浮针联合火针治疗脑卒中后肩手综合征Ⅰ期临床研究

Clinical Study of Fu’s Subcutaneous Needling Combined with Fire Acupuncture in Treatment of Post-Stroke SHS of StageⅠ

目的:观察浮针联合火针治疗脑卒中后肩手综合征(SHS)Ⅰ期的临床疗效。方法:将纳入的62例SHSⅠ期患者随机分成两组,每组各31例。两组均予常规治疗,对照组给予常规针刺治疗,每日治疗1次;治疗组采取浮针联合火针疗法,隔日治疗1次;两组连续治疗3周。观察两组治疗前、第1次治疗后、治疗3周后视觉模拟评分量表(VAS)评分、上肢水肿分级评分和上肢简化Fugl-Meyer运动功能(FMA)量表评分变化,取治疗前后血液检测两组降钙素基因相关肽(CGRP)、P物质(SP)含量变化,并分析两组临床疗效情况。结果:两组治疗后VAS评分、上肢水肿评分均较同组治疗前降低(均P<0.05),FMA总分较同组治疗后升高(P<0.05),且治疗组优于对照组(P<0.05);治疗组治疗3周后CGRP、SP水平均优于治疗前及对照组治疗3周后水平(均P<0.05);治疗组临床疗效优于对照组(P<0.05)。结论:浮针联合火针可以短时间内调节血液中CGRP及SP水平,明显缓解肩手综合症患者的疼痛、水肿症状,进一步改善患者患侧上肢活动功能,临床疗效优于常规针刺。

Objective:To observe the clinical efficacy of Fu’s subcutaneous needling combined with fire acupuncture in the treatment of post-stroke shoulder-hand syndrome(SHS)of stageⅠ.Methods:62 patients with post-stroke SHS of stageⅠwere randomly divided into the control group and the treatment group,with 31 cases in each group.Both groups were treated with routine medical therapy.The control group was treated with conventional acupuncture,once a day.The treatment group was treated with Fu’s subcutaneous needling combined with fire needling,once every two days.The two groups were treated for three continuous weeks.Scores of VAS,upper limb edema grading and upper limb simplified FMA were observed before the treatment,after the first treatment and after 3 weeks of the treatment in the two groups.Blood was taken to detect the contents of CGRP and SP before and after the treatment in the two groups.The clinical efficacy was analyzed and compared between the two groups.Results:The scores of VAS and upper limb edema were significantly decreased(P<0.05),and the total score of FMA was significantly increased after the treatment compared to those before the treatment in the two groups(P<0.05);of which the improvements were more significant in the treatment group(P<0.05).The levels of CGRP and SP were better after three weeks of the treatment than those before the treatment in the treatment group(P<0.05);which were also better in the treatment group than those in the control group after three weeks of the treatment(P<0.05).The clinical efficacy of the treatment group was superior to that of the control group(P<0.05).Conclusion:Fu’s subcutaneous needling combined with fire acupuncture can adjust the blood levels of CGRP and SP in a short period of time,it can significantly relieve the pain and edema of the patients with SHS of stageⅠ,and further improve the motility function of the affected upper limbs.Its clinical efficacy is better than conventional acupuncture.