揿针埋针联合关节松动术治疗脑卒中后肩手综合征的临床观察

Clinical Observation on the Thumb-tack Needling for Subcutaeous Embedding Combined with Joint Mobilization in the Treatment of Post-stroke Shoulder-Hand Syndrome

【目的】观察揿针埋针联合关节松动术治疗脑卒中后肩手综合征的临床疗效。【方法】将80例脑卒中后肩手综合征患者随机分为治疗组和对照组,每组各40例。2组均给予关节松动术治疗,对照组在关节松动术基础上给予普通针刺治疗,治疗组联合揿针埋针治疗。治疗4周为1个疗程。共治疗4周。治疗1个月后,评价2组临床疗效,观察2组患者治疗前后疼痛视觉模拟量表(VAS)评分和简化Fugl-Meyer上肢运动功能量表(FMA)评分的变化情况,以及患肢肩关节的被动前屈与外展无痛活动度的情况。比较2组患者治疗后简易生活质量量表(SF-36)评分的情况。并评价2组的安全性及不良反应的发生情况。【结果】(1)治疗组总有效率为95.00%(38/40),对照组为80.00%(32/40)。治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的VAS评分及上肢FMA评分均明显改善(P<0.05),且治疗组在改善VAS评分及上肢FMA评分方面均明显优于对照组,差异均有统计学意义(P<0.05)。(3)治疗后,2组患者关节活动度明显改善(P<0.05),且治疗组肩关节活动改善优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,治疗组SF-36生活质量量表在生理功能、心理功能、情感健康、社会功能方面的评分均明显优于对照组,差异均有统计学意义(P<0.05)。(5)治疗组与对照组不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】揿针埋针联合关节松动术治疗脑卒中后肩手综合征,能明显改善患者的疼痛症状,从而提高患者的生活质量,临床效果显著。

Objective To observe the clinical efficacy of thumb-tack needling for subcutaeous embedding combined with joint mobilization in the treatment of post-stroke shoulder-hand syndrome.Methods A total of 80 patients with post-stroke shoulder-hand syndrome were randomly divided into a treatment group and a control group,with 40 patients in each group.Both groups were given arthrocentesis,the control group was given ordinary acupuncture on the basis of arthrocentesis,and the treatment group was combined with thumb-tack needling for subcutaeous embedding.One course of treatment was 4 weeks and a total of 4 weeks of treatment was given.After 1 month of treatment,the clinical efficacy of the two groups was evaluated.The changes of Visual Analogue Scale(VAS)of pain scores and simplified Fugl-Meyer Assessment(FMA)scores,as well as the pain-free passive forward flexion and abduction of the shoulder joint of the affected limb were observed before and after treatment.The Simple Quality of Life Scale(SF-36)scores of the patients in the two groups were compared after treatment.The safety and the occurrence of adverse reactions in the two groups were also evaluated.Results(1)The total effective rate was 95.00%(38/40)in the treatment group and 80.00%(32/40)in the control group.The efficacy of the treatment group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the VAS scores and upper extremity FMA scores of the patients in the two groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving the VAS scores and upper extremity FMA scores,and the differences were statistically significant(P<0.05).(3)After treatment,the joint mobility of patients in the two groups were significantly improved(P<0.05),and the improvement of shoulder joint movement in the treatment group was superior to that in the control group,and the difference was statistically significant(P<0.05).(4)After treatment,the SF-36 Quality of Life Scale scores of the treatment group were significantly superior to those of the control group in terms of physical function,psychological function,emotional health,and social function levels,and the difference was statistically significant(P<0.05).(5)There was no significant difference in the incidence of adverse reactions between the treatment group and the control group(P>0.05).Conclusion Thumb-tack needling for subcutaeous embedding combined with joint mobilization exert certain effect in the treatment of post-stroke shoulder-hand syndrome.It can significantly improve the pain symptoms of patients,thus improving their quality of life,and the clinical effect is remarkable.