毛刺法结合肩周封闭术治疗脑卒中肩手综合征Ⅰ期的临床观察

Clinical Observation on Shallow Needling Combined with Periarthritis Closure Therapy in the Treatment of StageⅠShoulder-hand Syndrome after Stroke

【目的】观察毛刺法结合肩周封闭术治疗脑卒中肩手综合征Ⅰ期的临床疗效。【方法】将40例脑卒中后肩手综合征Ⅰ期患者随机分为治疗组和对照组,每组各20例。2组患者均给予脑卒中常规药物治疗和基础康复治疗。对照组在常规处理的基础上,给予肩周封闭术治疗。治疗组在对照组治疗的基础上,给予手背部毛刺法治疗。2周为1个疗程,共治疗1个疗程。治疗2周后,评价2组临床疗效,观察2组患者治疗前后疼痛视觉模拟量表(VAS)评分与手肿胀程度的变化情况,以及手部交感神经皮肤反应(SSR)的情况。比较2组患者治疗前后Fugl-Meyer手功能量表的变化情况,并评价2组不良反应的发生情况。【结果】(1)治疗后,2组患者的VAS评分、手肿胀程度、SSR波幅均明显改善(P<0.05),且治疗组在改善VAS评分、手肿胀程度、SSR波幅方面均明显优于对照组,差异均有统计学意义(P<0.05)。(2)治疗后,2组患者的Fugl-Meyer手功能量表评分明显改善(P<0.05),治疗组在改善Fugl-Meyer手功能量表评分方面稍优于对照组,但与对照组比较,差异无统计学意义(P>0.05)。(3)治疗组总有效率为95.00%(19/20),对照组为85.00%(17/20)。治疗组疗效稍优于对照组,但差异无统计学意义(P>0.05)。治疗组显效率为85.00%(17/20),对照组为15.00%(3/20)。治疗组显效率明显高于对照组,差异有统计学意义(P<0.05)。(4)2组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】毛刺法结合肩周封闭术治疗脑卒中肩手综合征Ⅰ期,能明显改善患者疼痛、肿胀等症状,改善交感神经皮肤反应,疗效显著。

Objective To observe the clinical efficacy of shallow needling combined after periarthritis closure therapy in the treatment of stageⅠshoulder-hand syndrome after stroke.Methods Forty patients of stageⅠshoulder-hand syndrome after stroke were randomly divided into treatment group and control group,with 20 patients in each group.Patients in both groups were given conventional drug therapy and basic rehabilitation therapy for stroke.The control group was treated with periarthritis closure therapy on the basis of conventional treatment,and the treatment group was treated with shallow needling at hand back on the basis of the control group,two weeks as a course of treatment and lasting one course.After 2 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes of Visual Analogue Scale(VAS)score and hand swelling degree,as well as the sympathetic skin reaction(SSR)of hands were observed before and after treatment.The changes of Fugl-Meyer hand function scale were compared between the two groups before and after treatment,and the incidence of adverse reactions in the two groups was evaluated.Results(1)After treatment,VAS score,hand swelling degree and SSR amplitude in the two groups were significantly improved(P<0.05),and the improvement of VAS score,hand swelling degree and SSR amplitude in the treatment group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(2)After treatment,the scores of Fugl-Meyer hand function scale in both groups were significantly improved(P<0.05).The improvement of score of Fugl-Meyer hand function scale in the treatment group was slightly superior to that in the control group,but there was no statistically significant difference(P>0.05).(3)The total effective rate was 95.00%(19/20)in the treatment group and 85.00%(17/20)in the control group.The therapeutic effect of the treatment group was slightly superior to that of the control group,but there was no statistically significant difference(P>0.05).The marked effective rate was 85.00%(17/20)in the treatment group and 15.00%(3/20)in the control group.The marked effective rate of the treatment group was higher than that of the control group,the difference being statistically significant(P<0.05).(4)There was no statistical significance in the incidence of adverse reactions between two groups(P>0.05).Conclusion The shallow needling therapy combined with periarthritis closure therapy has significant effect in treating stageⅠshoulder-hand syndrome after stroke by improving the symptoms of pain,swelling and sympathetic nerve skin reaction.