巨刺法结合康复训练治疗中风后肩手综合征临床研究

Clinical Study on the Treatment of Shoulder Hand Syndrome after Apoplexy with the Combination of Giant Needling and Rehabilitation Training

目的:观察巨刺法结合康复训练对中风后肩手综合征的治疗效果,为临床开辟治疗新路径。方法:收集中风后肩手综合征的患者90例,采用SPSS 20.0软件将患者随机分为巨刺康复组、单纯康复组和常规针刺组各30例,在接受基础治疗的同时,常规针刺组予针刺患侧穴位;单纯康复组给予肢体康复训练治疗;巨刺康复组在单纯康复组治疗内容的基础上进行针刺健侧穴位。疗效标准采用视觉模拟评分(VAS)与简化Fugl-Meyer运动功能评分(FMA)。结果:巨刺康复组显效率达到50.0%,而单纯康复组及常规针刺组分别为26.7%与16.7%,组间差异具有统计学意义。治疗后巨刺康复组VAS评分均较单纯康复组及常规针刺组低,而FMA评分均较单纯康复组及常规针刺组高,差异均有统计学意义(P<0.05);不同SHS分期(Ⅰ、Ⅱ期)中,巨刺康复组疗效均优于单纯康复组及常规针刺组,具有显著性差异(P<0.05)。结论:无论是处于中风后肩手综合征Ⅰ期,还是Ⅱ期,巨刺法结合康复训练的治疗效果均较为显著,均能更有效地缓解患肢疼痛,改善上肢运动功能。

Objective：To observe the therapeutic effect of the combined rehabilitation training for the shoulder hand syndrome after stroke,and to open up a new path for clinical treatment. Methods：Collected after stroke shoulder hand syndrome in patients 90 cases,spss 20.0 software was adopted for the patients were randomly divided into opposing needling rehabilitation group and simple rehabilitation group and routine acupuncture group,30 cases in each,in accepting the foundation treatment at the same time,the routine acupuncture group treated by acupuncture points on the affected side;a simple rehabilitation group received rehabilitation treatment;opposing needling rehabilitation group acupuncture contralateral acupoints in simple rehabilitation treatment group content on the basis. The efficacy standard was using visual analog scale（VAS）and simplified Fugl-Meyer motor function score（FMA）. Results：The effective rate of the rehabilitation group was 50%,while the simple rehabilitation group and the routine acupuncture group were 26.7% and 16.7% respectively,and the difference was statistically significant. Treatment after needling rehabilitation group VAS scores were significantly higher than those of simple low rehabilitation group and routine acupuncture group,and FMA scores were significantly higher than those of simple rehabilitation group and routine acupuncture group high,differences were statistically significant（P〈0.05）;different SHS staging（I,II）,needling effect in rehabilitation group were superior to that of simple rehabilitation group and routine acupuncture group,with significant difference（P〈0.05）. Conclusion：Regardless of is in post-stroke shoulder hand syndrome stage I,or II,needling method combined with rehabilitation training in the treatment effects are more significant,more effectively alleviate suffering from limb pain,improve the movement function of upper extremities.