针灸结合作业疗法治疗肩手综合征临床研究

Clinical Study on Acupuncture and Moxibustion Combined with Occupational Therapy in the Treatment of Shoulder-Hand Syndrome

目的:观察针灸结合作业疗法治疗肩手综合征的临床疗效及其对患者生活质量的影响。方法:选取2019年1月至2021年1月济源市中医院治疗的肩手综合征患者100例,按照随机数字表法分为对照组和研究组,每组50例。对照组给予常规康复治疗,研究组给予针灸结合作业疗法治疗。观察两组患者的临床疗效及治疗前后生活质量、Fugl-Meyer运动功能评估量表(fugl-meyer assessment scale,FMA)评分、改良Barthel指数、肩关节活动评分、肩部活动疼痛、中医证候积分变化情况。结果:研究组有效率为92.0%,对照组有效率为78.0%,研究组有效率高于对照组,差异有统计学意义(P<0.05);研究组治疗后生活质量评分高于对照组,差异有统计学意义(P<0.05);研究组治疗后FMA评分、改良Barthel指数、肩关节活动评分均高于对照组,差异有统计学意义(P<0.05);研究组治疗后肩部外展、屈曲、内旋、外旋时的疼痛评分均低于对照组,差异有统计学意义(P<0.05);研究组治疗后肩关节活动受限评分、肢体瘫痪评分、肩关节疼痛评分均低于对照组,差异有统计学意义(P<0.05)。结论:针灸结合作业疗法治疗肩手综合征,可提高患者生活质量、运动功能、日常生活能力及肩部活动能力,还可减轻疼痛,改善中医证候积分。

Objective:To observe the clinical efficacy of acupuncture and moxibustion combined with occupational therapy on shoulder-hand syndrome and the effect on the quality of life of patients.Methods:A total of 100 patients with shoulder-hand syndrome treated in Jiyuan Hospital of Traditional Chinese Medicine from January 2019 to January 2020 were randomly divided into the control group and the study group,with 50 cases in each group.The control group was given routine rehabilitation treatment,while the study group was given acupuncture and moxibustion combined with occupational therapy.The clinical efficacy,quality of life,fugl meyer assessment scale(FMA),modified Barthel index,shoulder activity score,shoulder activity pain and TCM syndrome score of the two groups were observed before and after treatment.Results:The effective rate of the study group was 92.0%,and that of the control group was 78.0%.The effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).The score of quality of life in the study group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The FMA score,modified Barthel index and shoulder joint activity score in the study group were significantly higher than those in the control group,and all the differences were statistically significant(P<0.05).The pain scores of shoulder abduction,flexion,internal rotation and external rotation in the study group were significantly lower than those in the control group,and all the differences were statistically significant(P<0.05).After treatment,the scores of limited shoulder movement,limb paralysis and shoulder pain in the study group were lower than those in the control group and all the differences were statistically significant(P<0.05).Conclusion:Acupuncture and moxibustion combined with occupational therapy in the treatment of shoulder hand syndrome can improve the quality of life,motor function,daily living ability and shoulder activity of patients,reduce pain and improve the score of TCM syndromes.