温针灸联合推拿手法对脑卒中后肩手综合征患者临床疗效和上肢功能的影响

Effect of Warm Acupuncture Combined with Massage on Clinical Efficacy and Upper Limb Function in Patients with Shoulder Hand Syndrome after Stroke

目的研究脑卒中后肩手综合征患者实施温针灸联合推拿手法对其临床疗效和上肢功能的影响。方法选取2018年9月-2020年10月龙岩市中医院脑病科收治的86例脑卒中后肩手综合征患者,按照随机数字表法分为试验组(n=43)、对照组(n=43)。对照组患者实施推拿手法治疗,试验组患者开展温针灸联合推拿手法治疗。比较观察两组患者临床疗效、治疗前后临床症状积分、上肢运动功能和日常生活活动能力。结果试验组的临床总有效率(97.67%)高于对照组(81.40%)(P<0.05)。治疗前,两组的临床症状积分比较,差异无统计学意义(P>0.05);治疗后,试验组的疼痛、水肿、关节活动度临床症状积分均低于对照组(P<0.05)。治疗前,两组的Fugl-Meyer上肢运动功能评定量表(FMA-UE)评分和改良Barthel指数(MBI)评分比较,差异无统计学意义(P>0.05);治疗后,试验组的FMA-UE(41.51±8.14)分、MBI(61.08±12.82)分均高于对照组(P<0.05)。结论脑卒中后肩手综合征患者实施温针灸联合推拿手法能够有效提升患者综合疗效,改善患者上肢功能。

Objective To study the effect of warm acupuncture combined with massage on the clinical efficacy and upper limb function of patients with shoulder hand syndrome after stroke.Methods 86 patients with shoulder hand syndrome after stroke treated in the Department of encephalology of Longyan Hospital of traditional Chinese medicine from September 2018 to October 2020 were randomly divided into experimental group(n=43)and control group(n=43).The patients in the control group were treated with massage,and the patients in the experimental group were treated with warm acupuncture and moxibustion combined with massage.The clinical efficacy,clinical symptom score,upper limb motor function,activities of daily living and quality of life were compared between the two groups.Results The total clinical effective rate of the experimental group(97.67%)was higher than that of the control group(81.40%)(P<0.05).Before treatment,there was no significant difference in clinical symptom scores between the two groups(P>0.05);After treatment,the clinical symptom scores of pain,edema and joint mobility in the experimental group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference in Fugl Meyer upper limb motor function rating scale(FMA-UE)score and modified Barthel Index(MBI)score between the two groups(P>0.05);After treatment,the scores of FMA-UE(41.51±8.14)and MBI(61.08±12.82)in the experimental group were higher than those in the control group(P<0.05).Conclusion Warm acupuncture combined with massage in patients with shoulder hand syndrome after stroke can effectively improve the comprehensive curative effect,upper limb function.