子午流注低频电疗配合中药封包治疗脑卒中后肩手综合征的疗效及对患者上肢动脉血流速度的影响

Therapeutic Effects of Meridian Ebb-flow Low Frequency Electrotherapy Combined with Traditional Chinese Medicine Package on Shoulder-hand Syndrome Post Stroke and its Effect on Arterial Blood Flow Velocity of Upper Limbs

目的探讨子午流注低频电疗配合中药封包治疗脑卒中后肩手综合征的疗效及对患者上肢动脉血流速度的影响。方法选取2018年6月至2020年6月于蕉岭县人民医院康复科住院的60例在脑卒中并发肩手综合征患者作为研究对象,按患者就诊顺序,随机分为观察组和对照组,各30例。观察组行子午流注低频电疗配合中药封包治疗加常规康复治疗,对照组仅进行常规康复治疗。两组患者在治疗前后分别运用视觉模拟评分法(VAS)评价疼痛程度;改良Ashworth量表评定痉挛程度;Fugl-Meyer上肢运动功能评定量表及肩手综合征量表(SHSS)评定上肢运动功能;彩色多普勒监测上肢桡动脉及肱动脉收缩期峰值血流速度(PSV);观察治疗前后两组血清炎症介质白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)变化情况。结果治疗后,观察组Ashworth评分明显低于对照组,Fugl-Meyer评分明显高于对照组,差异有统计学意义(P<0.05);治疗后,观察组SHSS及VAS评分明显低于对照组,差异有统计学意义(P<0.05);治疗后,观察组肱动脉及桡动脉PSV明显低于对照组,差异有统计学意义(P<0.05);治疗后,观察组血清IL-6、TNF-α明显低于对照组,差异有统计学意义(P<0.05)。结论子午流注低频电疗配合中药封包治疗脑卒中后肩手综合征疗效好,可减轻疼痛,改善上肢痉挛程度及运动功能,改善血液循环。

Objective To explore the therapeutic effect of meridian ebb-flow low-frequency electrotherapy combined with traditional Chinese medicine(TCM) package in the treatment of shoulder-hand syndrome post stroke and its effect on the arterial blood flow velocity of the upper limbs. Methods A total of 60 patients with shoulder-hand syndrome post stroke were selected as the research objects and were randomly divided into an observation group and a control group with 30 cases in each group. The observation group received meridian ebb-flow low-frequency electrotherapy combined with traditional Chinese medicine packet treatment and conventional rehabilitation therapy, while the control group received conventional rehabilitation therapy. The 2 groups of patients used visual analogue scale(VAS) to evaluate the degree of pain before and after treatment;the modified Ashworth scale to evaluate the degree of spasticity;the Fugl-Meyer upper limb motor function rating scale and the shoulder-hand syndrome scale(SHSS) to evaluate upper limb motor function;Color Doppler was used monitored of upper limb radial artery and brachial artery peak systolic blood flow velocity(PSV);the serum inflammatory mediator interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) before and after treatment) changes were observed. Results After treatment, the Ashworth score of the observation group was significantly lower than that of the control group, and the Fugl-Meyer score was significantly higher than that of the control group, and the difference was statistically significant(P<0.05);after treatment, the SHSS and VAS scores of the observation group were significantly lower than the control group. It was statistically significant(P<0.05);after treatment, PSV of brachial artery and radial artery in the observation group was significantly lower than that of the control group, and the difference was statistically significant(P<0.05);Serum IL-6 and TNF-α of the observation group were significantly lower than those of the control group, the difference was statistically significant(P<0.05). Conclusion The meridian Ebb-flow low-frequency electrotherapy combined with traditional Chinese medicine package has positive effect on shoulder-hand syndrome post stroke, which can reduce pain, improve the upper limb spasticity and motor function, improve blood circulation.