加味黄芪桂枝五物汤联合醒脑开窍针刺法治疗脑卒中后肩手综合征的临床观察

Clinical observation on treating shoulder and hand syndrome after stroke with the modified Huangqi Guizhi Wuwu decoction plus Xingnao Kaiqiao acupuncture

目的:探析脑卒中后肩手综合征(Should-hand Syndrome,SHS)应用黄芪桂枝五物汤加减联合醒脑开窍针刺法的临床价值。方法:选取昌乐县妇幼保健院2018年6月-2020年11月收治的82例脑卒中后SHS患者,随机分为两组,各41例。对照组实施常规康复治疗联合醒脑开窍针刺法治疗,观察组在对照组基础上加服加味黄芪桂枝五物汤治疗,比较两组临床疗效及康复情况。结果:观察组脑卒中后SHS患者的总有效率。显著高于对照组(P<0.05);观察组脑卒中后SHS患者的康复指标[肢体运动功能Fugel-Meyer评定量表(Fugl-Meyer Assessment,FMA)、肩手综合征评估量表(Shoulder Hand Syndrome Score,SHSS)]显著优于对照组(P<0.05)。结论:内外同治(黄芪桂枝五物汤加减+醒脑开窍针刺法)治疗脑卒中后SHS临床效果显著,可有效改善肩手关节疼痛、皮肤潮红、活动受限等症状,值得临床推广。

Objective:To explore the clinical value of the modified Huangqi Guizhi Wuwu decoction(加味黄芪桂枝五物汤)plus Xingnao Kaiqiao acupuncture(醒脑开窍针刺法)on post-stroke shoulder and hand syndrome(SHS).Methods:82 patients with post-stroke SHS admitted to People’s Hospital of Changle County from June 2018 to November 2020 were randomly divided into two groups,with 41 patients in each group.The control group was treated with conventional rehabilitation therapy plus Xingnao Kaiqiao acupuncture,and the observation group was treated with the modified Huangqi Guizhi Wuwu decoction plus Xingnao Kaiqiao acupuncture on the basis of the treatment of the control group.The clinical efficacy and rehabilitation status in the two groups were compared.Results:The total effective rate of SHS patients after stroke in the observation group was significantly higher than that in the control group(P<0.05).The recovery indexes(FMA and SHSS)of SHS patients after stroke in the observation group were significantly better than those in the control group(P<0.05).Conclusion:The modified Huangqi Guizhi Wuwu decoction plus Xingnao Kaiqiao acupuncture has a significant clinical effect in the treatment of post-stroke SHS,which can effectively relieve shoulder and hand joint pain,skin flushing,restricted activity and other symptoms,and is worthy of clinical promotion.