中医定向透药联合康复手法用于缺血性脑卒中肩手综合征患者上肢功能改善的价值

Value of Traditional Chinese Medicine Directional Permeation Combined with Rehabilitation Manipulation for Improving Upper Limb Function in Patients with Shoulder-Hand Syndrome of Ischemic Stroke

目的:观察中医定向透药联合康复手法用于缺血性脑卒中肩手综合征患者上肢功能改善的价值。方法:选择我院2017年2月~2019年2月收治的86例缺血性脑卒中肩手综合征患者为研究对象,利用随机数字法将其分成联合组和康复组,均43例。康复组采用康复手法治疗,联合组在康复组的基础上给予中医定向透药治疗。比较两组患者临床疗效,对比两组患者治疗前后Fygl-Meyer运动功能(FMA)、日常生活活动指数(Barthel)、视觉模拟疼痛(VAS)评分和生活质量量表(SF-36)评分差异,最后统计联合组不良发应发生情况。结果:联合组治疗后总有效率93.02%显著高于康复组76.74%,差异有统计学意义(P<0.05)。联合组治疗后FMA、Barthel评分显著高于治疗前及康复组治疗后,差异有统计学意义(P<0.05);联合组治疗后VAS评分显著低于治疗前及康复组治疗后,差异有统计学意义(P<0.05)。联合组治疗后生理功能、躯体疼痛、总体健康、活力和精神健康显著高于治疗前及康复组治疗后,差异有统计学意义(P<0.05);两组治疗前后组内比较,生理职能、社会功能和情感职能显著增高,差异有统计学意义(P<0.05);两组生理职能、社会功能和情感职能组间比较,差异无统计学意义(P>0.05)。联合组出现恶心呕吐2例,头晕发热1例,乏力胸闷1例,均为轻微不良发应,未采取相关具体措施患者自行缓解。结论:中医定向透药联合康复手法治疗缺血性脑卒中肩手综合征患者,可提高治疗疗效和生活质量,改善上肢功能,有利于肩手关节的恢复,安全性较高,具有一定的临床应用价值。

Objective:To explore the value of traditional Chinese medicine directional permeation combined with rehabilitation methods in improving upper limb function in patients with ischemic stroke and shoulder-hand syndrome.Methods:A total of 86 patients with shoulder-hand syndrome of ischemic stroke who were treated in our hospital from February 2017 to February 2019 were selected as the research subjects.They were divided into a combined group and a rehabilitation group by random number methods,with 43 cases each.The rehabilitation group was treated with rehabilitation techniques,and the combined group was given TCM directional drug therapy based on the rehabilitation group.Compared the clinical efficacy of the two groups of patients,and compared the differences in Fygl-Meyer motor function(FMA),daily activity index(Barthel),visual simulated pain(VAS)score and quality of life scale(SF-36)scores before and after treatment in the two groups.Finally,statistics on the occurrence of adverse reactions in the joint group.Results:The total effective rate of the combined group after treatment was 93.02%significantly higher than the rehabilitation group of 76.74%,and the difference was statistically significant(P<0.05).The FMA and Barthel scores in the combined group were significantly higher than those before the treatment and after the rehabilitation group,and the differences were statistically significant(P<0.05).The VAS scores in the combined group were significantly lower than those before and after the rehabilitation group,and the differences were statistically significant(P<0.05).The physiological function,physical pain,overall health,vitality,and mental health of the combination group were significantly higher than those before the treatment and after the rehabilitation group,and the differences were statistically significant(P<0.05).Comparing the two groups before and after treatment,the physiological functions,social function and emotional function were significantly increased,and the difference was statistically significant(P<0.05).There was no significant difference in physiological function,social function,and emotional function between the two groups(P>0.05).In the combination group,nausea and vomiting occurred in 2 cases,dizziness and fever in 1 case,and fatigue and chest tightness in 1 case,all of which were minor adverse reactions,and patients who did not take specific measures relieved themselves.Conclusion:Traditional Chinese medicine with directional permeation combined with rehabilitation therapy for patients with ischemic stroke and shoulder-hand syndrome can improve the therapeutic efficacy and quality of life,improve upper limb function,facilitate the recovery of shoulder-hand joints,and have high safety.