俞募配穴对脑卒中后肩手综合征的临床疗效及作用机制探讨

Clinical Curative Effect of Shu-Mu Acupoints on Shoulder-hand Syndrome after Stroke and Its Mechanism

目的:观察俞募配穴穴位注射丹参注射液对脑卒中后肩手综合征的临床疗效并对其作用机制进行探讨。方法:将本院2009年1月至2014年12月80例脑卒中后肩手综合征患者随机分为对照组和观察组,各40例。2组患者均接受脑卒中内科常规治疗,对照组在常规治疗基础上常规取穴针灸,将压痛明显的2组穴位通以电针仪装置,疏密波条件下留针30 min;观察组采用俞募配穴法进行针刺,2组针刺手法一一对应。比较2组患者治疗前后简易Mc Gill疼痛评分、贝克焦虑量表评分以及外周单核细胞NMDA受体、血浆缓激肽的表达变化。结果:1)治疗后2组Mc Gill疼痛评分及贝克焦虑量表评分均较治疗前下降,其中观察组下降的趋势更明显(P<0.05);2)治疗后2组外周单核细胞NMDA受体及血浆缓激肽表达量均较治疗前下调,其中观察组下调较对照组明显(P<0.05)。结论:俞募配穴可以明显缓解脑卒中后肩手综合征的临床症状,其作用机制可能与下调患者外周血NMDA受体及血浆缓激肽的表达有关。

Objective： To observe clinical curative effect of the Shu-Mu points acupoint injection with Danshen solution on shoulder hand-syndrome after stroke and its possible mechanism. Methods： Eighty patients with shoulder hand syndrome after stroke treated in our hospital from January 2009 to December 2014 were included and randomly divided into the control group and the observation group,with 40 cases in each group. Patients in both the two groups received conventional medical treatment for stroke. Patients in the control group also had conventional acupuncture treatment and electric acupuncture device with dilatational wave was used for the two acupoints whose sensation were much more with the maintenance of 30 minutes; Shu-Mu acupoints were selected for the patients in the observation group with the same stimulation as the control group. Changes of simplified Mc Gill pain scores,Beck anxiety inventory and the expression changes of peripheral mononuclear cells,NMDA receptor,and plasma bradykinin were compared between patients in the two groups before and after treatment. Results： 1） Mc Gill pain scores and Beck anxiety inventory in the two groups decreased after the treatment,compared with that before the treatment and the down-regulation of the observation group was more obvious（ P〈0. 05）. 2） The expression of peripheral mononuclear cells NMDA receptor and plasma bradykinin in the two groups after treatment reduced compared those before the treatment,and the down-regulation of the observation group were significant than those of the control group（ P〈0. 05）. Conclusion： Shu-Mu acupoints may obviously relieve the clinical symptoms of patients with shoulder-hand syndrome after stroke,and its mechanism may be related to down-regulation of the expression of NMDA receptors and plasma bradykinin in the peripheral blood plasma.