温阳灸联合活血消肿散改善中风后偏瘫肢体肿胀的效果观察
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摘要
目的探讨温阳灸联合活血消肿散对改善中风后偏瘫肢体肿胀的应用效果。方法选取2015年2月—2016年7月住院的中风恢复期患者120例,患者随机分成对照组40例,干预1组40例,干预2组40例。对照组采用常规药物治疗,并抬高患肢处于功能位;干预1组在对照组的基础上加用活血消肿散热敷,干预2组在对照组的基础上采用温阳灸联合活血消肿散热敷。观察干预前、干预后第14天患肢上、下肢周径,FuglM eyer评分,Barthel指数(BI)。结果干预后,干预1组上、下肢周径小于对照组(P<0.05),而干预2组则小于干预1组(P<0.05)及对照组(P<0.01);干预后,干预1组Fugl-Meyer评分、BI值高于对照组(P<0.05),而干预2组则高于干预1组(P<0.05)及对照组(P<0.01)。结论中风后偏瘫肢体肿胀患者采用温阳灸联合活血消肿散热敷可有效缓解肢体肿胀的症状,促进肢体功能恢复,提高患者生活自理能力。
Objective To investigate the effect of warming-yang moxibustion combined with pulvis of activating-blood and detumescence in relieving limb swelling of patients with hemiplegia after stroke. Methods Totally 120 patients with hemiplegia in convalescence after stroke were assigned to the control group( n = 40),intervention group 1( n = 40) and intervention group 2( n =40). All patients received comprehensive treatment and their affected limb in the functional position. Patients in the intervention group 1 received pulvis of activating-blood and detumescence,and those in the intervention group 2 received warming-yang moxibustion combined with pulvis of activating-blood and detumescence. The upper limb circumference,lower limb circumference,FuglMeyer scale,Barthelindex( BI) were evaluated before intervention and 14 days after intervention.Results The upper and lower affected limb circumference were smaller in the intervention group 1 than those in the control group( P < 0. 05),and the upper and lower affected limb circumference were smaller in the intervention group 2 than those in the control group( P < 0. 01) and those in the intervention group 1( P < 0. 05). The Fugl-Meyer scale and BI were higher in the intervention group 1 than those in the control group( P < 0. 05),and Fugl-Meyer scale and BI were higher were smaller in the intervention group 2 than those in the control group( P < 0. 01) and those in the intervention group 1( P < 0. 05). Conclusion Warming-yang moxibustion combined with pulvis of activating-blood and detumescence can effectively relieve the symptoms of affected limb swelling,promote the recovery of limb function and improve the self-management ability of patients.
Objective To investigate the effect of warming-yang moxibustion combined with pulvis of activating-blood and detumescence in relieving limb swelling of patients with hemiplegia after stroke. Methods Totally 120 patients with hemiplegia in convalescence after stroke were assigned to the control group( n = 40),intervention group 1( n = 40) and intervention group 2( n =40). All patients received comprehensive treatment and their affected limb in the functional position. Patients in the intervention group 1 received pulvis of activating-blood and detumescence,and those in the intervention group 2 received warming-yang moxibustion combined with pulvis of activating-blood and detumescence. The upper limb circumference,lower limb circumference,FuglMeyer scale,Barthelindex( BI) were evaluated before intervention and 14 days after intervention.Results The upper and lower affected limb circumference were smaller in the intervention group 1 than those in the control group( P < 0. 05),and the upper and lower affected limb circumference were smaller in the intervention group 2 than those in the control group( P < 0. 01) and those in the intervention group 1( P < 0. 05). The Fugl-Meyer scale and BI were higher in the intervention group 1 than those in the control group( P < 0. 05),and Fugl-Meyer scale and BI were higher were smaller in the intervention group 2 than those in the control group( P < 0. 01) and those in the intervention group 1( P < 0. 05). Conclusion Warming-yang moxibustion combined with pulvis of activating-blood and detumescence can effectively relieve the symptoms of affected limb swelling,promote the recovery of limb function and improve the self-management ability of patients.
引文
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[11]张爱香,俞征宙.“血不利则为水”当为中风后偏瘫肢体肿胀的病机[J].按摩与康复医学,2015,6(15):133-135.
[12]李峥亮,张健君.活血利水法治疗中风偏瘫左侧肢体肿胀[J].中医临床研究,2014,6(7):115-116.
