星状神经节埋线结合康复训练治疗脑卒中后肩手综合征疗效观察

Curative Observation Effect of Stellate Ganglion Catgut Implantation Combined with Rehabilitation Training on Shoulder-hand Syndrome after Stroke

目的:探究星状神经节埋线结合康复训练对肩手综合征的疗效。方法:将90例脑卒中后肩手综合征患者随机分为埋线组、电针组和康复组,每组30例。3组患者均给予康复训练治疗,针刺组给予常规电针治疗,埋线组予以颈部双侧星状神经节埋线治疗。治疗1个疗程后,采用证候总积分、视觉模拟评分、FCA评分对患者治疗前后症状改善,上肢疼痛及综合功能进行评价,并比较两组临床疗效。结果:(1)治疗后,3组患者的证候总积分、VAS评分、FCA评分均较治疗前显著改善(P<0.01),且埋线组均优于电针组及康复组(P<0.05)。(2)埋线组总有效率达92.50%,电针组80.00%,康复组75%,差异有统计学意义(P<0.05)。(3)3组患者均无脱落病例,依从性好,都能正常完成整个治疗过程,且未出现明显的不良反应。结论:星状神经节埋线结合康复训练对脑卒中后肩手综合征患者有显著疗效,其疗效优于电针组及单纯的康复训练治疗。

Objective ： To explore the curative effect of stellate ganglion catgut implantation combined with rehabilitation training on shoulder-hand syndrome. Methods： Ninety patients with shoulder-hand syndrome after stroke were randomly divided into three groups： catgut implantation group, electro- acupuncture group and rehabilitation group （ n=30 ） . Three groups of patients were given rehabilitation training, electro-acupuncture group were given conventional electro-acupuncture treatment, the catgut implantation group were given bilateral neck stellate ganglion catgut embedding treatment. After one course of treatment, the total score of syndromes, visual analogue scale （ VAS ） and functional comprehensive assessment （ FCA ）score were used to evaluate the improvement of symptoms, upper limb pain and comprehensive function before and after treatment, and to compare the clinical curative effect between the two groups. Resuhs ： （ 1 ） After treatment, the total score of syndromes, VAS score and FCA score of the three groups were significantly improved （P〈0.01）, and the catgut implantation group was better than the electro-acupuncture group and the rehabilitation group （ P〈0.05 ）. （ 2 ） The total effective rate was 92.50% in the catgut implantation group, 80.00% in the electro-acupuncture group and 75% in the rehabilitation group, the difference was statistically significant （ P〈0.05 ）. （ 3 ） The three groups of patients had no cases of fall off, compliance is good, can complete the normal course of treatment, and no obvious adverse reactions. Conclusion ： Stellate ganglion catgut implantation combined with rehabilitation training has a significant curative effect on patients with shoulder-hand syndrome after stroke, and its curative effect is better than electro-acupuncture group and simple rehabilitation training.