针刺结合康复治疗中风后肩-手综合征

Clinical study on acupuncture combined with rehabilitation therapy for treatment of poststroke shoulder-hand syndrome

目的:比较针刺结合康复疗法与单纯针刺、康复治疗中风后肩-手综合征的疗效差异。方法:将120例患者随机分为针灸结合康复组(针康组)、针刺组、康复组各40例。针康组取肩髃、肩前、肩髎等穴针刺,结合运动疗法以康复训练;针刺组单纯采用针刺疗法;康复组单纯采用运动疗法。通过上肢运动功能、疼痛、关节活动度等指标判断其疗效。结果:针康组总有效率为87.5%,明显优于针刺组的67.5%和康复组的65.0%(P<0.01);针刺结合康复能够明显改善患者的上肢运动功能、上肢疼痛及关节活动度,与单纯针刺和单纯康复比较差异有非常显著性意义(均P<0.01)。结论:针刺结合康复治疗中风后肩-手综合征具有治愈率高、疗效显著的特点。

Objective To observe therapeutic effect of acupuncture combined with rehabilitation therapy on poststroke shoulder-hand syndrome. Methods One hundred and twenty cases of poststroke shoulder-hand syndrome were randomly divided into an acupuncture-rehabilitation group, an acupuncture group and a rehabilitation group, 40 cases in each group. The acupuncture-rehabilitation group were treated with acupuncture at Jianyu （LI 15）, Jianqian, Jianliao （TE 14）, etc. in combination with motor therapy （rehabilitation training）, the acupuncture group with simple acupuncture therapy, and the rehabilitation group with simple motor therapy. Upper extremity motor function, pain, joint activity were used for assessment of therapeutic effects. Results The total effective rate of 87.5% in the acupuncture-rehabilitation group was significantly better than 67.5% in the acupuncture group and 65.0% in the rehabilitation group （P〈0. 01）; acupuncture combined with rehabilitation therapy could significantly improve upper limb motor function, pain and joint activity with very significant differences as compared with the acu- puncture group and the rehabilitation group （P〈0.01）. Conclusion Acupuncture combined with rehabilitation therapy has a high cured rate and an obvious therapeutic effect on poststroke shoulder-hand syndrome.