护肩载药用于脑卒中肩手综合征Ⅰ期的疗效观察

目的评估护肩载药对脑卒中患者肩手综合征Ⅰ期的疗效。方法脑卒中肩手综合征Ⅰ期患者96例,随机分为对照组、中药外敷组与护肩载药组,每组各32例。所有患者均接受脑卒中基础治疗和常规护理,对照组予传统康复治疗,中药外敷组予传统康复治疗和中药外敷治疗,护肩载药组予护肩载药、传统康复治疗和中药外敷治疗。比较三组治疗前、治疗后2、4周疼痛评分(VAS)、上肢功能评分(FMA)、日常生活能力(Barthel指数)、手部肿胀情况,以及治疗后满意度和舒适度。结果4周后,护肩载药组总有效率高于中药外敷组和对照组,差异有统计学意义(P<0.05)。治疗2周后,护肩载药组和中药外敷组VAS评分和手部肿胀程度较治疗前下降,Barthel指数和FMA评分提高(P<0.05),护肩载药组效果优于中药外敷组和对照组(P<0.05)。治疗4周后,三组患者VAS评分和手部肿胀程度较治疗前明显降低;FMA评分和Barthel指数提高(P<0.05)。护肩载药组在改善VAS评分和FMA评分方面优于中药外敷组和对照组(P<0.05)。护肩载药组患者满意度和舒适度高于中药外敷组和对照组(P<0.05)。结论护肩载药对脑卒中后肩手综合征Ⅰ期治疗效果满意,能够有效缓解疼痛、减轻肿胀、提高患者肢体功能和日常生活能力,同时增强患者的舒适感和满意度。

Objective To assess the efficacy of shoulder-supported medication in treating stage I shoulder-hand syndrome in stroke patients.Methods 96 patients exhibiting shoulder-hand symptom were included and randomly divided into three groups:the control group,the traditional Chinese medicine(TCM)topical application group,and the shoulder-supported medication group,with 32 individuals in each group.All patients received basic stroke treatment and standard care.The control group received traditional rehabilitation therapy,the TCM topical application group received additional TCM topical treatment,while the shoulder-supported medication group underwent shoulder-supported medication,traditional rehabilitation,and TCM topical treatment.The groups'pain scores(VAS),upper limb function(FMA),activities of daily living(Barthel index),hand swelling,as well as satisfaction and comfort levels after treatment at 2 and 4 weeks were compared.Results Significant differences in total effective rates among the shoulder-supported medication,TCM topical application,and the control groups(P<0.05).After 2 weeks of the treatment,the shoulder-supported medication and TCM topical application groups experienced significant reductions in VAS scores and hand swelling and notable improvements in the Barthel index and FMA scores compared to baseline(P<0.05).The shoulder-supported medication group demonstrated superior results to the TCM topical application and control groups(P<0.05).After 4 weeks,all groups exhibited reduced VAS scores and hand swelling while showing increased FMA scores and Barthel index values compared to baseline(P<0.05).The shoulder-supported medication group outperformed the TCM topical application and the control groups in enhancing VAS and FMA scores(P<0.05).Moreover,patients in the shoulder-supported medication group reported significantly higher satisfaction and comfort levels compared to the TCM topical application and control groups(P<0.05).Conclusion Shoulder-supported medication demonstrates significant efficacy in treating stage I shoulder-hand syndrome following stroke,effectively alleviating pain,reducing swelling,improving limb functionality and daily activities,and enhancing patient comfort and satisfaction.