针刀结合电针和温针灸治疗脑卒中后肩手综合征疗效观察

Clinical Effect of Needle Knife Combined with Electroacupuncture and Warming Acupuncture-moxibustion in Treatment of Post-stroke Shoulder-Hand Syndrome

目的观察针刀结合电针和温针灸治疗脑卒中后肩手综合征(shoulder-hand syndrome,SHS)的临床疗效。方法将50例脑卒中后SHS患者随机分为观察组和对照组,每组25例。观察组予以针刀结合电针和温针灸治疗,对照组予以电针和温针灸治疗。两组均连续治疗2周,分别在治疗前后及疗程结束后3个月随访时采用肩手综合征评价量表(shoulder hand syndrome scale,SHSS)及简化Fugl-Meyer运动评分量表(Fugl-Meyer assessment,FMA)对患者的肢体感觉、水肿以及运动功能进行评价。结果两组治疗后SHSS、FMA评分较治疗前均明显改善(P<0.05),且观察组在治疗后及疗程结束后3个月随访时SHSS评分均显著低于对照组(P<0.05),FMA评分均显著高于对照组(P<0.05)。结论针刀结合电针和温针灸可明显改善脑卒中后SHS患者关节肿痛及上肢运动功能,疗效优于常规针灸治疗组,且具有较好的远期疗效。

Objective To observe the clinical effect of needle knife combined with electroacupuncture and warming acupuncture-moxibustion in the treatment of post-stroke shoulder-hand syndrome （SHS）. Methods Fifty patients with post-stroke SHS were randomly and equally divided into observation group and control group. The observation group was treated with needle knife combined with electroacupuncture and warming acupuncture-moxibustion, while the control group was given electroacupuncture and warming acupuncture-moxibustion. The course of treatment was two weeks for both groups. The shoulder hand syndrome scale （SHSS） and the shortened Fugl-Meyer Assessment （FMA） were used to assess limb feeling, edema, and motor function before and after treatment and at 3 months after the course of treatment. Results Both groups showed significant improvements in SHSS and FMA scores after treatment （P〈0.05）, and the observation group had a significantly lower SHSS score and a significantly higher FMA score compared with the control group immediately and at 3 months after the course of treatment （P〈0.05）. Conclusion For patients with post-stroke SHS, needle knife combined with electroacupuncture and warming acupuncture-moxibustion can significantly improve articular pain and swelling, and the motor function of the upper extremities, and has a better clinical effect than conventional acupuncture and moxibustion. In addition, it has a good long-term effect.