目的：探究下肢康复机器人联合针灸辅助治疗脑卒中偏瘫患者的应用效果。方法：选取 2023 年 2 月—2024 年 2 月于 南通大学附属医院收治的 92 例脑卒中偏瘫患者，按照随机数字表法分为研究组和对照组，每组 46 例。对照组实施常规康复 训练联合针灸辅助治疗，研究组实施下肢康复机器人联合针灸辅助治疗。比较两组患者的步行能力、下肢肌力、运动功能、 平衡功能、神经功能指标水平。结果：干预 2 周后两组患者功能性步行量表（FAC）分级、Lovett 分级、Fugl-Meyer 下肢运 动功能评分量表（FMA-LE）评分、Berg 平衡量表（BBS）评分均优于干预前，且研究组 FAC 分级、Lovett 分级、FMA-LE 评分、 BBS 评分均优于对照组（P<0.05）。干预 2 周后两组患者碱性成纤维细胞生长因子（bFGF）、血管内皮生长因子（VEGF）、 脑源性神经营养因子（BDNF）水平均高于干预前，且研究组 BDNF、bFGF、VEGF 水平高于对照组（P<0.05）。结论：下肢 康复机器人联合针灸辅助治疗脑卒中偏瘫具有较好的应用效果，可有效提高患者步行能力与肌力，改善运动功能与平衡功能， 促进神经功能好转。

Objective: To explore the application effect of lower limb rehabilitation robot combined with acupuncture-assisted therapy in hemiplegic stroke patients. Methods: 92 hemiplegic stroke patients in the Affiliated Hospital of Nantong University from February 2023 to February 2024 were selected and divided into the study group (lower limb rehabilitation robot combined with acupuncture-assisted therapy, n=46) and the control group (conventional rehabilitation training combined with acupuncture-assisted therapy, n=46) using a random number table. The walking ability, lower limb muscle strength, motor function, balance function, and level of neurological function indicators were compared between the two groups of patients. Results: Functional ambulation scale (FAC) rating, Lovett rating, Fugl-Meyer lower extremity motor function rating scale (FMA-LE) scores, and Berg balance scale (BBS) scores were better after 2 weeks of intervention than those before intervention in the two groups of patients, and the above indicators in the study group were better than those in the control group (P<0.05). The levels of basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), and brain-derived neurotrophic factor (BDNF) were both higher after 2 weeks of intervention than before intervention in the two groups, and these factors were higher in the study group than the control group (P<0.05). Conclusion: Lower limb rehabilitation robot combined with acupuncture-assisted therapy has a good application effect in the treatment of stroke patient with hemiplegia, which can effectively improve the walking ability and muscle strength, enhance motor function and balance function, and promote the improvement of neurological function of patients.

基金项目：南通大学附属医院科研项目（LCYJ20242006）

Foundation Item: Scietific Research Project of the Affiliated Hosipital of Nantong University(LCYJ20242006) 

引用格式：周小云，陈嘉雯，石彦桦，等 . 下肢康复机器人联合针灸治疗在脑卒中偏瘫患者中的应用 [J]. 机器人外科学杂志（中英文），2025， 6（2）：276-281. 

Citation: ZHOU X Y, CHEN J W, SHI Y H, et al. Effect of lower limb rehabilitation robot combined with acupuncture-assisted therapy in  hemiplegic stroke patients [J]. Chinese Journal of Robotic Surgery, 2025, 6(2): 276-281. 

通讯作者（Corresponding Author）：孙丽（SUN Li），Email：Lilysunntfy@163.com

[1] 李彤 , 刘永瑞 , 张芬 , 等 . 基于纽曼系统模式的 Nustep-t4 运动训练在 脑卒中偏瘫病人康复中的应用 [J]. 护理研究 , 2023, 37(24): 4458-4464. 

[2] HU C, WANG X, PAN T L. Effect of acupuncture combined with lower limb gait rehabilitation robot on improving walking function in stroke patients with hemiplegia[J]. NeuroRehabilitation, 2024, 54(2): 309-317. 

