皮内针结合肌内效贴扎治疗脑卒中后肩手综合征的效果

Effiect of intradermal acupuncture combined with intramuscular effective sticking on shoulder-hand syndrome after stroke

目的观察皮内针结合肌内效贴扎治疗脑卒中后肩手综合征的疗效。方法将2018年12月至2020年10月于福建省立医院康复科就诊的60例脑卒中后肩手综合征第Ⅰ期患者通过随机数字表法分为皮内针肌内效组(A组)和常规治疗组(B组),每组各30例。评估治疗前后的肩手综合征量表评分(SHSS)、Wong-Banker疼痛面部表情评分(NRS)、上肢Fugl-Meyer运动评分(FMA)、手肿胀程度及肱二头肌长头肌腱(BICT)、肩峰下三角肌下滑囊(SASD)肌骨超声检查。结果两组治疗前SHSS、NRS、FMA、手肿胀程度、BICT腱鞘炎、SASD炎比较,差异无统计学意义(P>0.05);两组治疗后较治疗前SHSS、NRS、FMA、手肿胀程度显著改善,差异有统计学意义(P<0.05);A组治疗后较治疗前BICT腱鞘炎、SASD炎显著改善,差异有统计学意义(P<0.05);B组治疗后较治疗前BICT腱鞘炎、SASD炎稍有改善,差异无统计学意义(P>0.05)。与B组比较,A组治疗后SHSS、NRS、FMA、手肿胀程度、BICT腱鞘炎、SASD炎显著改善,差异有统计学意义(P<0.05)。结论皮内针结合肌内效贴扎能有效改善脑卒中后肩手综合征患者的肩痛、手肿胀、BICT腱鞘炎、SASD炎及上肢运动功能。

Objective To observe the therapeutic efficacy of intradermal acupuncture combined with intramuscular effective sticking on shoulder-hand syndrome after stroke.Methods A total of 60 patients with stageⅠof shoulder-hand syndrome after stroke admitted to the department of rehabilitation of Fujian Provincial Hospital from December 2018 to October 2020 were randomly divided into the intradermal acupuncture intramuscular effect group(group A,n=30)and the conventional treatment group(group B,n=30).Shoulder-hand syndrome scale score(SHSS),Wong-Banker pain facial expression score(numerical rating scale,NRS),upper limb Fugl-Meyer motor function assessment(FMA),hand swelling degree and musculoskeletal ultrasound examination of biceps brachii long head tendon(BICT)and subacromial deltoid muscle descending capsule(SASD)were evaluated before and after treatment.Results Before treatment,SHSS,NRS,FMA,hand swelling degree,BICT tenosynovitis and SASD inflammation were similar between the two groups,without statistically significant differences(P>0.05).After treatment,SHSS,NRS,FMA and hand swelling degree in the two groups were significantly relieved compared with those before treatment,with statistically significant differences(P<0.05).After treatment,BICT tenosynovitis and SASD inflammation in group A were significantly relieved compared with those before treatment,with statistically significant differences(P<0.05).After treatment,BICT tenosynovitis and SASD inflammation in group B were slightly relieved compared with those before treatment,without statistically significant differences(P>0.05).Compared with group B,SHSS,NRS,FMA,hand swelling degree,BICT tenosynovitis and SASD inflammation in group A were significantly relieved after treatment,with statistically significant differences(P<0.05).Conclusion Intradermal acupuncture combined with intramuscular effective sticking can effectively relieve shoulder pain,hand swelling,BICT tenosynovitis,SASD inflammation and upper limb motor function in patients wit h shoulder-hand syndrome after stroke.