电针剌激下肢穴位恢复脑卒中偏瘫患者步行功能

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应用电针刺激患侧下肢穴位的方法对脑卒中后偏瘫患者23例进行治疗,治疗后步态变化、行走能力均较治疗前有提高,独立步行由治疗前0例提高到6例.提示电针刺激治疗下肢穴位对下肢运动功能恢复有效.材料:脑卒中患者23例,男19例,女4例,年龄56~79岁,平均70岁.脑出血8例,脑梗死15例,所有患者均经脑CT或MRI证实,均有肢体偏瘫,意识清楚,配合治疗.方法:所有患者均经神经内科常规治疗,于脑卒中病情稳定后1周开始电针刺治疗.取穴:患侧下肢环跳、风池、委中、足三里、阳陵泉、悬钟穴进针,连接G;6805型电针刺治疗仪,应用低频脉冲调制电流,连续波,以患者能耐受、引起局部肌肉收缩的最大强度为宜.1~2次/d,20~30min/次,10 d为1个疗程.同时进行肢体主动被动训练及坐站、车行、下肢步行能力训练.结果:偏瘫患者步行能力评级:1级:严重偏瘫步态,基本不能行走.2级:偏瘫步态,平衡杠内可帮助步行.3级:轻度偏瘫步态,平衡杠内步行.4级:步态基本正常,能独立步行.本组治疗前后步行能力:治疗前1级6例,2级5例,3级12例.治疗后1级3例,2级4例,3级9例,4级7例.治疗后治愈7例(34%),明显好转12例.讨论:针刺作为外周感觉输入的一种特殊方式,能调整神经反向环路中各个运动神经元的兴奋性,与现代康复的促通技术无论在理论上还是临床应用方式上均有许多相似之处.电刺激治疗使肌肉产生节律性收缩,促进神经传导功能和加强肌肉忖收缩力,改善血液循环和淋巴回流,增强组织营养,促进新陈代谢.本组患者应用电针刺激后,瘫痪肢体功能恢复较快,说明电针刺激有较好的改善脑卒中后运动功能的作用.
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