【目的】 观察腹针联合针康法治疗脑卒中后下肢痉挛性瘫痪的临床疗效。【方法】 选取 2024年 1月至 2024年 12月黑龙 江中医药大学附属第二医院病房及门诊收治的104例明确诊断为脑卒中后下肢痉挛性瘫痪的患者为研究对象。按随机数字表 将患者随机分为观察组和对照组，每组各52例。2组患者均给予常规康复性训练和基础治疗，对照组给予针康法治疗，观察 组在对照组治疗的基础上，给予腹针治疗。共治疗2周。治疗2周后，评价2组临床疗效。观察2组患者治疗前后中医证候 积分和肌张力分级的变化情况，以及痉挛指数（CSI）评分、Fugl-Meyer运动功能评分的情况。比较 2组患者治疗前后生活质 量测定量表（QOL-BREF）评分与改良 Barthel 指数（MBI）评分的变化情况。并评价 2 组的安全性及不良反应的发生情 况。【结果】（1）治疗后，2组患者的肌张力分级均明显改善（P＜0.05），且观察组在改善肌张力分级方面明显优于对照组，差 异有统计学意义（P＜0.05）。（2）治疗后，2 组患者的 CSI 评分、Fugl-Meyer 评分明显改善（P＜0.05），且观察组在改善 CSI 评 分、Fugl-Meyer 评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）治疗后，2 组患者的中医证候积分明显改善 （P＜0.05），且观察组在改善中医证候积分方面明显优于对照组，差异有统计学意义（P＜0.05）。（4）治疗后，2组患者的MBI、 QOL-BREF评分明显改善（P＜0.05），且观察组在改善MBI、QOL-BREF评分方面明显优于对照组，差异有统计学意义（P＜ 0.05）。（5）2组患者的不良反应发生率比较，差异无统计学意义（P＞0.05）。【结论】 腹针联合针康法治疗脑卒中后下肢痉挛性 瘫痪，能明显改善患者的临床症状，减轻患者患肢肌张力增高及痉挛的情况，促进下肢功能的恢复，从而提高患者的生活 质量，临床疗效显著。

Objective To evaluate the clinical efficacy of abdominal acupuncture combined with “acupuncturerehabilitation” therapy in patients with post-stroke lower limb spastic paralysis. Methods A total of 104 patients diagnosed with post-stroke lower limb spastic paralysis were enrolled from the wards and Outpatient Departments of the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine between January 2024 and December 2024. Participants were randomly divided into an observation group and a control group （n=52 each） using a random number table. Both groups received conventional rehabilitation training and basic treatment. The control group received “cupuncture-rehabilitation” therapy， while the observation group received additional abdominal acupuncture based on the control group’s treatment. The treatment duration was 2 weeks for both groups. After treatment， clinical efficacy was evaluated. Changes in traditional Chinese medicine （TCM） syndrome scores， muscle tone grading，Spasticity Index （CSI） scores，and Fugl-Meyer motor function scores were observed before and after treatment. Changes in Quality of Life-BREF （QOL-BREF） scores and Modified Barthel Index （MBI） scores were compared between the two groups. Safety and adverse reactions were also assessed. Results （1） After treatment，muscle tone grading was significantly improved in both groups （P＜0.05），with the observation group showing significantly greater improvement than the control group，the difference being statistically significant （P＜ 0.05）.（2） After treatment，CSI scores and Fugl-Meyer scores were significantly improved in both groups （P＜ 0.05），and the observation group demonstrated significantly greater improvements in both CSI and Fugl-Meyer scores compared to the control group，the difference being statistically significant （P＜0.05）.（3） After treatment， TCM syndrome scores were significantly improved in both groups （P＜0.05），with the observation group exhibiting significantly greater improvement than the control group，the difference being statistically significant （P＜0.05）. （4） After treatment，MBI and QOL-BREF scores were significantly improved in both groups （P＜0.05），and the observation group showed significantly greater improvements in both MBI and QOL-BREF scores than the control group， the difference being statistically significant （P＜0.05）.（5） No statistically significant difference was observed in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion Abdominal acupuncture combined with “acupuncture-rehabilitation” therapy significantly improves clinical symptoms， reduces increased muscle tone and spasticity in the affected limb，promotes the recovery of lower limb function， and enhances the quality of life in patients with post-stroke lower limb spastic paralysis，demonstrating notable clinical efficacy.

R246.9

黑龙江省中医药科研资助项目（编号：ZHY2023-177）