【摘要】 目的 探究剪切波弹性超声成像(SWE)对针刺治疗脑卒中肌痉挛疗效的临床效用。方法 选取2024年4月至12月符合标准的100例脑卒中肌痉挛患者(黑龙江中医药大学附属第一医院)按随机数字表法分为对照组(50例，口服药物治疗+蜡疗)及试验组(50例，联合局部拮抗肌针刺法)。在治疗前后基于SWE对患者患侧上肢肌肉(肱二头肌、肱肌、肱桡肌)进行杨氏模量平均值(Emean)和剪切波速度(Vs)的测量，并以改良Ashworth量表(MAS)和Barthel指数(BI)进行评估。结果 两组患者患侧的上肢肌肉的Emean和Vs治疗后较治疗前降低(P<0.01),试验组患侧肱二头肌和肱肌的Emean和Vs较对照组下降更显著(P<0.05),肱桡肌的Emean和Vs组间差异无统计学意义(P>0.05);两组MAS评分治疗后较治疗前降低(P<0.01),试验组降幅更显著(P<0.05);BI指数较治疗前均升高(P<0.01),试验组较对照组升高显著(P<0.05)。结论 SWE可通过定量肌肉硬度变化，客观评估针刺治疗脑卒中后上肢肌痉挛的疗效，为临床提供无创、精准的评估方法。更多还原

【Abstract】 Objective To investigate the diagnostic value of shear wave elastography(SWE) in evaluating the efficacy of acupuncture for post-stroke muscle spasticity. Methods Between April and December 2024, 100 stroke patients with muscular spasm meeting the eligibility criteria were recruited from the First Affiliated Hospital of Heilongjiang University of Chinese Medicine. Participants were allocated to the control group(50 cases, receiving oral pharmacotherapy combined with wax therapy) or the experimental group(50 cases, administered with local antagonist muscle acupuncture in conjunction with conventional therapy) using the random number table technique. Before and after treatment, SWE was used to measure the Young’s modulus mean value(Emean) and shear wave velocity(Vs) of the affected upper limb muscles(biceps brachii, brachialis, and brachioradialis). Clinical assessments included the Modified Ashworth Scale(MAS) and Barthel Index(BI). Results Post-treatment analysis revealed that Emean and Vs in the affected upper limb muscles were significantly lower in both groups(P<0.01). Compared with the control group, the experimental group demonstrated a more substantial decline in Emean and Vs parameters for the biceps brachii-brachialis complex(P<0.05). However, the brachioradialis showed no significant differences between groups(P>0.05). The MAS scores decreased post-treatment in both groups(P<0.01), with a more pronounced reduction in the experimental group(P<0.05). The BI scores increased in both groups(P<0.01), with a greater improvement in the experimental group(P<0.05). Conclusion SWE can quantitatively assess changes in muscle stiffness, providing an objective, non-invasive, and precise method for evaluating the therapeutic effect of acupuncture on post-stroke upper limb spasticity.更多还原