经筋结点恢刺法联合表面肌电生物反馈疗法治疗中风后肩手综合征的临床疗效观察

Clinical Study on the Treatment of Shoulder Hand Syndrome after Stroke by Jingjin Jiedian Huici Combined with Surface Electromyography Biofeedback

目的观察经筋结点恢刺法联合表面肌电生物反馈疗法治疗中风后肩手综合征(Shoulder Hand Syndrome,SHS)中的临床疗效。方法选取2019年5月—2020年12月期间重庆市大足区人民医院收治的90例中风后SHS患者作为研究对象,采用随机数字表法分为对照组和治疗组,每组各45例。两组患者均给予中风病康复期常规治疗与康复训练,在此基础上,对照组给予表面肌电生物反馈疗法,治疗组给予表面肌电生物反馈疗法+经筋结点恢刺疗法。治疗4周后,观察比较两组患者临床疗效、治疗前后肩手疼痛(Visual Analogue Scale,VAS)、关节活动度及生活质量(Stroke Specific Quality of Life Scale,SS-QOL)改善情况。结果治疗后治疗组临床总有效率95.56%(43/45)明显高于对照组82.22%(37/45),差异有统计学意义(P<0.05)。治疗后两组患者肩部、手部VAS评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组肩部、手部VAS评分较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者肩关节、腕关节活动度评分均较治疗前升高,差异有统计学意义(P<0.05);且治疗组肩关节、腕关节活动度评分均较对照组明显升高,差异有统计学意义(P<0.05)。治疗后两组患者SS-QOL各领域评分均较治疗前升高,差异有统计学意义(P<0.05);且治疗组SS-QOL各领域评分均较对照组明显升高,差异有统计学意义(P<0.05)。结论经筋结点恢刺法联合表面肌电生物反馈疗法治疗中风后SHS临床效果显著,有利于缓解肩手疼痛,改善关节活动度,促进生活质量改善。

Objective To observe the clinical value of Jingjin Jiedian Huici combined with surface electromyography(sEMG)biofeedback in the treatment of shoulder hand syndrome(SHS)after stroke.Methods A total of 90 patients with post-stroke SHS admitted to the People′s Hospital of Dazu, Chongqing from May 2019 to December 2020 were selected as the study subjects and assigned into the control group(45 patients)and the treatment group(45 patients)by random number table method.The control group was given sEMG biofeedback, and the treatment group was given sEMG biofeedback + Jingjin Jiedian Huici.Both groups were treated for 4 weeks.The clinical efficacy, as well as the visual analysis scale(VAS)score, joint range of motion, and stroke specific quality of life scale(SS-QOL)score before and after treatment, was compared between the two groups.Results(1)The total effective rate of the treatment group was 95.56%(43/45),which was higher than 82.22%(37/45)of the control group(P<0.05).(2)After treatment, the VAS scores of shoulder and hand in the two groups were lower than those before treatment, and the treatment group had more decrease than the control group(P<0.05).(3)After treatment, the range of motion scores of shoulder joint and wrist joint as well as the SS-QOL scores in upper limb function, self-care and mood of the two groups were increased(P<0.05),and the changes in the treatment group were more significant than those in the control group(P<0.05).Conclusion The effect of Jingjin Jiedian Huici combined with sEMG biofeedback in the treatment of SHS after stroke was remarkable, which was conducive to relieving shoulder and hand pain, improving joint range of motion, and improving the quality of life.