment, the scores on Fugl-Meyer assessment (FMA) and ADL scales were significantly increased in both treatment and control groups (P<0.05). Moreover, the treatment group had significantly greater improvements in FMA and ADL scores than the control group (P<0.05). Both groups had insignificant improvements in upper limb muscle tone after treatment (P>0.05), and there was no significant difference in the change in muscle tone between the two groups (P>0.05). Conclusion Acupuncture combined with bloodletting can attenuate post-stroke upper limb spastic paralysis without obvious side effects.