[3] Matsumoto S, Hoei T, Tojo R, et al. PS-C28-3: Effects of the olmesartan medoxomil on controlling hypertension and rehabilitation outcomes for inpatients in the stroke care unit[J]. J Hypertension, 2023, 41(1): 458-459. 

[4] Naz F, Hussain D, Ali H, et al. Effectiveness of functional electrical stimulation machine in managing neurological diseases-a retrospective study[J]. Pak J Med Sci, 2024, 40(2ICON Suppl): S53-S57. 

[5] YU W T, REN C H, DU J B, et al. Remote ischemic conditioning for motor recovery after acute ischemic stroke[J]. Neurologist, 2023, 28(6): 367-372. 

[6] 中华医学会神经病学分会 , 中华医学会神经病学分会脑血管病学 组 . 中国各类主要脑血管病诊断要点 2019[J]. 中华神经科杂志 , 2019, 52(9): 710-715. 

[7] 赵光标 , 吴冬玲 , 黄文锋 . 步行训练时机选择对脑卒中偏瘫病人平衡 及步行能力的影响 [J] 蚌埠医学院学报 , 2018, 43(1): 40-42. 

[8] 安丹蔷 , 季宇宣 , 张瀚之 , 等 . 下肢康复训练机器人联合等速肌力训 练对老年脑卒中偏瘫患者神经功能、步行能力、Lovett 肌力分级及 平衡能力的影响 [J]. 临床和实验医学杂志 , 2024, 23(4): 377-381. 

[9] 张晓雪 , 王睿月 , 樊虹玉 , 等 . 上肢功能测试量表的汉化及其在脑卒 中患者中的信效度研究 [J]. 中国全科医学 , 2023, 26(8): 1022-1027. 

[10] 金冬梅 , 燕铁斌 .Berg 平衡量表及其临床应用 [J]. 中国康复理论与实 践 , 2002, 8(3): 155-157. 

[11] Byrd E M, Jablonski R J, Vance D E. Understanding anosognosia for hemiplegia after stroke[J]. Rehabil Nurs, 2020, 45(1): 3-15. 

[12] 董春燕 , 安琦 , 吴小芳 , 等 . 阴阳透刺针法配合中医辨证穴位按摩 护理对脑卒中偏瘫患者康复效果的影响 [J]. 四川中医 , 2023, 41(8): 201-204. 

[13] Noor M B, Rashid M, Younas U, et al. Recent advances in the management of hemiplegic shoulder pain[J]. J Pak Med Assoc, 2022, 72(9): 1882-1884. 

[14] 吴奇勇 , 叶锦萍 , 李洋 , 等 . MOTOmed 智能运动训练系统对脑卒中 偏瘫患者上肢运动功能康复的成本 - 效果研究 [J]. 中国康复理论与 实践 , 2013, 19(2): 154-157. 

[15] Dhiman A, Saipangallu Y, Chakrabarti H R. Bilateral ventromedial medullary infarcts-paired earbuds sign[J]. Neurol India, 2023, 71(6): 1278-1279. 

[16] 毛珍芳 , 蒋志强 , 龙捷 , 等 . 下肢康复机器人在脑卒中伴重度偏瘫 患者康复中的价值及其对不良心理的影响 [J]. 中国医药导报 , 2023, 20(29): 78-82. 

[17] 王莉娜 , 陈志琴 , 董文敏 . 下肢康复机器人训练联合镜像疗法对 脑卒中偏瘫患者步态控制的影响 [J]. 海军医学杂志 , 2023, 44(11): 1163-1167. 

[18] Robbins M R, Risner-Bauman A. A patient with a history of right-sided stroke and hemiplegia, in a wheelchair, presents with a complaint of upper left tooth pain[J]. Dent Clin North Am, 2023, 67(4): 561-564. 

[19] Bei N, Long D Y, Bei Z, et al. Effect of water exercise therapy on lower limb function rehabilitation in hemiplegic patients with the first stroke[J]. Altern Ther Health Med, 2023, 29(7): 429-433. 

[20] Duc Nguyen M, Van Tran T, Vinh Nguyen Q, et al. Effectiveness on post-stroke hemiplegia in patients: electroacupuncture plus cycling electroacupuncture alone[J]. J Tradit Chin Med, 2023, 43(2): 352-358.