苗药马桑狗帮刮痧在脑卒中后肩手综合征Ⅰ期治疗中的应用效果评价

Evaluation of application effect of Miao medicine Masang Goubang Gua Sha in the treatment of shoulder and hand syndrome after stroke Stage Ⅰ

目的:探讨和评价苗药马桑狗帮刮痧在脑卒中后肩手综合征Ⅰ期治疗中的应用效果。方法:选取贵州中医药大学第一附属医院脑病内科收治的60例脑卒中后肩手综合征Ⅰ期患者,病历收集时间为2021年4月—2022年6月。将受试者随机(随机数表法)分为水剂组和马桑狗帮组各30例,水剂组予以基础治疗和清水刮痧,马桑狗帮组则在基础治疗上加用苗药马桑狗帮刮痧,两组的治疗时间均为4周。观察两组治疗前后患侧与健侧掌骨的周长差值、患侧的痛觉视觉模拟评分(VAS)、肢体运动功能评估Fugl-Meyer评分(FMA)、日常生活活动能力评分(ADL)的变化和临床疗效。结果:两组治疗前掌骨周长差、VAS、FMA及ADL的差异无统计学意义(P>0.05)。与本组治疗前相比,两组治疗后的掌骨周长差、VAS均降低,FMA、ADL均升高,且马桑狗帮组上述指标的改善程度均优于水剂组,差异有统计学意义(P<0.05)。治疗后,马桑狗帮组的总有效率(86.67%)高于水剂组(63.33%),差异有统计学意义(P<0.05)。结论:苗药马桑狗帮刮痧能有效改善脑卒中后肩手综合征Ⅰ期患者的临床症状,促进其上肢肢体运动功能的恢复,提高其日常生活活动能力,值得在临床上推广应用。

Objective:To investigate and evaluate the application effect of Miao medicine Masang Gubang Gua Sha in the treatment of stageⅠshoulder and hand syndrome after stroke.Methods:A total of 60 patients with stage I poststroke shoulder-hand syndrome admitted to the Department of Encephalopathy,the First Affiliated Hospital of Guizhou University of Chinese Medicine were selected,and their medical records were collected from April 2021 to June 2022.Subjects were randomly divided into water treatment group and Masang Gubang group(30 cases in each group)by random number table method.The water treatment group was given basic treatment and clean water scraping,while the Masang Gubang group was given seedling medicine Masang Gubang scraping.The treatment time of both groups was 4 weeks.The difference of the circumference of metacarpal between the affected side and the healthy side,the visual analog scale of pain(VAS),the Fugl-Meyer score of limb motor function assessment,and the score of ability to perform activi ties of daily living(ADL)before and after treatment were observed in the two groups.Results:There were no significant differences in the perimetry of metacarpal,VAS,FMA and ADL between the two groups(P>0.05).Compared with the group before treatment,the circumference difference of metacarpal and VAS were decreased,while FMA and ADL were increased in the two groups after treatment,and the improvement degree of the above indexes in Masangugbang group was better than that in water group,the difference was statistically significant(P<0.05).After treatment,the total effective rate of Masanggubang group(86.67%)was higher than that of water group(63.33%),the difference was statistically significant(P<0.05).Conclusion:Miao medicine Masang Guobang Gua Sha can effectively improve the clinical symptoms of stage I patients with shoulder hand syndrome after stroke,promote the recovery of upper limb motor function and improve the ability of daily living activities,wh ich is worthy of clinical application.