中药浸洗按摩联合综合康复护理在脑卒中后肩手综合征患者中的应用

Application of Traditional Chinese Medicine Immersion Massage Combined with Comprehensive Rehabilitation Nursing in Patients with Shoulder Hand Syndrome after Stroke

目的探讨中药浸洗按摩联合综合康复护理在脑卒中后肩手综合征(SHS)患者中的应用效果.方法选取2020年8月-2021年7月本院收治的脑卒中后SHS患者110例为研究对象,参照随机数字表法将其分为两组.对照组55例接受综合康复护理,研究组55例在此基础上接受中药浸洗按摩护理.比较两组的干预效果,干预前后肩关节外旋、内旋、后伸、前屈、外展的活动度,以及上肢肢体运动功能评分(FMA).结果两组干预总有效率比较,研究组的96.36%显著高于对照组的81.82%,组间差异有统计学意义(P<0.05).干预前,两组的肩关节外旋、内旋、后伸、前屈、外展活动度比较,组间差异无统计学意义(P>0.05);干预后,研究组的肩关节外旋、内旋、后伸、前屈、外展活动度均显著大于对照组,组间差异有统计学意义(P<0.05).干预前,两组的上肢FMA评分比较,组间差异无统计学意义(P>0.05);干预后,研究组的上肢FMA评分为(42.46±4.21)分,高于对照组的(36.15±3.80)分,组间差异有统计学意义(P<0.05).结论脑卒中后SHS患者采用中药浸洗按摩联合综合康复护理的效果显著,可有效改善其肩关节活动度,提高上肢活动功能,值得临床推广.

Objective To explore the application effect of traditional Chinese medicine immersion massage combined with comprehensive rehabilitation nursing in patients with shoulder hand syndrome(SHS)after stroke.Methods A total of 110 patients with SHS after stroke admitted to our hospital from August 2020 to July 2021 were selected as the research subjects,and were divided into two groups according to random number table method.55 cases in control group received comprehensive rehabilitation nursing,55 cases in study group received TCM immersion massage nursing on this basis.The effects of intervention were compared between the two groups.The range of motion of shoulder joint in external rotation,internal rotation,extension,flexion and abduction,as well as upper extremity Fugl–Meyer assessment score(FMA)were compared between the two groups.Results In the total effective rate of intervention,96.36%of the study group was significantly higher than 81.82%of the control group,the difference between the groups was statistically significant(P<0.05).Before intervention,there were no significant differences in the ranges of shoulder external rotation,internal rotation,extension,flexion and abduction between the two groups(P>0.05);after intervention,the ranges of motion of shoulder joint in the study group were significantly higher than those in the control group,the differences between the groups were statistically significant(P<0.05).Before intervention,there was no significant difference in upper extremity FMA score between the two groups(P>0.05);after intervention,the upper extremity FMA score of the study group was(42.46±4.21)points,which was higher than(36.15±3.80)points of the control group,and the difference between the groups was statistically significant(P<0.05).Conclusion TCM immersion massage combined with comprehensive rehabilitation nursing has a significant effect on SHS patients after stroke,which can effectively improve the range of motion of shoulder joint and upper limb mobility function,and is worthy of clinical promotion.