舒筋养血汤熏洗结合镜像疗法治疗脑梗死后肩手综合征临床研究

Clinical Study on Fumigation and Washing with Shujin Yangxue Tang Combined with Mirror Therapy for Shoulder-Hand Syndrome After Cerebral infarction

目的:观察舒筋养血汤熏洗结合镜像疗法治疗脑梗死后肩手综合征的临床效果。方法:将116例脑梗死后肩手综合征患者随机分为观察组、对照组各58例,对照组实施镜像疗法,观察组以舒筋养血汤熏洗联合镜像疗法治疗,2组均治疗4周。于治疗前、治疗4周后评价患侧肩关节的疼痛程度[视觉模拟评分法(VAS)评分]、肿胀程度及运动功能障碍程度[FuglMeyer运动功能评定量表-上肢部分(FMA-UE)评分],检测P物质(SP)、5-羟色胺(5-HT)及前列腺素E2(PGE2)水平,比较2组的临床疗效与不良反应发生率。结果:治疗4周后,观察组、对照组的临床疗效总有效率分别为93.10%、77.59%,2组比较,差异有统计学意义(P<0.05)。2组VAS评分、肿胀值均较治疗前下降,FMA-UE评分均较治疗前增加,差异均有统计学意义(P<0.05);观察组VAS评分、肿胀值均低于对照组,FMA-UE评分高于对照组,差异均有统计学意义(P<0.05)。2组血清SP、5-HT、PGE2水平与治疗前比较均下降,差异均有统计学意义(P<0.05);观察组血清SP、5-HT、PGE2水平均低于对照组,差异均有统计学意义(P<0.05)。观察组、对照组的不良反应发生率分别为6.90%、3.45%,2组比较,差异无统计学意义(P>0.05)。结论:采用舒筋养血汤熏洗结合镜像疗法治疗脑梗死后肩手综合征可有效促进症状缓解,提高临床疗效,减轻患处的疼痛程度,且安全性较好。

Objective:To observe the clinical effect of fumigation and washing with Shujin Yangxue tang combined with mirror therapy for shoulder-hand syndrome after cerebral infarction. Methods:A total of 116 cases of patients with shoulderhand syndrome after cerebral infarction were randomly divided into the observation group and the control group, with58 cases in each group. The control group was given mirror therapy,and the observation group was treated with fumigation and washing with Shujin Yangxue tang combined with mirror therapy. Both groups were treated for four weeks. Before treatment and after four-week treatment,the pain degrees of shoulder joint in the injured side[Visual Analogue Scale(VAS)scores], swelling degrees and motor dysfunction degrees[Fugl-Meyer Assessment for upper extremity(FMA-UE)] were evaluated. The levels of substance P(SP),5-hydroxytryptamine(5-HT) and prostaglandin E2(PGE2) were detected. The clinical effects and the incidences of adverse reactions in the two groups were compared. Results:After four-week treatment,the total effective rate of clinical effect was 93.10% in the observation group and 77.59% in the control group,the difference being significant(P<0.05). The VAS scores and the swelling values in the two groups were decreased when compared with those before treatment, and FMA-UE scores were increased, differences being significant(P<0.05);VAS score and swelling value in the observation group were lower than those in the control group, and FMA-UE score was higher,differences being significant(P<0.05). After treatment,the levels of SP,5-HT and PGE2in serum in the two groups were decreased when compared with those before treatment,differences being significant(P<0.05);the levels of SP,5-HT and PGE2in serum in the observation group were lower than those in the control group differences being significant(P<0.05).The incidence of adverse reactions was 6.90% in the observation group and 3.45% in the control group, there being no significance in the difference(P>0.05). Conclusion: The application of fumigation and washing with Shujin Yangxue tang combined with mirror therapy for shoulder-hand syndrome after cerebral infarction can effectively relieve symptoms and pain,and improve clinical effects,with good safety.