改良钩针疗法治疗卒中后肩手综合征急性期疗效观察
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摘要
目的观察改良钩针疗法治疗卒中后肩手综合征急性期的临床疗效。方法将80例卒中后肩手综合征急性期患者随机分为观察组和对照组,每组40例。两组予基础治疗后取穴均以痛为腧,每次取穴6～8个,观察组进行改良钩针疗法,对照组进行常规毫针疗法。采用VAS量表、FMA量表、ADL量表和中医证候积分分别对两组患者治疗前后的上肢疼痛、上肢运动功能、日常生活能力和主要症状进行评分并比较治疗方案的总有效率。结果两组治疗后各项评分较治疗前均有显著改善(P<0.05),且观察组改善均优于对照组(P<0.05)。观察组总有效率为95.0%,显著高于对照组的75.0%(P<0.05)。结论改良钩针疗法对卒中后肩手综合征急性期患者有显著疗效,且疗效优于常规毫针疗法。
Objective To observe the clinical efficacy of the modified hook needle therapy in treating post-stroke shoulder-hand syndrome in acute stage. Method Eighty patients with post-stroke shoulder-hand syndrome in acute stage were randomized into an observation group and a control group, with 40 cases in each group. The two groups both received basic interventions followed by selecting the tender points for treatment. Six to eight points were selected each time and treated with the modified hook needles in the observation group and conventional filiform needles in the control group. Visual analogue scale(VAS), Fugl-Meyer Assessment(FMA), activities of daily living(ADL) and traditional Chinese medicine(TCM) symptom and sign score were used to respectively estimate the upper-limb pain,upper-limb motor function, ADL and major symptoms, and the total effective rates of the two treatment protocols were compared. Result The indexes were significantly improved after the treatment in both groups(P<0.05), and the improvements in the observation group were superior to those in the control group(P<0.05). The total effective rate was 95.0% in the observation group, significantly higher than 75.0% in the control group(P<0.05). Conclusion The modified hook needle therapy can produce significant efficacy in treating post-stroke shoulder-hand syndrome in acute stage, and is superior to the conventional filiform needle therapy.
Objective To observe the clinical efficacy of the modified hook needle therapy in treating post-stroke shoulder-hand syndrome in acute stage. Method Eighty patients with post-stroke shoulder-hand syndrome in acute stage were randomized into an observation group and a control group, with 40 cases in each group. The two groups both received basic interventions followed by selecting the tender points for treatment. Six to eight points were selected each time and treated with the modified hook needles in the observation group and conventional filiform needles in the control group. Visual analogue scale(VAS), Fugl-Meyer Assessment(FMA), activities of daily living(ADL) and traditional Chinese medicine(TCM) symptom and sign score were used to respectively estimate the upper-limb pain,upper-limb motor function, ADL and major symptoms, and the total effective rates of the two treatment protocols were compared. Result The indexes were significantly improved after the treatment in both groups(P<0.05), and the improvements in the observation group were superior to those in the control group(P<0.05). The total effective rate was 95.0% in the observation group, significantly higher than 75.0% in the control group(P<0.05). Conclusion The modified hook needle therapy can produce significant efficacy in treating post-stroke shoulder-hand syndrome in acute stage, and is superior to the conventional filiform needle therapy.
引文
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[22]姜道新,马得旅,王楠,等.肩手综合征的流行病学及病因病机研究进展[J].中西医结合心脑血管病杂志,2016,14(1):47-49.
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[24]林梅珍,李群.手功能训练结合针灸治疗脑卒中后肩手综合征的效果观察[J].中国现代药物应用,2015,9(3):247-248.
[25]郑入文,任毅,胡慧.温针灸治疗卒中后肩手综合征的临床观察[J].世界中医药,2014,(11):1535-1537.
[26]孙昶晟,罗权,苏文渊,等.温针灸配合刺络放血治疗脑卒中后肩手综合征体会[J].河南中医,2014,34(6):52-53.
[27]李志宇.针灸推拿联合治疗中风后肩-手综合征的临床观察[J].中国伤残医学,2014,22(23):162-163.
[28]薛斐然,张维.不同时程温和灸对中风后肩痛患者肩髃穴热敏化现象影响[J].上海针灸杂志,2010,29(12):765-766.
[29]汤治中,徐应乐,易进科,等.针灸结合康复训练对肩手综合征患者肩痛及运动功能的影响[J].陕西中医,2013,34(7):882-883.
[30]胡俊霞,薛立文.针刺结合康复训练治疗中风后肩关节疼痛40例[J].陕西中医,2010,31(10):1392-1393.
[31]裘小玲,裘昊,黄涌,等.钩针疗法治疗中风偏瘫后肩痛疗效观察[J].上海针灸杂志,2006,25(7):10-12.
[32]杨楣良,周振鹤.钩针治疗肱骨外上髁炎119例:附54例对照组治疗观察[J].浙江中医杂志,1996,(6):271-272.
