电针联合隔姜艾灸治疗缺血性脑卒中后肩手综合征的疗效及对CGRP、BK、SP水平的影响

Therapeutic Effect of Electroacupuncture Combined with Ginger-Separated Moxibustion on Shoulder-Hand Syndrome After Ischemic Stroke and its Influence on CGRP and BK and SP Levels

目的:观察电针联合隔姜艾灸治疗缺血性脑卒中后肩手综合征的疗效及对降钙素基因相关肽(calcitonin gene related peptide,CGRP)、缓激肽(bradykinin,BK)及P物质(substance P,SP)水平的影响。方法:选取本院2015年4月至2017年6月收治的缺血性脑卒中后肩手综合征患者130例,按照随机数字表法分为对照组和针刺组,每组65例。对照组给予西医肢体康复锻炼治疗,针刺组在对照组治疗的基础上加用电针联合隔姜艾灸治疗。观察两组患者近期疗效,治疗前后中医证候积分、疼痛水肿视觉模拟评分、肩手综合征(shoulder-hand syndrome,RSD)功能量表评分、肩关节功能独立性评分,Fugl-Meyer评分法(FMA)、CGRP、BK、SP水平。结果:针刺组有效率89. 23%,对照组有效率73. 85%,针刺组近期疗效显著优于对照组,差异有统计学意义(P <0. 05);针刺组治疗后中医证候积分和疼痛水肿视觉模拟评分均显著低于对照组,差异有统计学意义(P <0. 05);针刺组治疗后RSD功能量表评分、肩关节功能独立性评分、FMA评分均优于对照组,差异有统计学意义(P <0. 05);针刺组治疗后CGRP、BK、SP水平均优于对照组,差异有统计学意义(P <0. 05)。结论:电针联合隔姜艾灸治疗缺血性脑卒中后肩手综合征可显著缓解患者肩手疼痛肿胀症状,促进肢体活动功能恢复,改善CGRP、BK及SP水平。

Objective: To observe the curative effect of electro-acupuncture combined with ginger-separated moxibustion on shoulder-hand syndrome after ischemic stroke and its influence on the levels of calcitonin gene-related peptide( CGRP),bradykinin( BK) and substance P( SP). Methods: A total of 130 patients with shoulder-hand syndrome after ischemic stroke admitted to our hospital from April 2015 to June 2017 were randomly divided into the control group and the acupuncture group,with 65 cases in each group. The ones in the control group were treated with limb rehabilitation exercises of Western medicine,while the ones in the acupuncture group were treated with electro-acupuncture combined with ginger-separated moxibustion on the basis of the control group. The short-term curative effect of the two groups,the scores of TCM syndromes,pain and edema visual simulation,shoulder-hand syndrome( RSD) functional scale,shoulder joint functional independence,Fugl-Meyer score( FMA),CGRP,BK and SP levels before and after treatment were observed. Results: The effective rate of the acupuncture group was 89. 23%,and that of the control group was 73. 85%. The short-term effect of the acupuncture group was significantly better than that of the control group,and the difference was statistically significant( P < 0. 05). The scores of TCM syndromes and visual analogue of pain and edema in the acupuncture group were significantly lower than those in the control group,and all the differences were statistically significant( P < 0. 05). After the treatment,the scores of RSD functional scale,shoulder functional independence and FMA in the acupuncture group were better than those in the control group,and all the differences were statistically significant( P < 0. 05). After the treatment,the levels of CGRP,BK and SP in the acupuncture group were better than those in the control group,and all the differences were statistically significant( P < 0. 05). Conclusion: Electro-acupuncture combined with ginger-separated moxibustion in the treatment of shoulder-hand syndrome after ischemic stroke can significantly alleviate the symptoms of shoulder-hand syndrome,promote the recovery of limb function,and enhance the levels of CGRP,BK and SP.