PNF疗法联合针灸感觉区治疗偏瘫本体感觉障碍疗效观察

Observation of the Therapeutic Efficacy of PNF Therapy Combined with Acupuncture and Moxibustion at the Sensory Area for Hemiplegic Proprioceptive Dysfunction

摘要: 目的：观察PNF疗法结合大脑皮层投射区的感觉区针刺留针方法治疗脑卒中偏瘫侧本体感觉障碍的临床疗效，为中西医结合治疗卒中深感觉康复方案提供依据。方法：选取2025年1月~2026年6月黑龙江省海员总医院康复治疗部收治的66例脑卒中后本体感觉障碍患者为研究对象，应用随机数字表法分为对照组与治疗组，各33例。对照组给予常规康复干预，治疗组在常规方案基础上，采用PNF疗法联合大脑皮层投射区的感觉区针刺留针方法，两组均持续治疗8周，每周训练5天。分别于干预前1天、干预结束后次日，采用关节位置觉(JPS)误差评分、简化Fugl-Meyer运动功能量表(FMA)、改良Barthel指数(MBI)、Holden功能性步行分级进行评估，记录不良事件发生情况。结果：干预前两组患者基线资料、各功能评估指标差异均无统计学意义(P > 0.05)；干预8周后，治疗组临床总有效率达90.91%，显著高于对照组的72.73%，差异具有统计学意义(P < 0.05)；治疗组JPS误差评分显著低于对照组，FMA、MBI评分及Holden步行分级改善幅度均显著优于对照组(P < 0.05)；亚组分析显示，缺血性卒中、Brunnstrom运动功能分级3~4级患者疗效提升更明显(P < 0.05)。两组均未出现严重心脑血管意外、晕针、运动损伤等不良事件，安全性良好。结论：PNF疗法结合大脑皮层投射区的感觉区针刺留针可有效促进脑卒中偏瘫患者本体感觉重塑，提升运动功能、平衡能力与日常生活自理能力，远期效果稳定，操作安全简便，具有较高的临床推广价值。

Abstract: Objective: To observe the clinical efficacy of PNF therapy combined with acupuncture and needle retention in the sensory area of the cerebral cortex projection area for the treatment of proprioceptive disorders on the hemiplegic side of stroke, and to provide a basis for the integrated treatment of stroke deep sensory rehabilitation with traditional Chinese and Western medicine. Method: 66 patients with post-stroke proprioceptive disorders admitted to the Rehabilitation Treatment Department of Heilongjiang Seamen’s General Hospital from January 2025 to June 2026 were selected as the research subjects. They were randomly divided into a control group and a treatment group using a random number table method, with 33 cases in each group. The control group received routine rehabilitation intervention, while the treatment group received PNF therapy combined with needle retention in the sensory area of the cerebral cortex projection area on the basis of the routine plan. Both groups received continuous treatment for 8 weeks, with 5 days of training per week. On the day before intervention and the day after the end of intervention, joint position sense (JPS) error score, simplified Fugl-Meyer motor function scale (FMA), modified Barthel index (MBI), and Holden functional walking grading were used for evaluation, and the occurrence of adverse events was recorded. Result: There was no statistically significant difference in baseline data and functional evaluation indicators between the two groups of patients before intervention (P > 0.05); After 8 weeks of intervention, the total clinical effective rate of the treatment group reached 90.91%, significantly higher than the control group’s 72.73%, and the difference was statistically significant (P < 0.05); The JPS error score of the treatment group was significantly lower than that of the control group, and the improvement in FMA, MBI scores, and Holden walking grading was significantly better than that of the control group (P < 0.05); Subgroup analysis showed that patients with ischemic stroke and Brunnstrom motor function grades 3~4 had a more significant improvement in therapeutic efficacy (P < 0.05). Both groups did not experience any serious adverse events such as cardiovascular and cerebrovascular accidents, acupuncture-related syncope, or sports injuries, indicating good safety. Conclusion: The combination of PNF therapy and needle retention in the sensory area of the cerebral cortex projection can effectively promote proprioceptive remodeling in stroke patients with hemiplegia, improve motor function, balance ability, and daily self-care ability. The long-term effect is stable, the operation is safe and simple, and it has high clinical promotion value.