针灸按摩联合现代康复训练治疗肩手综合征63例临床研究

Clinical study of acupuncture and massotherapy combined with modern rehabilitation training on the treatment of shoulder-hand syndrome

目的观察针灸按摩联合现代康复训练治疗肩手综合征(SHS)的临床疗效。方法将103例SHS患者随机分为2组,对照组40例予现代康复训练治疗,治疗组63例在对照组治疗基础上加用针灸按摩治疗。2组均1周为1个疗程,4个疗程后统计临床疗效,并观察2组治疗前后上肢运动功能评分、疼痛视觉模拟评分(VAS)、改良Barthel指数(BI)评分及水肿情况,并观察2组治疗前后血液流变学变化情况。结果治疗组总有效率95.65%,对照组总有效率82.50%,2组比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。2组治疗后上肢运动功能评分及BI评分均升高,VAS评分及手肿胀值均降低,差异均有统计学意义(P<0.05),且2组治疗后比较差异均有统计学意义(P<0.05)。2组治疗后血液流变学各项指标均降低,差异均有统计学意义(P<0.05),并且除纤维蛋白原外,其余各项指标比较差异有统计学意义(P<0.05)。结论针灸按摩联合现代康复训练治疗SHS疗效确切,且能改善上肢运动功能、疼痛症状、日常生活能力及血液流变学指标。

Objective To observe the clinical effects of acupuncture and massotherapy combined with modern rehabilitation training on the treatment of shoulder- hand syndrome. Methods 103 subjects with shoulder-hand syndrome were randomly divided into two groups. 40 subjects in control group were treated by modern rehabilitation training. 63 subjects in treatment group were treated by acupuncture and massotherapy on the basis of control group treatment. The course was one weeks in two groups. The curative effect was evaluated after four courses. The upper limb motor function score,visual analogue scale（ VAS）,modified Barthel index and the symptom of edema before and after treatment were observed in two groups,as well as the changes of hemorheology. Results The total effective rate in treatment group（ 95. 65%） was superior to that in control group（ 82. 5%,P〈0. 05）. The scores of upper limb motor function and life quality after treatment were obviously increased in two groups,and the scores of pain and edema were decreased（ P〈0. 05）,there were statistical difference between two groups（ P〈0. 05）. The hemorheology indexes after treatment were decreased in two groups,with statistical differences（ P〈0. 05）. Except fibrinogen,there were statistical differences on other hemorheology indexes between two groups（ P〈0. 05）. Conclusion Acupuncture and massotherapy combined with modern rehabilitation training has exact effects on the treatment of shoulder- hand syndrome,can improve upper limb movement function and hemorheology indexes,alleviating pain,enhance the activity of daily living.