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目的:观察针刺配合康复训练治疗脑卒中后偏瘫肢体痉挛的临床疗效,探讨脑卒中后偏瘫肢体痉挛的疗效评价指标.方法:按照随机、对照、盲法的临床试验设计,将符合纳入标准的229例患者按就诊顺序随机分为3组:治疗1组74例采用针刺治疗(穴取患侧肩骨禺、曲池、外关等),治疗2组75例采用针刺(同治疗1组)配合康复训练(同对照组),对照组80例采用康复训练(采用Bobath易化技术);每周治疗5次,连续治疗4周.系统观察针刺配合康复训练治疗脑卒中后偏瘫肢体痉挛的临床疗效.结果:研究显示3组基线状况良好,分组均衡,可比性强(P>0.05).以改良的Ashworth痉挛量表评定,治疗1组总有效率为63.01%(46/73),治疗2组总有效率为66.67%(50/75),对照组总有效率为44.00%(33/75),3组总有效率比较差异有统计学意义(P0.05). Based on the modified Ashworth Spasticity Scale (modified ASS), the total effective rate was 63.01% (46/73) in treatment group 1, 66.67%(50175) in treatment group 2 and 44.00% (33175) in control group, indicating a statistical significant difference among 3 groups (P<0.05). Based on MAS motor function scale, the function improvement in treatment group 2 was superior to that in treatment group 1 and control group, indicating statistical significant differences among 3 groups (both P0.05). Conclusion The efficacy of post-stroke hemiplegic spasticity is definite with acupuncture combined with rehabilitation, and the acupuncture program is safe and effective.