针刺联合常规康复治疗脑卒中后肩 – 手综合征临床疗效
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蔡群峰,男,主治医师,主要研究方向是针灸治疗脑卒中后遗症。

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R 743.3

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Clinical Effect of Acupuncture Combined with Routine Rehabilitation in the Treatment of Post-stroke Shoulder-hand Syndrome
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    摘要:

    摘 要目的:研究针刺联合常规的康复疗法对脑卒中后肩 – 手综合征(SHS)患者的运动功能、综合功能和日常生 活质量的影响。 方法:选取福建中医药大学附属人民医院 2021 年 3 月至 2022 年 3 月期间收治的脑卒中后 SHS 患者 178 例 进行前瞻性研究,随机分为对照组和观察组,各 89 例。两组患者均给予降血压、抗血小板聚集和营养支持等基础治疗,同 时进行良肢位摆放、被动运动和主动运动的康复训练,观察组患者另加用针刺疗法。比较两组患者治疗效果。 结果:治疗 1 个月后观察组患者疼痛改善总有效率为 92.13 %,高于对照组的 68.53 %,差异具有统计学意义(P < 0.05)。观察组 患者上肢运动功能改善总有效率为 82.02 %,高于对照组的 66.29 %,差异具有统计学意义(P < 0.05)。治疗后两组患者 视觉模拟评分法(VAS)评分较治疗前均有不同程度下降,Fugl–Meyer 评估量表(FMA)、躯体功能综合评估(bFCA)、 生活质量评分较治疗前均有不同程度提高,且治疗后观察组患者 VAS 评分低于对照组,FMA、bFCA、生活质量评分高于 对照组,差异具有统计学意义(P < 0.05)。 结论:针刺联合常规的康复疗法治疗脑卒中后 SHS 可有效改善患者运动功能、 综合功能和日常生活质量,疗效优于单康复疗法。

    Abstract:

    AbstractObjective To investigate the effects of acupuncture combined with conventional rehabilitation therapy on motor function, general function and quality of daily life in patients with post-stroke shoulder-hand syndrome (SHS). Methods A total of 178 patients with post-stroke SHS admitted to the Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine from March 2021 to March 2022 were selected for a prospective study and randomly divided into a control group and an observation group, with 89 cases in each group. Patients in both groups were given basic treatment such as lowering blood pressure, anti-platelet aggregation and nutritional support, and rehabilitation training of good limb position, passive and active exercise, and acupuncture therapy was added to patients in the observation group. The therapeutic effect of the two groups was compared. Results After 1 month of treatment, the total effective rate of pain improvement in the observation group was 92.13 %, which was higher than 68.53% in the control group, and the difference was statistically significant (P < 0.05). The total effective rate of upper limb motor function improvement in the observation group was 82.02 %, which was higher than 66.29 % in the control group, and the difference was statistically significant (P < 0.05). Visual analog scale (VAS) scores of the two groups were decreased to varying degrees after treatment, the scores of Fugl-Meyer assessment (FMA), comprehensive assessment of physical function (bFCA), and quality of life of the two groups were improved to varying degrees, and the VAS score of the observation group was lower than that of the control group after treatment.The scores of FMA, bFCA and quality of life were higher than those of the control group, and the differences were statistically significant (P < 0.05). Conclusion Acupuncture combined with conventional rehabilitation therapy in the treatment of post-stroke SHS can effectively improve the motor function, comprehensive function and daily life quality of patients, and the efficacy is better than rehabilitation therapy alone.

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  • 收稿日期:2023-03-24
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  • 在线发布日期: 2023-08-03
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