[1]李欣蔚,王亚楠,马晓东,等.针刺神经干治疗脑卒中后上肢痉挛疗效研究[J].陕西中医,2026,(2):264-269.[doi:DOI:10.3969/j.issn.1000-7369.2026.02.022]
　LI Xinwei,WANG Yanan,MA Xiaodong,et al.Study on therapeutic effect of acupuncture on nerve trunks in treatment of upper limb spasm after stroke[J].,2026,(2):264-269.[doi:DOI:10.3969/j.issn.1000-7369.2026.02.022]
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针刺神经干治疗脑卒中后上肢痉挛疗效研究

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年2期
页码:
264-269
栏目:
针灸经络
出版日期:
2026-02-05

文章信息/Info

Title:
Study on therapeutic effect of acupuncture on nerve trunks in treatment of upper limb spasm after stroke
作者:
李欣蔚1; 王亚楠1; 马晓东2; 袁洪超1
（1.黑龙江中医药大学附属第二医院哈南分院，黑龙江 哈尔滨 150000；2.黑龙江中医药大学附属第二医院，黑龙江 哈尔滨 150001）
Author(s):
LI Xinwei1; WANG Yanan1; MA Xiaodong2; YUAN Hongchao1
(1.Hanan Branch of the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150000，China；2.The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001，China)
关键词:
脑卒中; 上肢痉挛; 神经干刺激; 针灸疗法; 神经可塑性
Keywords:
Stroke; Upper limb spasm; Nerve trunk stimulation; Acupuncture therapy; Neural plasticity
分类号:
R 255.2
DOI:
DOI:10.3969/j.issn.1000-7369.2026.02.022
文献标志码:
A
摘要:
目的：探讨神经干刺激疗法对脑卒中后上肢痉挛患者的痉挛程度、运动功能、神经功能缺损、日常生活活动能力、桡动脉血流动力学、关节活动度、肌电活动及神经电生理的影响。方法：采用随机对照试验设计，纳入101例脑卒中后上肢痉挛患者，随机分为治疗组（神经干刺激疗法，51例）、对照组（常规针刺，50例）。两组均接受基础康复治疗及于氏头穴丛刺。治疗组选取内关、尺泽、极泉下行强刺激手法，不留针。对照组取肩髃、曲池等穴行平补平泻手法，留针40 min。治疗周期为4周。分别在治疗前、治疗2、4周后采用改良Ashworth量表、简化Fugl-Meyer上肢运动功能评定量表、美国国立卫生研究院卒中量表、Barthel指数及彩色多普勒超声检测桡动脉血流动力学参数、关节角度测量器测量肩手关节活动度、表面肌电分析仪检测积分肌电值(iEMG)及肌电诱发电位仪检测F波潜伏期与波幅进行评价。结果：重复测量方差分析显示，两组在痉挛程度、运动功能、神经功能、日常生活能力、血流动力学参数、肱二头肌与肱三头肌iEMG值、F波波幅及关节活动度的组间效应、时间效应及交互效应均有统计学意义（P＜0.05）。组间比较显示，治疗4周后，治疗组在改良Ashworth量表评分、NIHSS评分及舒张期反向血流速度的降低方面均优于对照组（均P＜0.05），而在Fugl-Meyer评分、Barthel指数及收缩期峰值流速的提升方面亦优于对照组（均P＜0.05）。治疗组在关节活动度（肩前屈、外展、内旋及掌指关节屈曲）、肱二头肌与肱三头肌iEMG值的降低，以及正中神经F波潜伏期的缩短和波幅的下降方面，均优于对照组（均P＜0.05）。结论：神经干刺激疗法能有效缓解脑卒中后上肢痉挛，改善患肢运动功能、神经功能缺损及日常生活活动能力，其作用机制可能与调节中枢运动控制及改善局部血流灌注有关。
Abstract:
Objective:To explore effects of nerve trunk stimulation therapy on spasticity,motor function,neurological deficits,activities of daily living,radial artery hemodynamics,joint range of motion,electromyographic activity and neuroelectrophysiological parameters in patients with upper limb spasticity after stroke.Methods:A randomized controlled trial was designed,and 101 patients with upper limb spasticity after stroke were included and randomly divided into treatment group (nerve trunk stimulation therapy,51 cases) and control group (conventional acupuncture,50 cases).both groups received basic rehabilitation treatment and Yu’s scalp acupuncture.In the treatment group,neiguan,Shize,and Jiquan were selected for strong stimulation without needle retention.In the control group,Jianyu and Quchi were selected for balanced tonification and dispersion with needle retention for 40 minutes.the treatment period was 4 weeks.the modified Ashworth scale,the Fugl-Meyer assessment of upper extremity,the national institutes of health stroke scale,the Barthel index,color doppler ultrasound for radial artery hemodynamic parameters,a goniometer for shoulder and wrist joint range of motion,a surface electromyography analyzer for integrated electromyography (iEMG) values,and a nerve conduction study for F-wave latency and amplitude were used for evaluation before treatment and at 2 and 4 weeks after treatment.Results:Repeated measures analysis of variance showed that there were statistically significant differences in the group effect,time effect,and interaction effect of spasticity,motor function,neurological deficits,activities of daily living,hemodynamic parameters,iEMG values of biceps brachii and triceps brachii,F-wave amplitude,and joint range of motion between the two groups (P<0.05).Group comparison showed that after 4 weeks of treatment,the treatment group had better improvement in modified Ashworth scale score,NIHSS score,and diastolic reverse blood flow velocity than the control group (all P<0.05),and also had better improvement in Fugl-Meyer score,Barthel index,and systolic peak flow velocity than the control group (all P<0.05).The treatment group had better improvement in joint range of motion (shoulder flexion,abduction,internal rotation,and metacarpophalangeal joint flexion),reduction in iEMG values of biceps brachii and triceps brachii,and shortening of median nerve F-wave latency and reduction in amplitude than the control group (all P<0.05).Conclusion:Nerve trunk stimulation therapy can effectively relieve upper limb spasticity after stroke,improve motor function,neurological deficits,and activities of daily living of the affected limb.The mechanism of action may be related to the regulation of central motor control and improvement of local blood perfusion.

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备注/Memo

备注/Memo:
黑龙江省中医药科研项目（ZHY2023-205）
更新日期/Last Update: 2026-02-09