徒手淋巴引流手法联合肌内效贴技术治疗卒中后肩手综合征Ⅰ期患者的临床观察

Clinical efficacy of manual lymphatic drainage massage combined with kinesio taping technique for patients with stage 1 post-stroke shoulder-hand syndrome

目的观察徒手淋巴引流手法联合肌内效贴技术治疗卒中后肩手综合征Ⅰ期患者的临床疗效。方法选择2018年1月至2020年12月收治的78例脑卒中后肩手综合征Ⅰ期患者为研究对象,按照随机数字表法分为2组,对照组39例予常规康复治疗,治疗组39例在对照组的基础上加用徒手淋巴引流手法联合肌内效贴技术治疗。2组均治疗1个月后统计疗效,比较2组治疗前后Fugl-Meyer运动功能评分量表(FMA)上肢部分评分、疼痛视觉模拟评分法(VAS)评分、患手体积值、上肢肌围度值水平及炎症因子血清白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)水平变化情况,观察2组治疗期间不良反应发生情况。结果治疗组总有效率94.87%(37/39),对照组总有效率76.92%(30/39),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后FMA上肢部分评分均升高,(P<0.05),疼痛VAS评分均降低(P<0.05),且治疗组治疗后FMA上肢部分评分高于对照组(P<0.05),疼痛VAS评分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后患手体积值及上肢肌围度值水平均降低(P<0.05),且治疗组治疗后患手体积值及上肢肌围度值水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清IL-6及hs-CRP水平均降低(P<0.05),且治疗组治疗后血清IL-6及hs-CRP水平均低于对照组(P<0.05)。治疗组不良反应总发生率7.68%(3/39),对照组不良反应总发生率10.24%(4/39),2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论徒手淋巴引流手法联合肌内效贴技术治疗卒中后肩手综合征临床疗效确切,可有效改善患者上肢功能,缓解疼痛症状,减轻炎症反应,且安全可靠。

Objective To observe the clinical efficacy of manual lymphatic drainage(MLD)massage combined with kinesio taping(KT)technique for patients with stage 1 post-stroke shoulder-hand syndrome(SHS).Methods A total of 78 patients with stage 1 post-stroke SHS admitted to our hospital from January 2018 to December 2020 were randomly assigned into treatment group(n=39)and control group(n=39).All patients were managed by routine rehabilitation,and those in treatment group were additionally given MLD massage combined with KT technique.Treated for 1 month,the aim was to compare Fugl-Meyer Assessment-Upper Extremity(FMA-UE),visual analogue scale(VAS)for pain,volume value of affected hand,mid-upper arm circumference(MUAC),serum interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP).The curative effect and adverse reactions were assessed.Results The overall effective rate in the treatment group was better than that in the control group(94.87%[37/39]vs 76.92%[30/39],P<0.05).After treatment,FMA-UE scores were significantly increased in the two groups than those before treatment,but VAS scores were significantly decreased(all P<0.05),and the treatment group was superior to the control group for FMA-UE and VAS scores(all P<0.05).After treatment,volume value affected hand and MUAC in the both groups were significantly decreased(P<0.05),which decreased notably in the treatment group compared with the control group(P<0.05).The levels of IL-6 and hs-CRP in the both groups were significantly decreased(P<0.05),the decrease in the treatment group was more common than the control group(P<0.05).The overall incidence of adverse reactions in the treatment group was comparable to that in the control group(7.68%[3/39]vs 10.24%[4/39],P>0.05).Conclusion For patients with stage 1 post-stroke SHS,MLD massage combined with KT technique has definite clinical efficacy,which can effectively improve upper limb function,relieve pain symptoms,reduce inflammatory response,and it is safe and reliable.