中西医结合治疗脑卒中后肩手综合征的临床研究

Application of combined therapy of traditional Chinese medicine and western medicine in shoulder-hand syndrome after cerebral apoplexy

目的研究中西医结合治疗脑卒中后肩手综合征的疗效与安全性。方法选取2010年1月至2012年6月入院治疗的脑卒中后肩手综合征患者130例,随机分为实验组(65例)和对照组(65例)。对照组患者应用常规西药泼尼松治疗,实验组应用泼尼松结合温针灸治疗方法,两组患者均行常规康复训练。观察并对比两组患者临床症状、手功能及整体疗效。结果实验组显效16例,好转45例,总有效93.85%;对照组显效10例,好转36例,总有效率70.77%。实验组和对照组患者治疗前在水肿、疼痛评分、关节活动度方面差异无统计学意义;治疗后,两组患者的症状均有所减轻,但实验组改善更为明显。治疗前,两组患者均无实用手,且失用手与辅助手比较差异无统计学意义;治疗后,实验组辅助手47例,实用手11例,对照组辅助手42例,实用手5例,差异均有统计学意义(P<0.05)。结论温针灸辅助常规西药治疗脑卒中后肩手综合征能有效提高患者上肢运动功能、减轻疼痛、消除水肿,有助于患者手功能的恢复,疗效显著。

Objective To study the efficacy and safety of combined therapy of traditional Chinese medicine and western medicine in shoulder-hand syndrome（SHS） after cerebral apoplexy. Methods 130 cases of patients with SHS after cerebral apoplexy,treated in this hospital from Jan. 2010 to Jun. 2012, were randomly divided into control group（65 cases）, receiving prednisone therapy,and experiment group（65 cases）, receiving combined therapy of pred- nisone and warm acupuncture treatment. Clinical symptoms, hand function and overall efficacy were compared be- tween the two groups. Results The total effective rate in experimental group was 93.85 ~ ,including 16 cases with marked effect and 45 cases with improvement,and that in control group was 70. 770/oo ,including 10 cases with marked effect and 36 cases with improvement. The differences of edema, pain score and joint activity between the two groups before treatment were not significant. After treatment,symptoms of patients in the two groups were mitigated, but the mitigation of experiment group was more obvious. Before treatment, patients in the two groups all had no practical hand,and the differences of lost practical hand and auxiliary hand were not significant. After treatment, the number of auxiliary hand and practical hand were 47 cases and 11 cases in experiment group,which were significantly different with control group（42 and 5 cases respectively,P^0.05）. Conclusion Application of combined therapy of predni- sone and warm acupuncture in SHS after cerebral apoplexy might be effective to improve hand function, relieve pain and eliminating swelling, which could be helpful for recovery of hand function and be with remarkable curative effect.