加味化痰通络汤联合针灸治疗中风后肩手综合征疗效观察

Observation on Therapeutic Effect of Jiawei Huatan Tongluo Decoction(加味化痰通络汤)Combined with Acupuncture on Shoulder-Hand Syndrome after Apoplexy

目的观察加味化痰通络汤联合针灸治疗中风后肩手综合征临床疗效。方法选取2017年2月—2019年2月来北京中医医院顺义医院脑病科就诊的75例中风后肩手综合征患者为观察对象,采用数字表法分组,在常规治疗基础上,对照组37例给予口服布洛芬缓释胶囊,观察组38例给予口服加味化痰通络汤及配合针灸治疗,两组均治疗4周。观察两组治疗效果及Fugl-Meyer关节活动及疼痛评定。结果经治疗4周后,两组患者关节活动度较治疗前均有改善,观察组Fugl-Meyer评分高于对照组,两组患者疼痛评分均降低,且观察组改善程度均较对照组更明显;治疗4周后观察组总有效率(94.73%,36/38)明显高于对照组(70.27%,26/37),差异有统计学意义(均P<0.05);治疗4周后,观察组1例便溏,对照组2例恶心,两组患者治疗过程中的不良反应发生率比较,差异无统计学意义(P>0.05)。结论加味化痰通络汤联合针灸治疗中风后肩手综合征可以有效缓解患者疼痛,增强患者肩手关节活动功能,加速患者患肢功能康复,提高患者生活质量,具有临床应用价值。

Objective To observe the clinical effect of Jiawei Huatan Tongluo Decoction(加味化痰通络汤)combined with acupuncture on shoulder hand syndrome after apoplexy.Methods From February 2017 to February 2019,75 patients with shoulder-hand syndrome after apoplexy who came to the Encephalopathy Department of Shunyi Hospital of Beijing Traditional Chinese Medicine Hospital were selected as the observation objects.They were divided into groups by digital table method.On the basis of conventional treatment,37 patients in the control group were given ibuprofen sustained-release capsule,38 patients in the obser⁃vation group were given Jiawei Huatan Tongluo Decoction and acupuncture treatment,and both groups were treated for 4 weeks.The therapeutic effect,Fugl Meyer joint activity and pain evaluation were observed.Results After 4 weeks of treatment,the joint activity of the two groups was improved,the Fugl Meyer score of the observation group was higher than that of the control group,and the pain score of the two groups was lower,and the improvement degree of the observation group was more obvious than that of the control group.After 4 weeks of treatment,the total effective rate of the observation group(94.73%,36/38)was significantly higher than that of the control group(70.27%,26/37).The difference was statistically significant(P<0.05).After 4 weeks of treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Jiawei Huatan Tongluo Decoction combined with acupuncture and moxibustion can effectively relieve the pain,enhance the func⁃tion of shoulder-hand joint activity,accelerate the rehabilitation of limb function and improve the quality of life of the patients,which has clinical application value.