王东岩1.2，杨海永2，董　旭1.2，张　蕊2，宋　晶2，何　雷2

（1黑龙江中医药大学，哈尔滨150001；2黑龙江中医药大学附属第二医院，哈尔滨150001）

摘要：目的：观察电针结合屈伸肌交替低频穴位电刺激治疗和电针治疗对中风后下肢功能障碍患者步行能力的影响，优化临床治疗方案。方法：将60例符合纳入标准的患者随机分为对照组和试验组，每组30例。两组患者均接受针灸科常规治疗。对照组接受常规电针治疗，选取患侧阳陵泉、足三里、悬钟与丘墟，采用频率为2Hz的连续波，每日治疗2次，每次30分钟，治疗6天，休息1天，共治疗28天；试验组在电针治疗基础上接受屈伸肌交替低频穴位电刺激治疗，选取患侧阳陵泉、悬钟；承山、昆仑，采用断续波，断续比（1:1），频率为50Hz，每次治疗20分钟。每日1次，治疗6天，休息1天，共治疗28天。采用RM Gait步态分析系统（步长、步速、步频及患侧单支撑相），运动功能评定表（Fugl-Meyer量表），日常生活活动表Barthel指数，Tinnetti平衡步态评分进行疗效判定。利用SPSS 20.0统计软件对数据进行处理与分析。结果：1.治疗后对照组与试验组患者患侧步长、步速、步频与患侧单支撑相占整个步态周期百分比较疗前均有改善，两组患者疗后疗前组内差异均具有统计学意义（P＜0.01），试验组患者患侧步长、步速、步频与患侧单支撑相占整个步态周期百分比较对照组显著改善，两组患者疗后组间差异具有统计学意义（P＜0.05），电针结合屈伸肌交替低频电刺激治疗优于电针治疗。2.治疗后对照组与试验组患者的下肢Fulg-Meyer评分、Barthel指数、Tinnetti平衡步态评分较治疗前均改善，两组患者疗后疗前组内差异具有统计学意义（P＜0.01），治疗后试验组患者下肢Fulg-Meyer评分较对照组显著改善，两组患者疗后组间差异具有统计学意义（P＜0.05），电针结合屈伸肌交替低频电刺激治疗优于电针治疗。结论：1.电针结合屈伸肌交替低频穴位电刺激治疗与电针治疗均能改善中风偏瘫患者下肢功能障碍，提高中风偏瘫患者步行能力。2.电针结合屈伸肌交替低频穴位电刺激对改善中风后下肢功能障碍疗效优于常规电针治疗。

关键词：针灸推拿学；中风；屈伸肌交替刺激法；下肢；功能重建；步态分析

Effects of the Combination of Electroacupuncture and Flexor and Extensor Alternative Low-frequency Electrical Stimulation on Walking Ability of Apoplectic Semiplegia Patients

WANG Dongyan1.2,YANG Haiyong2,DONG Xu1.2,ZHANG Rui2,SONG Jing2,HE Lei2

(Heilongjiang University of Chinese Medicine, Harbin 150001,China; 2Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150001)

ABSTRACT Objective Using the Gait analysis to observe the effects between the combination of electroacupuncture and flexor and extensor alternative low-frequency electrical stimulation on walking ability of apoplectic semiplegia patients, to confirm the effects of the method of flexor and extensor alternate low-frequency electrical stimulation and provide a truly effective treatment measures for clinical rehabilitation.Methods: We selected 60 apoplectic semiplegia patients with walking disorder and randomly divided them into the treatment group and the control group within 30 cases each group. Both two groups of patients were treated with basis of rehabilitation therapy. The control group received electroacupuncture therapy, continuous wave, frequency is 2Hz, 30 minutes every day lasting 28days and with one day rest every six days .stimulating acupoints are zusanli yanglinquan xuanzhong and qiuxu on the affected side. The treatment group received flexor and extensor alternation of low-frequency electrical acupoint stimulation treatment after the electroacupuncture therapy,discontinuous wave,frequency is 50Hz,20 minutes each time,and the stimulating acupoints are yanglingquan, xuanzhong, chengshan and Kunlun on the affected side. The duration of treatment in the treatment group were the same as the control group. Using RM Gait analysis system, Fulg-Meyer score, Barthel(ADL) index and Tinnetti balanced gait score evaluates the treatment effects. SPSS 20.0 statistical software was used to process the data.Results:Firstly. The differences between prior treatment and post treatment among stride length, velocity, cadence, single support phase time on the affected side, of two groups patients are pretty significant (P<0.01). The difference between prior treatment and post treatment among stride length,velocity,cadence,single support phase time on the affected side in the treatment group are significant when compared with the control group (P<0.05), the treatment group is better than the control group;Secondly. The differences between prior treatment and post treatment in the Fulg-Meyer score ,Tinnetti balanced gait score and Barthel(ADL) index of two groups of patients are pretty significant (P <0.01). The difference between prior treatment and post treatment of Fulg-Meyer score ,Tinnetti balanced gait score and Barthel(ADL) index in the treatment group are significant when compared the control group (P<0.05),the treatment group is better than the control group.Conclusion:1. Both Electroacupuncture therapy and flexor and extensor alternate low-frequency electrical stimulation treatment and the conventional low-frequency electrical acupoint stimulation treatment can improve the function of walking ability;2. Effect of electroacupuncture combined with flexor and extensor alternative low-frequency electrical acupoint stimulation treatment is better than the conventional electroacupuncture treatment on improving the function of walking ability.

Keywords Acu-moxibustion and Tuina，Stroke, flexor and extensor alternative stimulation, Lower limbs, functional reconstruction, Gait analysis