小针刀治疗脑梗死后Ⅰ期肩手综合征的疗效观察

目的探讨针刀疗法对脑梗死后I期肩手综合征的临床疗效。方法将2016年1月至2017年7月符合脑梗死后Ⅰ期肩手综合征诊断的患者60例，随机分为针刀组及对照组，每组各30例。针刀组采用针刀联合康复治疗，对照组只采用康复治疗。针刀治疗1次／周，治疗4周。康复治疗每天进行，包括患侧肩部良肢位摆放，冰袋刺激，气压治疗，关节松动术及主被动活动等，治疗4周。治疗前和治疗4周后分别予以改良Barthel指数评分及患侧肩部活动度（前屈，后伸）、肌电图正中神经感觉传导速度检测，对结果进行治疗前后及治疗后组间统计学分析。结果针刀组和对照组治疗前年龄、发病时间、改良Barthel指数评分，正中神经感觉传导速度及肩部（前屈，后伸）活动度比较，两组无统计学差异（P〉0．05）。具可比性。4周后两组治疗后分别与治疗前比较，差异均有统计学意义（P〈0．05）。两组治疗后组间相比较差异均有统计学意义（P〈0．05）。结论针刀疗法能显著改善脑梗死后Ⅰ期肩手综合征患者的肩痛和减轻肿胀，促进患侧上肢功能恢复，值得临床推广。

Objective To observe and evaluate the clinical efficacy of the treatment of the shoulder- hand syndrome at Stage I by using acupotomy. Methods From January 2016 to July 2017, 60 patients were diagnosed with stage I shoulder hand syndrome after cerebral infarction. They were randomly divided into acupotomy group and control group, with 30 cases in each group. Acupotomy group was treated with needle knife combined with rehabilitation therapy, and the control group was only treated with rehabilitation. Acupotomy was treated for 1 times / week, and the treatment was 4 weeks. Rehabilitative treatment was carried out every day, including the good position of the affected side of the shoulder, the ice bag stimulation, the pressure treatment, the joint loosening and the active and passive activities for 4 weeks. Before and after treatment for 4 weeks, the modified Barthel index and the shoulder shoulder mobility （ flexion and extension ） and the median nerve sensory conduction velocity of the electromyogram were detected, and the results were statistically analyzed before and after treatment. Result~ The acupotomy group compared with the control group, the age, course of disease modified Barthel index scores and the shoulder motion （flexion, extension ） were no significant difference between the two groups, P〉0.05. The results of two groups afeer treatment were compared with before treatment, there were statistical differences （P〈0.05） . The acupotomy group compared with the control group after 4 weeks treatment, there were statistical differences （ P〈0.05 ） . Conclusion The acupotomy can significantly reduce shoulder pain and swelling of the shoulder- hand syndrome at stage I after cerebral infarction, promote the recovery of upper limb function, worthy of clinical promotion.