关键词: 通督调神, 针刺, 手功能训练, 脑梗死, 手功能障碍

Abstract:

Objective To evaluate the clinical efficacy of "Tongdu Tiaoshen" acupuncture combined with hand function rehabilitation training in patients with hand dysfunction following cerebral infarction. Methods A total of 104 patients were randomly assigned to either the observation group （receiving "Tongdu Tiaoshen" acupuncture combined with hand function rehabilitation training） or the control group （undergoing hand function rehabilitation training alone）， with 52 patients in each group. Both groups underwent a 4-week treatment regimen. The following outcome measures were assessed pre- and post-treatment： Modified Ashworth Scale （MAS）， Modified Lindmark Scale （MLS）， Brunnstrom Motor Function Score （BMS） for upper limbs， Fugl-Meyer Assessment （FMA） of upper limb motor function， Modified Barthel Index （MBI）， and grip strength （GS）. Adverse events were documented， and the clinical efficacy in each group was evaluated by calculating the effective rate. Results After excluding dropouts， a total of 94 cases were included in the final statistical analysis， with 48 cases assigned to the observation group and 46 to the control group. Both groups demonstrated significant improvements in MLS， MAS， BMS， FMA， MBI， and GS scores compared to pre-treatment levels， with all differences being statistically significant （P < 0.05）. Following treatment， intergroup comparisons also revealed statistically significant differences in all measured indicators （P < 0.05）. The total effective rate was higher in the observation group （91.7%） than in the control group （82.6%）， and the difference in efficacy grades between the two groups was statistically significant （P < 0.05）. Conclusions "Tongdu Tiaoshen" acupuncture， when combined with hand function training， demonstrates significantly greater efficacy than hand function rehabilitation training alone in improving post-cerebral infarction hand dysfunction. It enhances grip strength and fine motor coordination of the affected limb， alleviates hand muscle spasticity and joint stiffness， and promotes recovery of upper limb motor function， thereby improving patients' activities of daily living. This integrated therapeutic approach warrants further clinical validation and in-depth research for broader implementation.

Key words: Tongdu Tiaoshen, acupuncture, hand function training, cerebral infarction, hand dysfunction