世界科学技术-中医药现代化2025，Vol.27Issue(4)：962-972,11.DOI:10.11842/wst.20240304007
耳皮内刺改善Brunnstrom Ⅰ期缺血性中风后偏瘫患者上肢功能:单盲、随机对照临床研究
Upper Limb Function in Post-ischemic Stroke Hemiplegia Patients with Stage Brunnstrom Ⅰ Treated with Auricular Intradermal Acupuncture:A Single-Blinded,Randomized Controlled Clinical Trial
摘要
Abstract
Background Previous studies have demonstrated that the vagus nerve stimulation improves upper limb function in patients with stroke sequelae(six month-two years).This study aimed to investigate whether the auricular intradermal acupuncture(AIA)acted on the auricular branch of the vagus nerve can facilitate the recovery of upper limb motor function and expedite the effects and characteristics of rehabilitation processes in flaccid phase after stroke in Phase Brunnstrom Ⅰ.Methods This study utilized a randomized controlled single-blinded clinical design.Patients with ischemic stroke in Phase Brunnstrom Ⅰ were randomly assigned to the auricular intradermal acupuncture(AIA)group(AIA,standard rehabilitation,conventional acupuncture)or the sham auricular intradermal acupuncture(sham AIA)group(the sham AIA,standard rehabilitation,conventional acupuncture)for 6 days of 1 week(6 times).Primary outcome measures:Brunnstrom(Ueda Assessment),Fugl-Meyer assessment of the upper extremity(FMA-UE)and its subtype score(FMA-UEFS,FMA-UEES),Wolf motor function test scale(WMFT).Secondary outcome measures:Upper limb active range of joint motion(AROM),manual muscle test(MMT)of upper limb muscles,Barthel index(BI).Results Of the 332 patients who were screened,70 patients met the criteria and were recruited.There were 35 patients in the AIA group,1 patient was fall off,34 patients were actually completed;35 patients in the sham AIA group had no falling off case.Primary outcome measures:The upper Ueda assessment of the AIA group were better than those of the sham AIA group after treatment on days 3 and 6(P<0.05,P<0.001,respectively).The FMA-UEFS score on days 6 of the AIA group were significantly better than those of the sham AIA group(P<0.05).FMA-UEES of the AIA group was more associated with FMA-UE than FMA-UEFS with FMA-UE after treatment on day 6(FMA-UEFS:r=0.728,P<0.001;FMA-UEES:r=0.744,P<0.001).After 3 days and 6 days of treatment,the AIA group of the WMFT were significantly improved in the sham AIA group(P<0.05,P<0.001,respectively).Secondary outcome measures:AROM:After 6 days of treatment,the AIA group of shoulder abduction were more improved than in the sham AIA group(P<0.05).MMT:The muscle strength of elbow flexion,and elbow extension muscle improved more in the AIA group than in the sham AIA group(P<0.05).Barthel index(BI):After 6 days of treatment,there was a significant improvement in the group compared with before treatment(P<0.05),but no difference compared with the group(P>0.05).Conclusions AIA combined with conventional rehabilitation and acupuncture,can effectively improve the upper limb motor function of patients with post-ischemic stroke flaccid hemiplegia and accelerates the rehabilitation process of upper limb motor function.Clinical Trial Registration The study protocol is registered withhttp://www.chictr.org.cn(accession number:ChiCTR2200058141).关键词
耳皮内刺/偏瘫/软瘫期/迷走神经/上肢功能Key words
Auricular intradermal acupuncture/Hemiplegia/Flaccid Hemiplegia after Ischemic Stroke/Vagus nerve stimulation/Upper limb function分类
医药卫生引用本文复制引用
林萍,唐庆福,高亚婷,徐超,邓翠翠,廖瑶,陈文娟,卢洁,姜劲峰..耳皮内刺改善Brunnstrom Ⅰ期缺血性中风后偏瘫患者上肢功能:单盲、随机对照临床研究[J].世界科学技术-中医药现代化,2025,27(4):962-972,11.基金项目
2022年度省中医药科技发展计划项目(MS2022118):基于步态分析的足部点刺改善Brunnstrom Ⅲ期偏瘫患者下肢运动功能的临床研究,负责人:卢洁 （MS2022118）
2023年扬州市卫生健康委员会科研项目(2023-4-18):基于体表VNS的耳皮内刺改善Brunnstrom Ⅲ期偏瘫上肢运动功能临床研究,负责人:卢洁. （2023-4-18）
