摘要
Objective To observe influence of kinetic needling on functional restoration of upper limbs of patients with apoplexy-induced shoulder-hand syndrome. Methods Ninety patients were randomly divided into an observation group （45 cases） and a control group （45 cases）. Basic treatments selected according to corresponding stroke units were applied to both groups. Besides, scalp acupuncture at Dingnie Qianxiexian （MS 6, 顶颞前斜线）, Dingnie Houxiexian （MS 6, 顶颞前斜线） and Dingzhongxian （NS 5, 顶中线）, was applied in the treatment group. In the observation group, active and passive movement was carried out during the process of scalp acupuncture, and then needling plus bloodletting puncturing and cupping was applied. In the control group, only needling plus blood-letting puncturing and cupping was given. Therapeutic effects, pain scoring obtained by visual analogue scales （VAS）, FugI-Meyer and FugI-Meyer＇s scoring reflecting moving functions of upper limbs were made after 4 courses of treatments in both groups. Results The total effective rate was 95.5% and 91.1% in the observation group and control group, respectively, showing superiority of the former to the latter （P〈0.05）. After treatment, VAS scores were all obviously reduced in both groups （P〈0.01）, and the reduction in the former was significantly more than that in the latter （P〈0.01）. Moving functions of upper limbs shown by Fugl-Meyer＇s scoring were improved after 2 courses of treatment in both groups （P〈0.01）. The improvement was more obvious after 4 courses of treatment than that after 2 courses of treatment in both groups （P〈0.05）. After 4 courses of treatment, moving functions shown by FugI-Meyer＇s scoring were more remarkably improved in the observation group than those in the control group（t=3.9, P〈0.01）. Conclusion Both kinetic needling combined with needling plus blood-letting puncturing and cupping and simple needling plus blood-letting puncturing and cupping are effective in treating shoulder-hand syndrome after apoplexy, and the former is better than the latter.
目的:观察运动针法对脑卒中后肩手综合征患者上肢功能恢复的影响。方法:将90例患者随机分为观察组和对照组,每组各45例。两组均进行卒中单元的基础治疗,观察组采用顶颞前斜线、顶颞后斜线和顶中线头皮针刺期间配合主动和被动运动后再行针刺结合刺络拔罐治疗,对照组只采用针刺结合刺络拔罐治疗,4个疗程后观察两组疗效、视觉模拟疼痛(VAS)评分和上肢Fugl-Meyer运动功能评分。结果:观察组总有效率为95.5%,优于对照组的91.1%(P<0.05);两组治疗后VAS疼痛积分均较治疗前显著减少(均P<0.01),同时治疗后观察组优于对照组(P<0.01);在上肢Fugl-Meyer运动功能评分方面,两组2个疗程后较治疗前、4个疗程后较2个疗程后均有改善(P<0.01,P<0.05),其中4个疗程后观察组Fugl-Meyer运动功能评分优于对照组(t=3.9,P<0.01)。结论:运动针法后再行针刺结合刺络拔罐和单纯针刺结合刺络拔罐治疗脑卒中后肩手综合征都有明显效果,但运动针法后再行针刺结合刺络拔罐的疗效更优一些。
