针刺星状神经节对脑卒中后肩手综合征的疗效研究  

Clinical Research of Acupuncture at Stellate Ganglion for Treatment of Post-stroke Shoulder-hand Syndrome

作　　者：黄凡[1] 陈天龙[2] 杨海涛[1] 陆彦青[1] 唐明[1] 原筝 萧婷[2] 古柱亮 

机构地区：[1]广东省第二中医院针灸科,广东广州510095 [2]广州中医药大学

出　　处：《广州中医药大学学报》2015年第5期868-873,共6页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】比较针刺星状神经节与常规针刺治疗脑卒中后肩手综合征的临床疗效差异。【方法】将90例脑卒中后肩手综合征(第Ⅰ期或第Ⅱ期)患者随机分为治疗组和对照组各45例。2组患者均给予基础康复训练,治疗组同时予以针刺颈部的双侧星状神经节,行捻转泻法;对照组给予常规针刺治疗,穴位选取极泉、尺泽、肩髃、曲池、手三里、合谷,极泉、尺泽用提插泻法,余穴用平补平泻法。2组均每天治疗1次,共治疗14次。采用证候总积分、视觉模拟评分法(VAS)、改良Fugl-Meyer运动功能评定积分量表(FMA)和改良Barthel指数对患者治疗前后症状变化、上肢疼痛、上肢综合运动功能、日常生活活动能力进行评价,并比较2组临床疗效。【结果】(1)治疗后,2组患者的证候总积分、VAS评分、FMA评分、改良Barthel指数均较治疗前显著改善(P<0.01),且治疗组的改善作用均优于对照组(P<0.01)。(2)治疗组总有效率为93.33%,对照组为73.33%,治疗组疗效优于对照组(P<0.05)。(3)治疗期间,2组患者依从性良好,均能正常完成整个治疗过程,无脱落病例;2组均未见明显不良反应,具有较好的安全性。【结论】针刺星状神经节对脑卒中后肩手综合征患者有显著疗效,其疗效优于常规针刺治疗。Objective To compare the difference of the clinical efficacy on post-stroke shoulder-hand syndrome treated by acupuncture at stellate ganglion and by conventional acupuncture. Methods Ninety cases of post-stroke shoulder-hand syndrome （ at stageⅠ or stageⅡ） were randomized into treatment group and control group, 45 cases in each group. Both groups received basic rehabilitation training. Additionally, the treatment group received acupuncture at the bilateral stellate ganglions of the neck, with reducing acupuncture by rotating the needles. The control group received the conventional acupuncture on Jiquan （ HT 1） , Chize （ LU 5） , Jianyu （LI 15）, Quchi （LI 11）, Shousanli （LI 10）, Hegu （LI 4）, with reducing acupuncture by lifting and thrusting the needle on Jiquan （ HT 1） and Chize （ LU 5） , and with mild reinforcing and reducong acupuncture on the other acupoints. The treatment for both groups was given once every day, and 14 times in total. The total syndrome scores, visual analogue scale （VAS） scores, modified Fugl-Meyer Assessment of motor function scale （FMA） scores, and modified Barthel index （MBI） were observed to evaluate the changes of symptoms, pain and motor function of the upper limbs, and activity of daily life before and after treatment in the two groups. The clinical efficacy was also compared between the two groups. Results The total syndrome scores, VAS scores, FMA scores and the modified Barthel index were improved apparently after treatment in the two groups （all P〈0.01）, and the improvement in the treatment group as more obvious （all P〈0.01） . The total effective rate was 93.33% （42/45） in the treatment group, which was better than 73.33% （33/45） in the control group （ P〈0.05） . During the treatment, patients of both groups had good compliance, and all completed the trial. No obvious adverse reaction was found in the two groups. Conclusion Acupuncture at stellate ganglion is effective and safe for the treatment of post-

关 键 词：脑卒中/并发症 肩手综合征/针灸疗法 星状神经节 交感神经 

分 类 号：R246.6[医药卫生—针灸推拿学]