靳三针配合康复训练治疗缺血性脑卒中后肩手综合征临床研究
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摘要
目的:观察在常规干预措施基础上采用靳三针配合康复训练治疗缺血性脑卒中后肩手综合征风痰瘀阻证的临床疗效。方法:选取本院收治的108例风痰瘀阻型缺血性脑卒中后肩手综合征患者,按随机数字表法将患者分为治疗组和对照组各54例。2组均予常规干预措施和康复训练治疗,治疗组加予靳三针治疗,2组连续治疗4周。比较2组治疗前后的风痰瘀阻证症状评分、肩手综合征量表评分及治疗后的临床疗效。结果:治疗后,治疗组总有效率90.74%,高于对照组的72.22%,差异有统计学意义(P <0.05)。2组头晕目眩、言语謇涩、痰多、感觉减退评分均较治疗前减少(P <0.01),治疗组上述症状评分均低于对照组(P <0.01)。2组肩手综合征量表的感觉、自主神经、运动评分均较治疗前减少(P <0.01),治疗组各项评分均低于对照组(P <0.01)。结论:在常规干预措施基础上采用靳三针配合康复训练治疗缺血性脑卒中后肩手综合征风痰瘀阻证患者,可有效改善症状,提高临床疗效。
Objective:To observe the clinical effect of Jin's three-needle technique combined with rehabilitation training based on routine treatment for shoulder-hand syndrome after ischemic stroke with wind-phlegm stagnation syndrome.Methods: Selected 108 cases of patients with shoulder-hand syndrome after ischemic stroke of wind-phlegm stagnation type who were admitted and treated in our hospital, and divided them into the treatment group and the control group randomly,54 cases in each group. Both groups received routine interventions and rehabilitation training,while the treatment group additionally received Jin's three-needle technique. The treatment of both groups lasted for 4 weeks continuously.Compared the symptom scores of wind-phlegm stagnation syndrome and scores of shoulder-hand syndrome scale(SHSS) in both groups before and after treatment,and evaluated the clinical effect after treatment. Results:After treatment,the total effective rate was 90.7% in the treatment group,being higher than 72.22% in the control group,difference being significant(P < 0.05). The scores of such symptoms as vertigo,dysphasia,excessive phlegm and hypoesthesia in both groups were all lower than those before treatment(P < 0.01), each score above in the treatment group was lower than that in the control group(P < 0.01). The scores of sense, autonomic nerve system and motion in SHSS were all lower than those before treatment(P < 0.01),each score above in the treatment group was lower than that in the control group(P < 0.01). Conclusion:The application of Jin's three-needle technique combined with rehabilitation training based on routine treatment for patients with shoulder-hand syndrome after ischemic stroke with wind-phlegm stagnation syndrome can effectively improve clinical symptoms and enhance clinical effect.
Objective:To observe the clinical effect of Jin's three-needle technique combined with rehabilitation training based on routine treatment for shoulder-hand syndrome after ischemic stroke with wind-phlegm stagnation syndrome.Methods: Selected 108 cases of patients with shoulder-hand syndrome after ischemic stroke of wind-phlegm stagnation type who were admitted and treated in our hospital, and divided them into the treatment group and the control group randomly,54 cases in each group. Both groups received routine interventions and rehabilitation training,while the treatment group additionally received Jin's three-needle technique. The treatment of both groups lasted for 4 weeks continuously.Compared the symptom scores of wind-phlegm stagnation syndrome and scores of shoulder-hand syndrome scale(SHSS) in both groups before and after treatment,and evaluated the clinical effect after treatment. Results:After treatment,the total effective rate was 90.7% in the treatment group,being higher than 72.22% in the control group,difference being significant(P < 0.05). The scores of such symptoms as vertigo,dysphasia,excessive phlegm and hypoesthesia in both groups were all lower than those before treatment(P < 0.01), each score above in the treatment group was lower than that in the control group(P < 0.01). The scores of sense, autonomic nerve system and motion in SHSS were all lower than those before treatment(P < 0.01),each score above in the treatment group was lower than that in the control group(P < 0.01). Conclusion:The application of Jin's three-needle technique combined with rehabilitation training based on routine treatment for patients with shoulder-hand syndrome after ischemic stroke with wind-phlegm stagnation syndrome can effectively improve clinical symptoms and enhance clinical effect.
引文
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[13]王磊.自拟化痰通络汤联合针刺治疗风痰瘀阻型中风病临床观察[J].亚太传统医药,2017,13(10):140-142.
[2]万文蓉,王天磊,程绍鲁,等.针刺结合康复治疗中风后肩手综合征:随机对照研究[J].中国针灸,2013,33(11):970-974.
[3]闫兵,吴立雄,许能贵,等.靳三针配合十二井穴治疗脑卒中后肩手综合征疗效观察[J].上海针灸杂志,2015,34(7):605-607.
[4]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.
[5]全国第四届脑血管病学术会议.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):381-383.
[6]中华医学会神经病学分会神经康复学组.中国脑卒中康复治疗指南(2011完全版)[J].中国康复理论与实践,2012,4(4):55-76.
[7]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[8]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:99-104.
[9]中华医学会神经病学分会.中国脑卒中康复治疗指南[J].中国康复理论与实践,2012,18(4):301-318.
[10]王茂斌.偏瘫的现代评价与治疗[M].北京:华夏出版社,1990:226-231.
[11]王雪莲,毛芝芳.活血通络中药熏蒸联合综合康复训练治疗脑梗死后肩手综合征疗效及对CGRP、NO、ET-1水平的影响[J].中华中医药学刊,2018,36(4):1004-1006.
[12]曹凤,狄振峰,陆雪琴.脑卒中后并发肩手综合征的研究进展[J].上海医药,2015,36(24):3-6.
[13]王磊.自拟化痰通络汤联合针刺治疗风痰瘀阻型中风病临床观察[J].亚太传统医药,2017,13(10):140-142.