针灸联合体外冲击波治疗肩手综合征的疗效观察

Therapeutic Effect of Acupuncture Combined with Extracorporeal Shock Wave Therapy on Shoulder-hand Syndrome

【目的】观察针灸联合体外冲击波对肩手综合征的临床疗效。【方法】选取符合纳入标准的肩手综合征患者60例,随机分为对照组和观察组,每组各30例。对照组给予现代康复治疗,如Bobath疗法、间歇气压和神经肌肉电刺激;观察组在此基础上增加针灸及体外冲击波治疗。现代康复及针灸治疗每天1次,连续治疗6 d后休息1 d,共治疗12周;体外冲击波治疗每周1次,共治疗12周。比较2组治疗前后的疼痛视觉模拟法(VAS)评分、Fugl-Meyer上肢运动功能(FMA)评分和日常生活活动能力(ADL)评分。【结果】治疗前后的同组比较中,观察组治疗后的VAS评分低于治疗前,差异有统计学意义(P<0.05),而对照组治疗后的VAS评分虽然低于治疗前,但差异无统计学意义(P>0.05);2组治疗后的FMA及ADL评分均显著高于治疗前,差异均有统计学意义(P<0.05)。治疗后的组间比较中,观察组的VAS评分低于对照组,差异有统计学意义(P<0.05),ADL评分高于对照组,差异有统计学意义(P<0.05),而FMA评分虽然高于对照组,但差异无统计学意义(P>0.05)。【结论】在现代康复治疗基础上结合针灸及体外冲击波治疗肩手综合征,可有效缓解上肢疼痛,改善患者上肢运动功能,提高患者生活能力。

Objective To observe the clinical efficacy of acupuncture combined with extracorporeal shock wave therapy on shoulder-hand syndrome. Methods A total of 60 patients with shoulder-hand syndrome who met theinclusion criteria were randomly divided into control group and observation group,30 cases in each group. Thecontrol group was given modern rehabilitation therapies such as Bobath therapy, intermittent pneumaticcompression therapy and neuromuscular electrical stimulation,and the observation group was given acupunctureand extracorporeal shock wave therapy together with the treatment for the control group. Modern rehabilitationtherapy and acupuncture treatment were performed once a day for 6 continuous days and with the intermission forone day,the treatment lasting for a total of 12 weeks. The extracorporeal shock wave treatment was performed oncea week for a total of 12 weeks. Visual Analogue Scale(VAS)scores for pain,Fugl-Meyer Assessment(FMA)scores for upper limb motor function,and activities of daily living(ADL)scores were compared between the twogroups before and after treatment. Results After treatment,the VAS scores in the observation group were lowerthan those before treatment,the difference being statistically significant(P < 0.05),while the VAS scores in thecontrol group only showed a decreasing trend(P > 0.05 compared with those before treatment). Tthe FMA andADL scores in the two groups after treatment were significantly higher than those before treatment,the differencebeing statistically significant(P < 0.05). The inter-group comparison between the two groups after treatmentshowed that the VAS scores were decreased and the ADL scores were increased in the observation group as comparedwith those in the control group,the difference being statistically significant(P < 0.05),while the difference ofFMA scores between the two groups was statistically insignificant(P > 0.05). Conclusion On the basis of modernrehabilitation therapy, the combination of acupuncture and extracorporeal shock wave therapy can effectivelyrelieve upper limb pain,and improve the upper limb motor function and ADL of shoulder-hand syndrome patients.