针刺联合体外冲击波治疗脑卒中后肩手综合征的临床效果

Clinical Effect of Acupuncture Combined with Extracorporeal Shock Wave on Shoulder-Hand Syndrome After Stroke

目的观察针刺联合体外冲击波治疗对脑卒中后肩手综合征(SHS)患者上肢功能及生活质量的影响。方法将40例脑卒中后SHS患者按随机数表法分为治疗组和对照组,每组20例。对照组接受Maitland手法联合中药熏蒸局部治疗,治疗组接受针刺联合体外冲击波治疗,均治疗4周。治疗结束后评估治疗效果,分别于治疗前和治疗后采用Fugl-Meyer评分评估患者患侧上肢活动功能情况,采用脑卒中专用生活质量量表(SS-QOL)评估脑卒中患者的生活质量,采用视觉模拟评分法(VAS)评估患侧关节疼痛程度。结果对照组总有效率为65.0%(13/20),治疗组总有效率为95.0%(19/20),治疗组总有效率高于对照组(P<0.05)。治疗后,两组Fugl-Meyer评分、SS-QOL评分均较治疗前升高,VAS评分均较治疗前降低(P<0.05)。治疗组治疗后Fugl-Meyer评分、SS-QOL评分高于对照组,VAS评分低于对照组(P<0.05)。结论针刺联合体外冲击波治疗可显著改善脑卒中后SHS患者的上肢功能,减轻疼痛,提高患者生活质量,治疗效果好,患者易于接受,值得临床推荐。

Objective To observe the effect of acupuncture combined with extracorporeal shock wave on upper limb function and quality of life in patients with shoulder-hand syndrome(SHS)after stroke.Methods A total of 40 patients with SHS after stroke were randomly divided into treatment group and control group,with 20 cases in each group.The control group received Maitland manipulation combined with traditional Chinese medicine fumigation,and the treatment group received acupuncture combined with extracorporeal shock wave for 4 weeks.After treatment,the treatment effect was evaluated.Fugl-Meyer score was used to evaluate the activity function of the affected side of the upper limb before and after treatment.Stroke specific quality of life scales(SS-QOL)was used to evaluate the quality of life of stroke patients,and visual analogue scale(VAS)was used to evaluate the degree of joint pain of the affected side.Results The total effective rate was 65.0%(13/20)in control group and 95.0%(19/20)in treatment group.The total effective rate in treatment group was higher than that in control group(P<0.05).After treatment,Fugl-Meyer score and SS-QOL score in the two groups were higher than those before treatment,and VAS score was lower than those before treatment(P<0.05).After treatment,Fugl-Meyer score and SS-QOL score in treatment group were higher than those in control group,and VAS score in treatment group was lower than that in control group(P<0.05).Conclusion Acupuncture combined with extracorporeal shock wave treatment can significantly improve the upper limb function,reduce pain and improve the quality of life of SHS patients after stroke.The treatment effect is good and easy to be accepted by patients,which is worthy of clinical recommendation.