目的

观察拮抗肌运动点电员针治疗对卒中后上肢痉挛的临床疗效。

方法

回顾性分析2011 年11 月至2014 年11 月黑龙江省东宁市人民医院康复医学科收治的卒中后上肢痉挛患者90 例。 按照随机数字表法分为治疗组与对照组，每组45 例，两组患者均进行基础治疗及康复训练，对照组采用拮抗肌运动点针刺疗法，治疗组采用拮抗肌运动点电员针疗法。 采用χ² 检验比较两组患者治疗4 周后临床疗效差异，采用Ridit分析比较两组患者改良Ashworth 量表（MAS）分级差异，采用t检验比较两组患者改良Barthel指数（BI）评分和Fugl-Meyer运动功能评分（FMA）差异。

结果

治疗4 周后，对照组和治疗组总有效率分别为64.44%（29/45）和86.67%（39/45），两组疗效比较，差异具有统计学意义（χ² =6.016 0，P＜0.05）。 对照组治疗前后、治疗组治疗前后和治疗后两组MAS 分级差异均有统计学意义（u=2.015 1、5.069 1、3.369 1，P均＜0.05）。 对照组治疗前后、治疗组治疗前后和治疗后两组BI指数评分差异均有统计学意义（t=2.44、5.19、2.54，P均＜0.05）。 对照组治疗前后、治疗组治疗前后和治疗后两组FMA评分差异均有统计学意义（t=2.51、5.64、2.80，P均＜0.05）。

结论

拮抗肌运动点电员针疗法可有效改善卒中患者上肢痉挛程度，提高患者运动功能水平及日常生活活动能力，值得临床推广。

Objective

To investigate the clinical curative effect of electric rounded needle treatment on muscular motor point of antagonistic muscle in patients with upper limb spasticity after stroke.

Methods

Ninety patients with upper limb spasm after cerebral apoplexy hospitalized in the department of rehabilitation medicine，Dongning city people's hospital from November 2011 to November 2014 were retrospectively analyzed in this study.According to random number table method patients were divided into the treatment group and control group，45 cases in each group.Two groups of patients were given the basic treatment and rehabilitation training.Patients of the control group were given acupuncture therapy at muscular motor point of antagonistic muscle.Patients of the treatment group were given electric rounded needle treatment at muscular motor point of antagonistic muscle.The clinical curative effect was compared between two groups using χ² test.Results of the modified Ashworth scale（MAS）in two groups of patients were compared by Ridit analysis.Results of the modified Barthel index（BI）score and Fugl-Meyer movement function score（FMA）were compared between two groups of patients by t test.

Results

After four-week treatment，there were significant differences in the total effective rates between control group and treatment group ［64.44% （29/45）and 86.67% （39/45），χ² =6.016 0，P＜0.05）］.There were significant differences in MAS grades before and after treatment between two groups（u =2.015 1，5.069 1，3.369 1，all P＜0.05）.There were significant differences in BI index scores before and after treatment between two groups（t=2.44，5.19，2.54，all P＜0.05）.There were also significant differences in FMA scores before and after treatment between two groups（t=2.51，5.64，2.80，all P＜0.05）.

Conclusion

The Dian Yuan Zhen treatment in muscular motor point of antagonistic muscle can effectively improve the degree of upper limb spasm in patients after stroke，which can improve the level of motor function and daily life of patients，and is worth clinical promotion.