八邪透刺配合系统康复训练治疗中风偏瘫后肩手综合征疗效观察
|
摘要
目的:观察八邪透刺配合系统康复训练治疗中风偏瘫后肩手综合征的临床效果。方法:将中风偏瘫后肩手综合征患者178例按随机数字表法分为研究组、对照组各89例,对照组予系统康复训练治疗,研究组在对照组基础上予八邪透刺法治疗,观察并记录2组患者上肢肿胀、疼痛及患肢损伤程度评分、上肢运动功能、神经功能及相关生活能力评分、SF-36生存质量评分,比较2组临床疗效。结果:研究组治疗后上肢肿胀程度评分、视觉模拟(VAS)评分、肩手综合征评估量表(SHSS)评分、上肢神经功能缺损量表(NDS)评分低于对照组,治疗后简化上肢Fugl-Meyer运动功能量表(FMA)评分、日常生活活动量表(ADL)评分、SF-36生存质量评分高于对照组,差异具有统计学意义(P<0.05);总有效率对照组为77.5%,低于研究组的94.4%,差异具有统计学意义(P<0.05)。结论:八邪透刺配合系统康复训练能够减轻中风偏瘫后肩手综合征患者上肢肿胀、疼痛等临床症状,减轻患肢损伤,促进患者运动功能及神经功能恢复,提高日常生活能力和生存质量,临床疗效优于单纯系统康复训练。
Objective: To observe clinical effects of penetration needling at Baxie(Extra 28) combined with systematic rehabilitation training in the treatment for shoulder-hand syndrome after hemiplegia. Methods: All 178 patients were assigned into the study group and the control group according to random number table method, 89 cases each group, the control group were given systematic rehabilitation training, and the study group penetration needling at Baxie, to observe and record swelling, pain and damage degree scores of the affected limb in both groups,upper limb motor function, neurological function and the related living ability scores, SF-36 scores, and compare clinical effects between both groups. Results: The study group was lower than the control group in the scores of swelling degree, VAS scores, shoulder-hand syndrome scores(SHSS) and NDS of upper limb, after treating, higher than the control group in FMA scores, ADL scores and the scores of different items in SF-36, and the difference showed statistical meaning(P<0.05), Total effective rate of the control group was 77.5%, lower than 94.4% of the study group, and the difference was statistically significant(P <0.05). Conclusion: Penetration needling at Baxie combined with systematic rehabilitation training in the treatment for shoulder-hand syndrome after hemiplegia could relieve clinical symptoms including upper limb swelling, pain and others, mitigate the damage of the affected limb,promote motor function and neurological function recovery of the patients, raise ADL and quality of life, its effects are superior to only systematic rehabilitation training.
Objective: To observe clinical effects of penetration needling at Baxie(Extra 28) combined with systematic rehabilitation training in the treatment for shoulder-hand syndrome after hemiplegia. Methods: All 178 patients were assigned into the study group and the control group according to random number table method, 89 cases each group, the control group were given systematic rehabilitation training, and the study group penetration needling at Baxie, to observe and record swelling, pain and damage degree scores of the affected limb in both groups,upper limb motor function, neurological function and the related living ability scores, SF-36 scores, and compare clinical effects between both groups. Results: The study group was lower than the control group in the scores of swelling degree, VAS scores, shoulder-hand syndrome scores(SHSS) and NDS of upper limb, after treating, higher than the control group in FMA scores, ADL scores and the scores of different items in SF-36, and the difference showed statistical meaning(P<0.05), Total effective rate of the control group was 77.5%, lower than 94.4% of the study group, and the difference was statistically significant(P <0.05). Conclusion: Penetration needling at Baxie combined with systematic rehabilitation training in the treatment for shoulder-hand syndrome after hemiplegia could relieve clinical symptoms including upper limb swelling, pain and others, mitigate the damage of the affected limb,promote motor function and neurological function recovery of the patients, raise ADL and quality of life, its effects are superior to only systematic rehabilitation training.
引文
[1]张晓莉,唐朝正,贾杰.中西医治疗脑卒中后肩手综合征现状分析[J].中国康复医学杂志,2015,30(3):294-298.
[2]吴蓉蓉,杨训红,殷红彪,等.针灸治疗中风后肩手综合征现状[J].中医药临床杂志,2015,27(10):1473-1476.
