脳血管障害片麻痺患者に対する陽陵泉穴への置鍼刺激による鍼治療の効果

Purpose : To investigate the neurophysiological mechanism of the acupuncture effect in patients with cerebrovascular disease (CVD), the H-reflex was analyzed before, during and after acupuncture. Subjects : The subjects were two hemiplegic patients, a 61-year-old female and a 26-year-old female. Both patients showed left hemiplegia with hypertonus and hyperreflexia, including triceps surae muscle and achilles tendon reflex. The range of motion at the ankle joint was decreased caused by hypertonus of triceps surae muscle. Method : H-reflex before (at rest), during and after acupuncture was recorded from the soleus after stimulation of tibial nerve at the popliteal fossa. The intensity of constant current stimulation was 1.2 times to evoke M-wave, with the frequency of 0.3 Hz,the duration of 1 ms and persistence of 32 times, respectively. H-reflex was analyzed for persistence, amplitude, amplitude ratio of H/M and latency under these conditions. The point of acupuncture was left GB34, specific point for controlling of muscle tone. The depth and period of the retaining needle were 10 mm and 4 minuets. Clinical findings : triceps surae muscle tone, achilles tendon reflex and ROM at the ankle joint were also evaluated before and after acupuncture. Results : The amolitude and amplitude ratio of H/M during and after acupuncture were significantly lower than those before acupuncture. No significant difference between during and after acupuncture was shown in latency. Clinical findings after acupuncture ; triceps surae muscle tone, achilles tendon reflex and ROM at the ankle joint were improved in both patients. Conclusion : From these results, it is suesested that acupuncture on GB34 showed improvement in the excitability of spinal neural function and clinical findings ; muscle tone, deep tendon reflex and ROM at the ankle joint in patients with CVD.