缪刺巨刺法治疗脑卒中后肩手综合征的疗效观察

Effect of the contralateral needling therapy on post-stroke shoulder-hand syndrome

目的:观察缪刺巨刺法对中风后肩手综合征引起的疼痛、水肿以及肢体功能障碍的影响,分析其临床疗效。方法:将62例脑卒中后肩手综合征患者分为对照组和观察组,每组31例。在常规内科治疗+康复手法治疗的基础上,对照组采用常规的针刺方法治疗,观察组采用缪刺巨刺针刺方法治疗,两组均每日治疗1次,每次留针30 min,每周治疗5 d,连续治疗4周。评估两组治疗前后改良Fugl-Meyer运动功能评定量表积分(FMA评分)、视觉模拟量尺(VAS)评分、手部水肿分级评分和改良Barthel指数评分(ADL评分)的情况。结果:观察组总有效率为90.32%(28/31),对照组总有效率为67.74%(21/31),观察组高于对照组(P<0.05)。两组治疗后的VAS评分、手部水肿分级评分、FMA评分以及ADL评分均较本组治疗前明显改善(P<0.05),且观察组优于对照组(P<0.05)。结论:缪刺巨刺法在改善卒中后肩手综合征患肢的疼痛、水肿方面以及患侧肢体功能方面均有疗效。

Objective To observe the effect contralateral needling of in improving pain, edema and limb dysfunction in stroke patients with shoulder-hand syndrome. Methods A total of 62 patients with post-stroke shoulder-hand syndrome were divided into a control group and an observation group, 31 cases in each one. The routine treatment with internal medicine and rehabilitation manipulation was adopted in the two groups. Additionally, the routine acupuncture treatment was used in the control group and the contralateral needling techniques was applied in the observation group. The needles were retained for 30 min. The treatment was given once a day for 5 days a week and consecutively for 4 weeks. Before and after treatment, the score of the modified Fugl-Meyer assessment scale(FMA scale), the score of the visual analogue scale(VAS), the score of the hand edema rating and the score of the modified Barthel index(ADL score) were evaluated. Results The total effective rate was 90.32%(28/31) in the observation group and was 67.74%(21/31) in the control group. The effective rate in the observation group was higher than that in the control group(P<0.05). VAS score, the score of the hand edema rating, FMA score and ADL score were obviously improved as compared with those before treatment in each group and the scores in the observation group were better than those of the control group(P<0.05). Conclusion The contralateral needling therapy of acupuncture is effective for relieving pain and edema as well as improving the motor function of the affected limb in the patients with post-stroke shoulder-hand syndrome.