[3]张园园,潘化平,冯慧,等.超声结合扶他林痛点导入治疗卒中后复杂区域疼痛综合征临床分析[J].中国疼痛医学杂志,2015,21(4):309-311.
[4]李新洲,陆兰芬.脑卒中后肩手综合征治疗进展[J].右江民族医学院学报,2014,36(2):273-275.
[5]Sun YZ,Wang YJ,Wang W.Effect of acupuncture plus rehabilitation training on shoulder-hand syndrome due to ischemic stroke[J].Journal of Acupuncture and Tuina Science,2012,10(2):109-113.
[6]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[7]王茂斌.神经康复学[M].北京:人民卫生出版社,2009:580-581.
[8]卫生部医政司.中国康复医学诊疗规范[M].北京:华夏出版社,1998:123-125.
[9]神经病理性疼痛诊疗专家组.神经病理性疼痛诊疗专家共识[J].中国疼痛医学杂志,2013,19(12):705-710.
[10]周小炫,方云华,陈善佳,等.健康调查简表和脑卒中影响量表在脑卒中康复临床中应用情况的调查分析[J].中国康复医学杂志,2014,29(5):455-459.
[11]郑筱萸.中药新药临床研究指导原则(试行)[J].北京:中国医药科技出版社,2002:162-164.
[12]Upadhyay A.Reflex sympathetic dystrophy-like syndrome,possibly caused by aripiprazole,in an adolescent patient[J].Journal of Child Adolescent Psychopharmacology,2014,24(7):414-415.
[13]Borchers AT,Gershwin ME.Complex regional pain syndrome:a comprehensive and critical review[J].Autoimmunity Reviews,2014,13(3):242-265.
[14]廖战军.采用针刺八邪穴的方法治疗中风后肩手综合征的效果研究[J].当代医药论丛,2015,13(15):26-27.
[15]黄春水,樊文朝,余安胜,等.八邪透刺配合康复训练治疗脑卒中后肩手综合征手肿胀疗效观察[J].中国针灸,2017,37(2):121-124.
[2]吴蓉蓉,杨训红,殷红彪,等.针灸治疗中风后肩手综合征现状[J].中医药临床杂志,2015,27(10):1473-1476.
[3]张园园,潘化平,冯慧,等.超声结合扶他林痛点导入治疗卒中后复杂区域疼痛综合征临床分析[J].中国疼痛医学杂志,2015,21(4):309-311.
[4]李新洲,陆兰芬.脑卒中后肩手综合征治疗进展[J].右江民族医学院学报,2014,36(2):273-275.
[5]Sun YZ,Wang YJ,Wang W.Effect of acupuncture plus rehabilitation training on shoulder-hand syndrome due to ischemic stroke[J].Journal of Acupuncture and Tuina Science,2012,10(2):109-113.
[6]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[7]王茂斌.神经康复学[M].北京:人民卫生出版社,2009:580-581.
[8]卫生部医政司.中国康复医学诊疗规范[M].北京:华夏出版社,1998:123-125.
[9]神经病理性疼痛诊疗专家组.神经病理性疼痛诊疗专家共识[J].中国疼痛医学杂志,2013,19(12):705-710.
[10]周小炫,方云华,陈善佳,等.健康调查简表和脑卒中影响量表在脑卒中康复临床中应用情况的调查分析[J].中国康复医学杂志,2014,29(5):455-459.
[11]郑筱萸.中药新药临床研究指导原则(试行)[J].北京:中国医药科技出版社,2002:162-164.
[12]Upadhyay A.Reflex sympathetic dystrophy-like syndrome,possibly caused by aripiprazole,in an adolescent patient[J].Journal of Child Adolescent Psychopharmacology,2014,24(7):414-415.
[13]Borchers AT,Gershwin ME.Complex regional pain syndrome:a comprehensive and critical review[J].Autoimmunity Reviews,2014,13(3):242-265.
[14]廖战军.采用针刺八邪穴的方法治疗中风后肩手综合征的效果研究[J].当代医药论丛,2015,13(15):26-27.
[15]黄春水,樊文朝,余安胜,等.八邪透刺配合康复训练治疗脑卒中后肩手综合征手肿胀疗效观察[J].中国针灸,2017,37(2):121-124.