活血除瘀方熏蒸结合药饼灸治疗对脑卒中后肩手综合征患者临床症状及上肢运动功能的影响研究

Effect of Huoxue Chuyu Recipe Fumigation Combined with Medicated-cake Moxibustion on Clinical Symptoms and Upper Limb MotoRFunction foRPatients with Shoulder-hand Syndrome after Stroke

目的:探究活血除瘀方熏蒸结合药饼灸治疗对脑卒中后肩手综合征(Shoulder-hand Syndrome,SHS)患者临床症状及上肢运动功能的影响。方法选取本院2019年10月~2020年10月收治的脑卒中后SHS患者98例,按照投掷法随机设为50例观察组和48例对照组。两组均给予常规治疗,在此基础上观察组接受活血除瘀方熏蒸结合药饼灸治疗,对照组仅接受药饼灸治疗。观察两组总有效率,并将治疗前、后两组疼痛、肿胀程度、肩关节活动度、一氧化氮(NO)、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)及上肢运动功能(FMA评分)、日常生活能力(MBI评分)进行比较。结果观察组治疗总有效率为92.00%,高于对照组的77.08%(P<0.05);两组治疗后疼痛、肿胀程度评分较治疗前降低,肩关节活动度较治疗前升高,且观察组各临床症状优于对照组(P<0.05);两组治疗后NO、CGRP水平较治疗前高,ET-1水平较治疗前低,且观察组各指标优于对照组(P<0.05);两组治疗后FMA、MBI评分较治疗前高,且观察组治疗后各评分比对照组高(P<0.05)。结论对脑卒中后肩手综合征患者采取活血除瘀方熏蒸结合药饼灸治疗疗效显著,能有效改善患者临床症状,提高上肢运动功能。

Objective:To explore the effect of Huoxue Chuyu Recipe fumigation combined with medicated-cake moxibustion on clinical symptoms and uppeRlimb motoRfunction foRpatients with shoulder-hand syndrome(SHS)afteRstroke.Methods:A total of 98 SHS patients afteRstroke admitted to the hospital from OctobeR2019 to OctobeR2020 were enrolled and randomly divided into an observation group(50 cases)and a controlled group(48 cases)according to throwing method,both groups were given routine treatment.On this basis,the observation group was given Huoxue Chuyu Recipe fumigation combined with medicatedcake moxibustion,while the controlled group was only given medicated-cake moxibustion.The total response ratesin both groups were observed.The pain,swelling,shouldeRrange of motion(ROM),nitric oxide(NO),endothelin-1(ET-1),calcitonin gene-related peptide(CGRP),Fugl-MeyeRassessment scale(FMA)and Modified BarthelIndex(MBI)before and afteRtreatment were compared between the two groups.Results:The total response rate of treatment in the observation group was higher than that in the controlled group(92.00%vs 77.08%)(P<0.05).After treatment,scores of pain and swelling were decreased,while shoulder ROM was increased in both groups.The clinical symptoms in the observation group were better than those in the controlled group(P<0.05).After treatment,levels of NO and CGRP were increased,while ET-1 level was decreased in both groups.And all the above indexes in the observation group were better than those in the controlled group(P<0.05).After treatment,FMA and MBI scores were increased in both groups,which were higher in the observation group than the controlled group(P<0.05).Conclusion:The curative effect of Huoxue Chuyu Recipe fumigation combined with medicated-cake moxibustion is significant on SHS patients after stroke,which can effectively improve clinical symptoms and upper limb motor function of patients.