浮针疗法结合康复训练治疗中风后肩手综合征:随机对照研究

Post-stroke shoulder-hand syndrome treated with floating-needle therapy combined with rehabilitation training:a randomized controlled trial

目的：在康复训练基础上,比较浮针与常规针刺治疗中风后肩手综合征的临床疗效差异。方法：将100例中风后肩手综合征患者随机分为浮针组和针刺组,每组50例。在患肢被动和主动康复训练基础上,浮针组采用浮针疗法,在距离肌筋膜触发点（MTrP点）5～10cm处确定进针点,于皮下进行运针、扫散,持续2min;针刺组采用常规针刺治疗,穴取肩前、肩髃、肩髎等,均隔天治疗1次,每周3次,共治疗14天。采用肩手综合征评估量表（SHSS）、简式McGill疼痛量表（SF-MPQ）和简化Fugl-Meyer运动功能量表（FMA）对患者治疗前后上肢的损伤程度、疼痛症状、运动功能进行评价,并比较两组临床疗效。结果：治疗后两组患者SHSS评分、SF-MPQ评分、FMA评分均显著改善（均P〈0.01）,且浮针组的改善程度均优于针刺组（均P〈0.05）;浮针组总有效率为94.0%（47/50）,优于针刺组的90.0%（45/50,P〈0.05）。结论：浮针疗法结合康复训练治疗中风后肩手综合征疗效满意,优于常规针刺治疗结合康复训练者。

Objective To compare the clinical efficacy in the treatment of post-stroke shoulder-hand syndrome between floating-needle therapy and conventional acupuncture on the basis of rehabilitation training.Methods One hundred cases of post-stroke shoulder-hand syndrome were randomized into a floating-needle group and an acupuncture group,50cases in each one.The passive and positive rehabilitation training was adopted in the two groups.Additionally,in the floating-needle group,the floating-needle therapy was used.The needle was inserted at the site 5to 10cm away from myofasical trigger point（MTrP）,manipulated and scattered subcutaneously,for2min continuously.In the acupuncture group,the conventional acupuncture was applied at Jianqian（EX-UE）,Jianyu（LI 15）,Jianliao（TE 14）,etc.The treatment was given once every two days,3times a week,and 14days of treatment were required.The shoulder hand syndrome scale（SHSS）,the short form McGill pain scale（SFMPQ）and the modified Fugl-Meyer motor function scale（FMA）were used to evaluate the damage severity,pain and motor function of the upper limbs before and after treatment in the two groups.The clinical efficacy was compared between the two groups.Results SHSS score,SF-MPQ score and FMA score were improved significantly after treatment in the two groups（all P〈0.01）,and the improvements in the floating-needle group were superior to those in the acupuncture group（all P〈0.05）.The total effective rate was 94.0%（47/50）in the floatingneedle group,which was better than 90.0%（45/50）in the acupuncture group（P〈0.05）.Conclusion The floating-needle therapy combined with rehabilitation training achieves a satisfactory efficacy on post-stroke shoulderhand syndrome,which is better than the combined therapy of conventional acupuncture and rehabilitation training.