动留针术治疗卒中后上肢痉挛临床疗效回顾性研究

Retrospective Study on Clinical Efficacy of Moving-Retained Acupuncture for Post-Stroke Upper Limb Spasticity

摘要: 目的：本研究为一项回顾性临床研究，旨在评估动留针术联合康复训练对卒中后上肢痉挛患者肌张力、运动功能及日常生活能力的干预效果。方法：研究纳入2022年1月至2025年1月重庆医科大学附属第二医院收治的60例卒中后上肢痉挛患者，依据治疗方案分为观察组与对照组各30例。观察组采用手阳明经穴位(肩髃、曲池、合谷等)动留针术结合常规康复训练，对照组仅接受常规康复训练，干预周期为4周。通过改良Ashworth量表、Fugl-Meyer上肢运动功能评分、改良Barthel指数及疼痛视觉模拟量表(VAS)评估治疗前后疗效。结果：治疗后观察组改良Ashworth量表评分显著低于对照组，分别为1.2 ± 0.4与1.7 ± 0.5；Fugl-Meyer上肢运动功能评分提升幅度较对照组更显著，分别达35.8 ± 6.1与28.6 ± 5.9；改良Barthel指数改善程度亦优于对照组，分别为52.6 ± 9.1与43.5 ± 8.9；疼痛视觉模拟量表评分降幅为3.5 ± 0.9分，显著高于对照组的1.2 ± 0.6分。观察组总有效率为86.7%，对照组为66.7%，组间差异具有统计学意义。结论：研究表明，动留针术联合康复训练可有效缓解卒中后上肢痉挛，改善运动功能及日常生活能力，疗效优于单纯康复治疗。研究受限于样本量及短期随访，未来需多中心大样本随机对照试验进一步验证其长期疗效及作用机制。

Abstract: Objective: This retrospective clinical study evaluated the therapeutic effects of Moving-Retained Acupuncture combined with rehabilitation training on muscle tone, motor function, and daily living abilities in post-stroke upper limb spasticity. Methods: Sixty patients with post-stroke upper limb spasticity admitted to The Second Affiliated Hospital of Chongqing Medical University from January 2022 to January 2025 were enrolled and equally divided into an observation group (30 cases) and a control group (30 cases). The observation group received Moving-Retained Acupuncture at Large Intestine Meridian points (LI15-Jianyu, LI11-Quchi, LI4-Hegu) combined with conventional rehabilitation, while the control group received conventional rehabilitation alone. Both groups underwent a 4-week intervention. Outcomes were assessed using the modified Ashworth Scale (MAS), Fugl-Meyer Assessment for Upper Extremity (FMA-UE), modified Barthel Index (MBI), and Visual Analog Scale (VAS). Results: Post-treatment results demonstrated significantly lower MAS scores in the observation group (1.2 ± 0.4 vs. 1.7 ± 0.5, P < 0.05) and greater improvements in FMA-UE (35.8 ± 6.1 vs. 28.6 ± 5.9), MBI (52.6 ± 9.1 vs. 43.5 ± 8.9), and VAS reduction (3.5 ± 0.9 vs. 1.2 ± 0.6) compared to the control group (all P < 0.01). The total effective rate was 86.7% in the observation group versus 66.7% in the control group (P < 0.05). Conclusion: These findings suggest that Moving-Retained Acupuncture combined with rehabilitation training significantly alleviates upper limb spasticity, enhances motor recovery, and improves daily living outcomes in post-stroke patients compared to rehabilitation alone. Study limitations include sample size constraints and short-term follow-up; future multicenter randomized controlled trials with larger cohorts are warranted to validate long-term efficacy and mechanistic underpinnings.