温针灸结合刺络拔罐治疗脑卒中后肩手综合征疗效观察

Effect of warming acupuncture combined with blood-letting puncture and cupping on shoulder-hand syndrome after stroke

目的观察温针灸结合刺络拔罐治疗脑卒中后肩手综合征的临床疗效。方法选取2015年1月至2017年10月海南省人民医院中医科收治的脑卒中后肩手综合征患者64例,根据随机数表法分为观察组和对照组各32例。观察组采用温针灸结合刺络拔罐治疗,对照组仅用常规针刺治疗,两组均治疗2周。比较两组患者的综合临床疗效、患肢Fugl-Meyer运动功能评分(FMA)、疼痛视觉模拟评分(VAS)及肿胀程度评分变化情况。结果治疗结束后,观察组患者的疼痛VAS评分及肿胀评分分别为(3.37±1.54)分、(0.77±0.36)分,明显低于对照组的(4.45±1.36)分、(1.13±0.42)分,差异均有统计学意义(P<0.05);观察组患者的FMA评分为(41.87±15.83)分,明显高于对照组的(32.36±16.06)分,差异有统计学意义(P<0.05);观察组患者的治愈率和显效率分别为21.88%和56.25%,明显高于对照组的3.13%和18.75%,差异均有统计学意义(P<0.05)。结论温针灸结合刺络拔罐治疗和常规针刺治疗均能明显地缓解患肢的疼痛,改善患肢的运动功能,减轻患肢肿胀,但温针灸结合刺络拔罐优于常规针刺治疗。

Objective To observe the clinical effect of warming acupuncture combined with blood-letting puncture and cupping in the treatment of shoulder-hand syndrome after stroke. Methods A total of 64 patients with shoulder-hand syndrome after stroke admitted by the Department of Traditional Chinese Medicine of Hainan General Hospital from January 2015 to October 2017 were selected and divided into observation group and control group according to random number table method, with 32 patients in each group. Patients in the observation group were treated with warming acupuncture combined with blood-letting puncture and cupping, while the patients in control group were only treated with routine acupuncture. The two groups were treated for 2 weeks. The clinical efficacy, the affected limb fugl-meyer motor function score（FMA）, pain visual analogue score（VAS） and swelling score of the two groups were observed. Results After the treatment, the pain VAS score and swelling score in the observation group were（3.37 ±1.54） and（0.77±0.36）, respectively, which were significantly lower than corresponding（4.45±1.36） and（1.13±0.42） in the control group（P〈0.05）. The FMA score in the observation group was（41.87 ±15.83）, which was significantly higher than（32.36±16.06） in the control group（P〈0.05）. The cure rate and marked effective rate of the observation group were21.88% and 56.25%, respectively, which were significantly higher than 3.13% and 18.75% in the control group（P〈0.05）. Conclusion Warming acupuncture combined with blood-letting puncture and cupping and routine acupuncture can both obviously relieve the pain, improve the motor function, and reduce the swelling of the affected limbs, but the former is superior.