[33]徐放明,宋琬北.近10年来锋钩针临床应用概况[J].中国民间疗法,2000,8(3):48-49.
[2]吴圣婕,雷迈,谭威,等.脑卒中后肩手综合征的病因机制及诊疗进展[J].广西医学,2015,37(7):953-955.
[3]于金栋,曹世强,吕丽柯,等.中医药治疗卒中后肩手综合征临床研究进展[J].河北中医,2014,36(12):1908-1910.
[4]赵敬宜,王恩龙.脑卒中后肩手综合征诊疗概况[J].实用中医内科杂志,2016,30(5):119-120.
[5]刘英姣,张泓.针刺联合康复训练对脑卒中后肩手综合征急性期患者的疗效研究[J].湖南中医药大学学报,2018,38(5):546-549.
[6]周婧.加味补阳还五汤结合康复训练治疗脑卒中后急性期肩手综合征疗效观察[J].实用中医药杂志,2018,34(9):1054-1055.
[7]黄李容,钱拉拉,李俊纬,等.温针灸联合运动疗法治疗脑卒中后肩手综合征80例临床观察[J].中国中医药科技,2017,24(3):328-329.
[8]姜殷.电针治疗中风后肩手综合征概况[J].实用中医内科杂志,2015,(9):176-177.
[9]程学莲,程春霞.拔罐联合常规对症及康复训练治疗中风后肩手综合征随机平行对照研究[J].实用中医内科杂志,2014,(11):27-29.
[10]王宏宇.舒筋洗剂熏洗结合Bobath技术治疗脑卒中后肩-手综合征急性期的效果观察及护理[J].全科护理,2015,13(19):1862-1864.
[11]桑栎楠.加味补阳还五汤联合康复训练对脑卒中后急性期肩手综合征的疗效[J].中西医结合心血管病杂志(电子版),2018,6(11):147.
[12]贾建平,陈生弟.神经病学[M].第7版.北京:人民卫生出版社,2013:172.
[13]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.
[14]缪鸿石,朱镛连.脑卒中的康复评定与治疗[M].北京:华夏出版社,1996:149.
[15]饶明俐.中国脑血管病防治指南[M].北京:人民卫生出版社,2007:20-50.
[16]韦绪性.中西医临床疼痛学[M].北京:中国中医药出版社,1996:14-15.
[17]陈晓春,潘晓东.神经科查体及常用量表速查手册[M].北京:化学工业出版社,2013:119,111.
[18]王维艳.社区医疗在脑卒中并发症康复中的作用[J].辽宁医学杂志,2006,20(2):106.
[19]程小平.中风后肩手综合征的针刺康复治疗[J].上海针灸杂志,2007,26(6):24.
[20]冯斌,杨蓓玲.促神经针刺法在偏瘫早期康复中的应用[J].上海针灸杂志,1996,15(2):24.
[21]宋立公,徐金辉.卒中后肩手综合征中医病因病机的文献回顾与思考[J].中医临床研究,2016,8(24):5-7.
[22]姜道新,马得旅,王楠,等.肩手综合征的流行病学及病因病机研究进展[J].中西医结合心脑血管病杂志,2016,14(1):47-49.
[23]张燕龙,张方.中西医结合及康复训练治疗中风后肩手综合征60例[J].中国中医急症,2011,20(9):1473-1474.
[24]林梅珍,李群.手功能训练结合针灸治疗脑卒中后肩手综合征的效果观察[J].中国现代药物应用,2015,9(3):247-248.
[25]郑入文,任毅,胡慧.温针灸治疗卒中后肩手综合征的临床观察[J].世界中医药,2014,(11):1535-1537.
[26]孙昶晟,罗权,苏文渊,等.温针灸配合刺络放血治疗脑卒中后肩手综合征体会[J].河南中医,2014,34(6):52-53.
[27]李志宇.针灸推拿联合治疗中风后肩-手综合征的临床观察[J].中国伤残医学,2014,22(23):162-163.
[28]薛斐然,张维.不同时程温和灸对中风后肩痛患者肩髃穴热敏化现象影响[J].上海针灸杂志,2010,29(12):765-766.
[29]汤治中,徐应乐,易进科,等.针灸结合康复训练对肩手综合征患者肩痛及运动功能的影响[J].陕西中医,2013,34(7):882-883.
[30]胡俊霞,薛立文.针刺结合康复训练治疗中风后肩关节疼痛40例[J].陕西中医,2010,31(10):1392-1393.
[31]裘小玲,裘昊,黄涌,等.钩针疗法治疗中风偏瘫后肩痛疗效观察[J].上海针灸杂志,2006,25(7):10-12.
[32]杨楣良,周振鹤.钩针治疗肱骨外上髁炎119例:附54例对照组治疗观察[J].浙江中医杂志,1996,(6):271-272.
[33]徐放明,宋琬北.近10年来锋钩针临床应用概况[J].中国民间疗法,2000,8(3):48-49.