Objective: To observe the effect of acupuncture at Huatuo Jiaji (EX-B2) combined with core muscle training on motor function of lower limbs, balance function and core muscle in patients with hemiplegia after stroke.
Methods: A total of ninety-six patients with hemiplegia after stroke were randomly and equally divided into acupuncture, training and combination groups (n=32 cases in each). Patients of the acupuncture group were given acupuncture at the 5th, 7th, 9th and 11th chest vertebrae, and the 1st to 5th lumbar vertebrae of EX-B2. Patients in the training group received core muscle training. In the combination group, both acupuncture treatment and core muscle training were given to the patients. The treatment was conducted once daily, 5 times a week for 4 weeks. The Fugl-Meyer lower limb motor function score (FMA), Berg balance function scale (BBS), Barthel index (BI) and surface electromyography (sEMG) of the erector spinae and rectus abdominis were evaluated before and after treatment and during the follow-up period.
Results: Compared with the scores before the treatment, the FMA, BBS and BI scores were obviously increased after the treatment and during the follow-up period in the three groups respectively (P<0.05). After treatment and during the follow-up period, the root mean square (RMS) of erector spinae and rectus abdominis in the sitting position flexed 45° and extended 30° on the healthy and affected side were higher than those of the same side before treatment in the three groups (P<0.05). The therapeutic effect of combination of acupuncture at EX-B2 and core muscle training was obviously superior to that of single acupuncture or single training (P<0.05). Before the treatment, the RMS of erector spinae and rectus abdominis in the sitting position flexed 45° and extended 30° on the affected side were lower than those of the healthy side in the three groups (P<0.05), while there was no significant difference between the RMS of the erector spinae and rectus abdominis of the affected side and the healthy side in the comprehensive group after treatment and during the follow-up period (P＞0.05).
Conclusion: Acupuncture at EX-B2 combined with core muscle training can significantly improve the balance function and lower limb motor function of patients with hemiplegia after stroke.
目的：探讨针刺华佗夹脊穴结合核心肌群训练对脑卒中偏瘫患者下肢运动功能、平衡功能和核心肌群的影响。方法：将96例脑卒中偏瘫患者随机分为针刺组、核心肌群训练组和综合组，每组32例。针刺组给予针刺华佗夹脊穴治疗，取第5、7、9、11胸椎及第1—5腰椎相应的华佗夹脊穴；核心肌群训练组给予核心肌群训练；综合组在针刺华佗夹脊穴的基础上给予核心肌群训练。以上治疗均1次/d，5次/周，连续4周。分别评价治疗前后和随访期的Fugl-Meyer下肢运动功能(FMA)、Berg平衡功能量表(BBS)、Barthel指数(BI)和竖脊肌、腹直肌表面肌电图(sEMG)。结果：治疗后和随访期，3组患者下肢FMA、BBS、BI评分较本组治疗前均升高(P<0.05)，且综合组以上指标较同时点针刺组和核心肌群训练组均升高(P<0.05)。治疗后和随访期，3组患者在坐位前屈45°、后伸30°情况下，健侧、患侧的竖脊肌、腹直肌的均方根值(RMS)均高于本组同侧治疗前(P<0.05)，且综合组患者健侧、患侧竖脊肌、腹直肌的RMS均高于同时点针刺组和核心肌群训练组同侧(P<0.05)。治疗前，3组患者在坐位前屈45°、后伸30°情况下患侧的竖脊肌、腹直肌的RMS均低于本组健侧(P<0.05)；治疗后和随访期，针刺组和核心肌群训练组患者在坐位前屈45°、后伸30°情况下患侧竖脊肌、腹直肌的RMS仍低于本组同时点健侧(P<0.05)，而综合组患者患侧的竖脊肌、腹直肌的RMS与本组同时点健侧比较差异无统计学意义(P＞0.05)。结论：针刺华佗夹脊穴结合核心肌群训练可改善脑卒中偏瘫患者的肢体平衡、下肢运动能力，提高患者的日常生活活动能力。.
Keywords: Acupuncture; Core muscle training; Huatuo Jiaji (EX-B2); Lower limb motor function; Stroke.