中药联合针刺治疗脑卒中后肩手综合征的疗效观察

Clinical effect observation on treating shoulder-hand syndrome after stroke by traditional Chinese medicine formula combined with acupuncture

关键词:  脑卒中  肩手综合征  中药疗法  针刺疗法  康复

Key words:  stroke  shoulder-hand syndrome  traditional Chinese medicine formula therapy  acupuncture therapy  rehabilitation

摘要:

目的　观察中药联合针刺方法治疗对脑卒中后肩手综合征的疗效。　方法　68例确诊脑卒中后肩手综合征患者，随机分为对照组和观察组。对照组（34例）：采用现代Bobath运动训练；观察组（34例）：采用中药联合针刺方法。中药：内服法进行中医辨证分型用药，外治法采用中药熏洗治疗；针刺：采用毫针刺法进行辨证选穴结合局部选穴治疗。治疗时间均为3周。治疗前后分别采用视觉模拟量表（VAS）评定疼痛程度，公分软尺测定手肿胀程度，上肢功能评定表(DASH)了解患者上肢从事日常活动的能力及患肢症状严重程度。　结果　两组治疗后患肢肩痛、手肿胀及DASH评分（观察组：1.34±0.47，0.91±1.21，50.28±8.46；对照组：6.05±1.54，2.08±0.97，67.51±9.64）较治疗前相应评分（观察组：6.89±1.42，4.42±2.13，75.23±10.14；对照组：7.04±1.05，4.09±1.94,76.18±9.48）均有明显差异(P<0.05)，而治疗后评分进行比较，观察组优于对照组(P<0.05)。观察组临床总有效率（88.24%）优于对照组（73.53%）(P<0.05)。　结论　中药联合针刺方法可明显改善脑卒中后肩手综合征肩痛、肿胀症状，提高日常活动能力。

Abstract:

[Abstract] Objective To observe the clinical effect of traditional Chinese medicine formula combined with acupuncture in patients with shoulder-hand syndrome after stroke.　Methods Sixty-eight patients with shoulder-hand syndrome after stroke were randomly divided into two groups:a control group (CG,34 cases) treated with modern Bobath training; and an experimental group (EG,34 cases) treated with traditional Chinese medicine formula combined with acupuncture (herbal dose, acupuncture and herbal fumigating),the therapeutic course was 3 weeks. All patients were examined on the admission and discharged by using Visual Analogue Scale(VAS),centimeter band measuring and the Disabilities of the Arm,Shoulder and Hand Test(DASH Test) to assess respectively the degree of pain and swelling, as well as the degree of disability and symptoms for the arm’s area. 　Results Compared with that before treatment（EG：6.89±1.42，4.42±2.13，75.23±10.14；CG：7.04±1.05，4.09±1.94，76.18±9.48）,VAS scores,swelling of affected limb and DASH scores were significantly reduced after treatment in both groups（EG：1.34±0.47，0.91±1.21，50.28±8.46；CG：6.05±1.54，2.08±0.97，67.51±9.64）(P<0.05);However, the effects in EG was significantly superior to that in CG (P<0.05). And the total clinical effective rate（88.24%）in EG was significantly superior to that in CG（73.53%）(P<0.05). 　Conclusion Traditional Chinese medicine formula combined with acupuncture used on EG shows significantly better results in reducing pain, swelling and improvement of independency of the patients with shoulder-hand syndrome after stroke.