本文關(guān)鍵詞：屈伸肌交替低頻穴位電刺激促進中風(fēng)患者拇指運動功能恢復(fù)的臨床觀察　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 低頻穴位電刺激 電針 中風(fēng) 拇指 關(guān)節(jié)活動度 肌電峰值

【摘要】：目的:觀察屈伸肌交替低頻穴位電刺激與電針方法對中風(fēng)患者拇指運動功能障礙的臨床療效,進一步探討屈伸肌交替低頻穴位電刺激對中風(fēng)患者拇指關(guān)節(jié)活動度及相關(guān)肌肉的影響,優(yōu)化中風(fēng)上肢治療方案。方法:將符合納入標準的拇指運動功能障礙患者60例,采用隨機數(shù)字表法分成治療組和對照組,兩組各30例。治療前,采集兩組患者患側(cè)拇指外展、對掌的最大關(guān)節(jié)活動度及拇指側(cè)捏時拇指內(nèi)收肌群的肌電峰值。治療時,對照組應(yīng)用電針治療,波形選用連續(xù)波,頻率2Hz;治療組應(yīng)用低頻穴位電刺激治療,刺激模式為屈伸肌交替刺激,波形選用斷續(xù)波,斷續(xù)比1:1,頻率50Hz。兩組均每次治療30分,強度以患者耐受為度,每日1次,治療6天,休息1天,共治療4周。分別在治療前后選用M600肌電及關(guān)節(jié)活動度運動檢測系統(tǒng)檢測特征值(拇指側(cè)捏時,拇指內(nèi)收肌群表面肌電峰值,拇指對掌、外展時,關(guān)節(jié)最大活動度)、Lindmark運動功能評分(腕、手)、改良Barthel指數(shù)評分(上肢部分)和神經(jīng)功能缺損評分(CSS)來評價療效,利用統(tǒng)計學(xué)軟件SPSS19.0對數(shù)據(jù)進行處理與分析。結(jié)果:1.低頻穴位電刺激組與電針組患者治療后患側(cè)拇指側(cè)捏時拇指內(nèi)收肌群表面肌電峰值較治療前明顯增高,差異具有統(tǒng)計學(xué)意義(p0.01),且兩組患者拇指內(nèi)收肌群肌電峰值、治療前后差值的組間比較,差異具有統(tǒng)計學(xué)意義(P0.05),治療組優(yōu)于對照組。2.低頻穴位電刺激組與電針組患者治療后患側(cè)拇指外展、對掌角度較治療前明顯增大,差異具有統(tǒng)計學(xué)意義(P0.01),且兩組患者拇指外展、對掌角度、治療前后差值的組間比較,差異具有統(tǒng)計學(xué)意義(P0.01),治療組優(yōu)于對照組。3.低頻穴位電刺激組與電針組患者治療后Lindmark運動功能評分(腕、手)、改良Barthel指數(shù)評分(上肢部分),與治療前相比均有明顯提高;神經(jīng)功能缺損評分(CSS)較治療前相比,明顯降低,差異具有統(tǒng)計學(xué)意義(P0.01),且兩組患者各量表評分、治療前后差值的組間比較,差異具有統(tǒng)計學(xué)意義(P0.05),治療組優(yōu)于對照組。4.低頻穴位電刺激組總有效率為90%,電針組總有效率為63.33%,兩組有效率對比,差異具有統(tǒng)計學(xué)意義(P0.01),低頻穴位電刺激組總有效率高于電針組。結(jié)論:1.低頻穴位電刺激與電針治療均能改善中風(fēng)患者患肢拇指運動功能,對于中風(fēng)患者拇指運動功能重建具有顯著療效,且低頻穴位電刺激治療明顯優(yōu)于電針治療效果。2.低頻穴位電刺激對于拇指內(nèi)收肌群肌力改善明顯,可能通過提高拇指周邊肌肉肌力從而使拇指關(guān)節(jié)活動度得到擴大。3.低頻穴位電刺激能改善手指精細運動功能,綜合提高患者上肢精細運動能力,提高患者日常生活能力。
[Abstract]:Objective: to observe the clinical effect of alternating low frequency acupoint electric stimulation and electroacupuncture on motor dysfunction of thumb in patients with apoplexy. To further investigate the effect of alternating low frequency acupoint electrical stimulation of flexion and extensor on the motion of thumb joint and related muscles in patients with apoplexy. Methods: 60 patients with thumb motor dysfunction were randomly divided into treatment group and control group, 30 cases in each group. Before treatment, 60 patients with thumb motor dysfunction were divided into two groups: control group (n = 30), control group (n = 30) and control group (n = 30). The maximal joint activity and the peak value of the adductor muscle group of the thumb were collected in the two groups. The control group was treated with electroacupuncture, the waveform was continuous wave and the frequency was 2Hz. The treatment group was treated with low frequency acupoint electrical stimulation, the stimulation mode was alternately flexion and extensor muscle stimulation, the waveform was selected as intermittent wave, the intermittent ratio was 1: 1, and the frequency was 50 Hz. The two groups were treated for 30 minutes each time. The intensity was determined by patient tolerance once a day for 6 days and rest for 1 day for a total of 4 weeks. M600 electromyography and joint motion measurement system were used before and after treatment respectively to detect the characteristic values (thumb side pinch). The maximal motion of the joint was evaluated by Lindmark motor function score (wrist, hand). Modified Barthel index score (upper limb part) and neurologic impairment score (NDS) were used to evaluate the efficacy. The data were processed and analyzed by the statistical software SPSS19.0. Results:. 1. The peak value of surface electromyography of adductor muscle group was significantly higher in patients with low frequency acupoint stimulation and electroacupuncture than before treatment. The difference was statistically significant (P 0.01), and the peak value of adductor muscle group in the two groups, the difference between the groups before and after treatment, the difference was statistically significant (P 0.05). The treatment group is superior to the control group .2.The low-frequency acupoint electrical stimulation group and electroacupuncture group after treatment of thumb abduction, the palmar angle was significantly larger than before treatment, the difference was statistically significant (P 0.01). And the two groups of thumb abduction, palm angle, difference before and after treatment, the difference was statistically significant (P 0.01). The treatment group is superior to the control group .3.The low frequency acupoint electrical stimulation group and electroacupuncture group patients after treatment Lindmark motor function score (wrist, hand, modified Barthel index score (upper limb part)). Compared with before treatment, there was significant improvement. The neurological impairment score (CSS) was significantly lower than that before treatment, the difference was statistically significant (P 0.01), and the scores of each scale and the difference before and after treatment were compared between the two groups. The difference was statistically significant, the treatment group was better than the control group .4.The total effective rate of the low frequency acupoint stimulation group was 90, the total effective rate of the electroacupuncture group was 63.33, the effective rate of the two groups was compared. The total effective rate of low frequency acupoint electrical stimulation group was higher than that of electroacupuncture group. Conclusion the low frequency acupoint electrical stimulation and electroacupuncture treatment can improve the motor function of the affected limb thumb in apoplexy patients. For stroke patients with motor function reconstruction has a significant effect, and the low frequency acupoint electrical stimulation treatment is significantly better than electroacupuncture treatment effect. 2. Low frequency acupoint electrical stimulation for the thumb adductor muscle group improved significantly. It is possible to increase the muscle strength of the peripheral muscles of the thumb so as to expand the motion of the joint of the thumb .3.Electric stimulation at low frequency acupoints can improve the fine movement function of the finger and improve the fine motor ability of the upper extremity of the patients. Improve the ability of daily life of patients.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.6

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