针刺联合针刀治疗中风后肘痉挛的临床研究 进展

Clinical Research Progress on Acupuncture Combined with Acupotomy in the Treatment of Post-Stroke Elbow Spasticity

摘要: 中风后肘痉挛是脑卒中患者常见并发症之一，影响患者上肢功能恢复以及生活自理能力。本文总结了针刺配合针刀治疗中风后肘痉挛相关研究进展。从文献中可以得知，针刺对于治疗中风后痉挛有良好效果，主要是由于针刺可以调节神经递质释放、改善局部血循环、促进神经功能重建等，对于中风后肘痉挛也有一定疗效。针刀是微创治疗方法，可以松解肌肉粘连、改善软组织张力、恢复关节活动度，对于中风后痉挛状态有很好疗效，在肘痉挛治疗中有一定优势。针刺与针刀联合应用可以发挥两者优势互补，针刺可以调节全身经络气血，改善神经功能状态，针刀可以松解局部病变组织，两者结合可以从整体和局部两个方面治疗中风后肘痉挛。近年来临床研究表明，联合疗法在改善肘关节活动度、降低肌张力、提高运动功能评分等方面优于单一疗法，而且安全性较好，不良反应较少。但是目前研究在样本量、随访时间、疗效评价标准等方面还存在一定问题，需要进一步进行大样本、多中心、随机对照试验以评价其远期疗效及安全性，为临床应用提供更可靠的依据。

Abstract: Objective: Post-stroke elbow spasticity is one of the common complications in stroke patients, affecting the recovery of upper limb function and the ability to perform daily activities. This article summarizes the research progress on acupuncture combined with acupotomy in the treatment of post-stroke elbow spasticity. From the literature, it can be seen that acupuncture has a good effect on post-stroke spasticity, mainly because it can regulate the release of neurotransmitters, improve local blood circulation, and promote neural function reconstruction, thereby showing certain efficacy in post-stroke elbow spasticity. Acupotomy is a minimally invasive treatment that can release muscle adhesions, improve soft tissue tension, and restore joint range of motion. It has a significant effect on post-stroke spasticity and offers distinct advantages in the treatment of elbow spasticity. The combined application of acupuncture and acupotomy can complement each other’s strengths: acupuncture regulates the meridians and qi and blood of the whole body and improves neural function, while acupotomy releases local pathological tissues. The combination treats post-stroke elbow spasticity from both systemic and local perspectives. In recent years, clinical studies have shown that combined therapy is superior to monotherapy in improving elbow joint range of motion, reducing muscle tone, and enhancing motor function scores, with good safety and few adverse reactions. However, current studies still have certain issues regarding sample size, follow-up duration, and evaluation criteria for efficacy. Large-scale, multicenter, randomized controlled trials are needed to assess long-term efficacy and safety, thereby providing a more reliable basis for clinical application.