浮刺联合推拿疗法治疗脑卒中后肩手综合征临床研究

Clinical study of superficial acupuncture combined manipulation on treating shoulder-hand syndrome after stroke

目的观察浮刺联合推拿疗法治疗脑卒中后肩手综合征的临床疗效。方法将60例脑卒中后肩手综合征患者随机分为治疗组与对照组,每组30例。两组均进行相同常规康复治疗,对照组加予推拿治疗,治疗组在对照组治疗措施的基础上加用浮刺疗法。两组疗程均为6周,观察比较上肢FMA功能评分及疼痛VAS评分的变化情况。结果 1治疗前后组内比较,两组FMA评分水平差异有统计学意义(P<0.05);组间治疗前后FMA评分差值比较,差异有统计学意义(P<0.05)。2首次治疗前后,两组疼痛VAS评分水平差异有统计学意义(P<0.05);组间治疗后比较,疼痛VAS评分差异有统计学意义(P<0.05)。此后各时点,两组疼痛VAS评分均存在上升趋势,但治疗24 h后,治疗组疼痛VAS评分仍显著低于对照组(P<0.05)。3总体治疗前后,两组疼痛VAS评分差异有统计学意义(P<0.05);组间治疗前后疼痛VAS评分差值比较,差异有统计学意义(P<0.05)。结论浮刺联合推拿疗法治疗脑卒中后肩手综合征,可显著缓解患肢疼痛,改善其活动功能。

Objective To observe the effect of treating on shoulder-hand syndrome after stroke under superficial acupuncture combined manipulation. Methods 60 cases of the patient with shoulder-hand syndrome after stroke were randomly divided into treatment group and control group equally. Both of the two groups were treated with usual rehabilitation therapy, and control group was treated with manipulation therapy while treatment group was treated with superficial acupuncture on the base of control group. The courses of the two groups were 6 weeks. Cores of upper limb FMA function and pain VAS were observed. Results ① There were significant difference in FMA scores in each group before and after the treatment （ P 〈 0.05 ） ; there were significant difference in FMA scores between the two groups after the treatment （ P 〈 0.05 ）. ② There were significant difference in pain SVAS scores in each group before and after the first treatment （ P 〈 0.05 ） ; after the treatment, there were significant difference in pain VAS scores between the two groups （P 〈 0.05 ）. After that, VAS scores in the two groups increased, but after 24 hours, VAS pain score of the treatment group was significantly lower than that of the control group （ P 〈 0.05 ）. ③ Before and after the overall treatment, there were statistically difference in pain VAS scores in each group （ P 〈 0.05 ） ; before and after the treatment, there were statistically difference in pain VAS scores between the two groups （P 〈 0.05 ）. Conclusion The shoulder-hand syndrome after stroke treated by methods of superficial acupuncture combined manipulation can significantly alleviate limb pain and improve their motor functions.