[13]胡雅玲,张丽,马佳牧.芒硝湿敷配合冰袋冰敷治疗闭合性足踝部骨折早期肿胀[J].长春中医药大学学报,2014,30(5):920-922.
[14]明荷,谢寒,张泓,等.黄芪注射液治疗缺血性脑卒中偏瘫的效果[J].中国康复理论与实践,2016,22(6):684-687.
[15]纪蓉,江冰.活血消肿方熏蒸治疗中风后肢体肿胀32例临床观察[J].江苏中医药,2013,45(8):34-35.
[16]刘立鹏.活血消肿方熏蒸治疗中风后肢体肿胀临床分析[J].实用中医药杂志,2016,32(2):165.
[17]唐晓娜,曾瑶,陈阳阳,等.穴位贴敷结合艾灸辅助综合康复疗法治疗缺血性脑卒中偏瘫的临床观察[J].中医临床研究,2016,8(16):29-31.
[18]杨海侠,荣华.艾灸治疗中风恢复期患者肢体功能障碍的疗效观察[J].陕西中医,2016,37(3):351-352.
[19]吴圣婕,雷迈,谭威,等.脑卒中后肩手综合征的病因机制及诊断进展[J].广西医学,2015,6(15):953-955.
[2]张爱香.中风后偏瘫肢体肿胀中西医影响因素的临床研究[D].福州:福建中医药大学,2016.
[3]叶祥明.脑卒中后肩手综合征的发病机制及综合康复治疗研究进展[J].实用老年医学,2015,29(6):452-456.
[4]HARTWIG M,GELBRICH G,GRIEWING B.Functional orthosis in shoulder joint subluxation after ischaemic brain stroke to avoid post-hemiplegic shoulder-hand syndrome:a randomized clinical trial[J].Clin Rehabi,2012,26(9):807-816.
[5]国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56.
[6]BROTT T,ADAMS H P JR,OLINGER C P,et al.Measurements of acute cerebral infarction:a clinical examination scale[J].Stroke,1989,20(7):864-870.
[7]FUGL-MEYER A R,JAASKO L,LEYMAN I,et al.The post-stroke hemiplegic patient.1.a method for evaluation of physical performance[J].Scand J Rehabil M ed,1975,7(1):13-31.
[8]MAHONEY F I,BARTHEL D W.Functional Evaluation:The Barthel Index[J].M d State M ed J,1965,14:61-65.
[9]刘翾.药熨法治疗中风后偏瘫肢体肿胀及肢体活动能力的护理体会[J].中医外治杂志,2016,25(2):48-49.
[10]WINKLEWSKI P J,FRYDRYCHOWSKI A F.Cerebral blood flow,sympathetic nerve activity and stroke risk in obstructive sleep apnoea.Is there a direct link?[J].Blood Press,2013,22(1):27-33.
[11]张爱香,俞征宙.“血不利则为水”当为中风后偏瘫肢体肿胀的病机[J].按摩与康复医学,2015,6(15):133-135.
[12]李峥亮,张健君.活血利水法治疗中风偏瘫左侧肢体肿胀[J].中医临床研究,2014,6(7):115-116.
[13]胡雅玲,张丽,马佳牧.芒硝湿敷配合冰袋冰敷治疗闭合性足踝部骨折早期肿胀[J].长春中医药大学学报,2014,30(5):920-922.
[14]明荷,谢寒,张泓,等.黄芪注射液治疗缺血性脑卒中偏瘫的效果[J].中国康复理论与实践,2016,22(6):684-687.
[15]纪蓉,江冰.活血消肿方熏蒸治疗中风后肢体肿胀32例临床观察[J].江苏中医药,2013,45(8):34-35.
[16]刘立鹏.活血消肿方熏蒸治疗中风后肢体肿胀临床分析[J].实用中医药杂志,2016,32(2):165.
[17]唐晓娜,曾瑶,陈阳阳,等.穴位贴敷结合艾灸辅助综合康复疗法治疗缺血性脑卒中偏瘫的临床观察[J].中医临床研究,2016,8(16):29-31.
[18]杨海侠,荣华.艾灸治疗中风恢复期患者肢体功能障碍的疗效观察[J].陕西中医,2016,37(3):351-352.
[19]吴圣婕,雷迈,谭威,等.脑卒中后肩手综合征的病因机制及诊断进展[J].广西医学,2015,6(15):953-955.