中药熏蒸结合手法治疗脑卒中后肩手综合征临床观察

Clinical Observation on Traditional Chinese Medicine Fumigation Combined with Manipulation in the Treatment of Shoulder-Hand Syndrome after Stroke

目的观察中药熏蒸结合手法治疗脑卒中后肩手综合征(SHS)的疗效。方法选择210例2016年6月—2019年6月于洪洞县人民医院康复科就诊的脑卒中后SHS患者,以随机数字表法分为观察组(105例)、对照组(105例)。对照组接受手法治疗,观察组在对照组基础上接受中药熏蒸治疗,2组均连续治疗4周。观察2组治疗前、治疗后的主要证候评分、血浆细胞因子水平、肿胀、手指运动功能及疼痛情况。结果治疗后,2组肩部疼痛、舌淡苔薄、半身不遂、感觉减退、脉象弦滑、肿胀、疼痛评分及血清ET-1、BK水平低于治疗前,且观察组低于对照组(P<0.05);2组手指运动功能评分及血清NO、CGRP水平高于治疗前,观察组高于对照组(P<0.05)。结论中药熏蒸结合手法治疗脑卒中后SHS可降低血清ET-1、BK水平,升高血清NO、CGRP水平,抑制病情进展,有效缓解患者主要证候、肿胀、手指运动功能及疼痛情况。

Objective To observe the curative effect of traditional Chinese medicine fumigation combined with manipulation on SHS after stroke.Methods From June 2016 to June 2019,210 patients with post-stroke SHS in Hongtong County People’s Hospital were randomly divided into the observation group(105 cases)and the control group(105 cases).The control group received manipulation therapy,while the observation group received traditional Chinese medicine fumigation on the basis of the control group.Both groups were treated continuously for 4 weeks.The main syndrome scores,plasma cytokine levels,swelling,finger movement function and pain were observed before and after treatment.Results After treatment for 4 weeks,shoulder pain,thin tongue,hemiplegia,hypoesthesia,pulse slippery,swelling,pain score and serum ET-1 and BK levels in the two groups were lower than those before treatment,and that of the observation group was lower than that in the control group(P<0.05).Finger motor function scores and serum NO and CGRP levels in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).Conclusion Traditional Chinese medicine fumigation combined with manipulation therapy can reduce the levels of serum ET-1 and BK,increase the levels of serum NO and CGRP,inhibit the progress of the disease,and effectively relieve the main symptoms,swelling,finger movement function and pain of patients after stroke.