经筋透刺结合八邪穴治疗肩手综合征的临床疗效观察

Observation of Clinical Efficacy and Mechanism of the Treatment of Shoulder Hand Syndrome by Transformed-tendon Theory Combined with Baxie Points

目的:观察经筋透刺联合八邪穴针灸治疗肩手综合征的临床疗效。方法:采用随机对照的方法,将90名肩手综合征患者随机分为治疗组和对照组,治疗组予局部透刺联合八邪穴针灸治疗,对照组予常规针刺治疗,4周后评估2组患者肩关节活动度GEPI评分、疼痛VAS评分、上肢水肿评分、FMA评分及Barthel指数。并对透刺疗法、八邪穴及肩手综合征进行相关文献检索,探讨可能的作用机制。结果:两组患者治疗后疼痛VSA评分和水肿评分较治疗前改善(P<0.05);治疗组肩部疼痛、肩关节活动度、上肢水肿评分及总有效率与对照组比较具有显著差异(P<0.05)。结论:透刺疗法联合八邪穴针灸治疗肩手综合征临床疗效显著,透刺疗法联合八邪穴针灸在快速有效改善肩手综合征患者症状体征具有优势。

Objective:To study the clinical efficacy of penetrating needling combined with Baxie point acupuncture in the treatment of shoulder hand syndrome,and to explore an effective acupuncture treatment scheme for shoulder hand syndrome and explore its possible mechanism.Methods:90 patients with shoulder hand syndrome were randomly divided into treatment group and control group.The treatment group was treated with local penetration acupuncture combined with Baxie point acupuncture,while the control group was treated with conventional acupuncture.After 4 weeks,the shoulder joint activity Gepi score,pain VAS score,upper limb edema score,FMA score and Barthel index were evaluated.Meanwhile,the related literatures on penetration needling therapy,Baxie points and shoulder hand syndrome were searched to explore the possible mechanism.Results:the pain VSA score and edema score of the two groups were improved after treatment(P<0.05);There were significant differences in shoulder pain,shoulder joint range of motion,upper limb edema score and total effective rate between the treatment group and the control group(P<0.05).Conclusion:penetration needling combined with Baxie acupoint acupuncture and conventional acupuncture treatment has good clinical effect in shoulder hand syndrome.The combination of penetration acupuncture and moxibustion at eight evil points has advantages in rapidly and effectively improving symptoms and signs of shoulder hand syndrome patients,which may be associated with reducing sympathetic hyperactivity,relieving vasospasm,promoting blood circulation,eliminating inflammatory edema,regulating muscle tension and relaxing muscle tension The mechanism of adhesions is related.