不同频率提插手法针刺治疗中风后肩手综合征疗效观察

Therapeutic effect of acupuncture with different frequency of lifting and inserting manipulation on reflex sympathetic dystrophy after apoplexy

目的观察不同频率提插手法针刺治疗中风后肩手综合征的临床疗效。方法收集160例中风后肩手综合征患者,随机分为4组,每组40例。4组均予以常规康复功能训练。对照组予常规针刺疗法;其余3组取穴与对照组相同,低、中、高频针刺组分别予低频、中频、高频提插手法进行针刺治疗。治疗后观察比较各组临床疗效、生活质量评分、视觉模拟评分、水肿评分、肩关节活动度情况。结果治疗后,与对照组比较,中频及高频针刺组临床总有效率更高(P<0.05);4组肩关节活动度评分均显著提高(P<0.05),与对照组比较,高频针刺组改善更为显著(P<0.05);4组水肿评分均有改善,各组与对照组治疗后比较无统计学差异(P>0.05);4组VAS评分均显著下降(P<0.05),ADL评分均显著提高(P<0.05);与对照组比较,治疗后中频及高频针刺组的VAS评分均明显降低,ADL评分显著升高(P<0.05)。结论中风后肩手综合征采用高频针刺提插手法配合康复功能训练可有效提高临床疗效,改善症状,提高患者的肩关节活动度。

Objective To observe the clinical effect of acupuncture with different frequencies on the treatment of reflex sympathetic dystrophy after apoplexy.Methods A total of 160 patients with post-stroke reflex sympathetic dystrophy were randomly divided into 4 groups,40 in each group.All groups were trained in routine rehabilitation.The control group received conventional acupuncture therapy.The other three groups received the same points as the control group,and the low,medium and high frequency acupuncture groups were treated with low frequency,medium frequency and high frequency insertion methods for acupuncture treatment respectively.After treatment,the clinical efficacy,quality of life score,visual analog score(VAS),edema score,and shoulder joint mobility were compared.Results After treatment,compared with the control group,the total effective rate was higher in the intermediate frequency and high frequency acupuncture groups(P<0.05).The shoulder joint activity scores of the four groups were significantly increased(P<0.05).Compared with the control group,the improvement of high-frequency acupuncture group was more significant(P<0.05).The edema scores of the four groups were improved.There was no significant difference between each acupuncture group and the control group(P>0.05).The VAS of all groups significantly decreased(P<0.05),and the ADL scores of all groups were significantly increased(P<0.05).Compared with the control group,the VAS scores of the intermediate frequency and high frequency acupuncture groups were significantly lower after treatment,and the ADL scores were significantly increased(P<0.05).Conclusion The use of high-frequency acupuncture and lifting and inserting manipulation combined with rehabilitation function training can improve shoulder mobility,clinical efficacy and symptoms of reflex sympathetic dystrophy after apoplexy.