瑶医神火灸结合综合康复疗法治疗脑卒中后肩手综合征临床研究  

Clinical study on the treatment of shoulder-hand syndrome after stroke with Yaoyi-Shenhujiu combined with synthetic rehabilitation therapy

作　　者：刘国成[1] 周哲屹[1] 关建国[1] 徐宏[1] 

机构地区：[1]广西壮族自治区柳州市中医院脑病科,545001

出　　处：《国际中医中药杂志》2015年第11期977-980,共4页International Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区卫生厅中医药科技专项（GZKZ-G1111）;柳州市科学研究予技术开发计划课题（2013J030406）

摘　　要：目的：评价瑶医神火灸结合综合康复疗法治疗脑卒中后肩手综合征（shoulder-hand syndrome after stroke, SHSAS）的临床疗效。方法将符合入选标准的柳州市中医院脑病科 SHSAS 患者按随机数字表法分为2组各50例，对照组采用综合康复疗法治疗，观察组在对照组基础上结合瑶医神火灸治疗。共治疗2周。分别采用视觉模拟量表（visual analogue scale, VAS）、Fugl-Meyer 运动功能量表（Fugl-Meyer assessment, FMA）和改良 Barthel 指数（modified barthel index, MBI）对患者治疗前后疼痛、运动功能及日常生活活动能力进行评分，评价临床疗效。结果治疗后，观察组 VAS 评分[（3.43±1.76）分比（5.21±2.15）分，t＝4.530]下降情况及 FMA 评分[（55.66±4.33）分比（40.45±3.75）分，t＝18.776]升高情况均优于对照组（P＜0.01）；观察组健康状况调查问卷 SF-36中生理功能[（95.78±7.68）分比（87.88±7.21）分，Z＝-5.042]、生理角色限制[（50.78±21.44）分比（36.89±18.42）分，Z＝-7.241]、躯体疼痛[（83.22±13.45）分比（75.52±13.23）分， Z＝-4.055]、总体健康[（50.25±18.45）分比（39.01±18.63）分，Z＝-8.043]、活力[（79.28±11.92）分比（70.22±10.69）分，Z＝-3.216]、社会功能[（85.78±20.12）分比（74.71±19.22）分，Z＝-4.128]、情感角色限制[（36.66±23.79）分比（28.11±18.21）分，Z＝-6.052]和心理健康[（81.17±9.72）分比（74.61±11.25）分， Z＝-5.367]评分的升高情况均优于对照组（P＜0.05）。观察组总有效率为94.0%（47/50），对照组为76.0%（387/50），2组比较差异有统计学意义（χ2＝5.020，P＝0.025）。结论瑶医神火灸结合综合康复疗法可有效改善 SHSAS 患者肢体运动功能，提高其生活自理能力及生存质量，疗效优于综合康复疗法。Objective To observe the clinical efficacy of Yaoyi-Shenhuojiu combined with synthetic rehabilitation therapy on shoulder-hand syndrome after stroke （SHSAS）. Methods 100 SHSAS patients were randomly divided into an observation group and a control group, with 50 patients in each group. Patients in the observation group were treated with Yaoyi-Shenhuojiu on the basis of comprehensive rehabilitation training of the control group. After treated for 2 consecutive weeks, the pain, motor function, activities of daily living in patients of both groups were compared and improvement of the constitution according to VAS, FMA, MBI was also compared. Results After treatment, the decrease of VAS score in the observation group （3.43 ± 1.76 vs. 5.21 ± 2.15, t=4.530） and the increase of FMA score （55.66 ± 4.33 vs. 40.45 ± 3.75, t=18.776） was significantly better than the control group （P〈0.01）; Physiological function in SF-36 health survey questionnaire （95.78 ± 7.68 vs. 87.88 ± 7.21, Z=5.042）, physiological functions of （50.78 ± 21.44 vs. 36.89 ± 18.42, Z=7.241）, body pain （83.22 ± 13.45 vs. 75.52 ± 13.23, Z=4.055）, overall health （50.25 ± 18.45 vs. 39.01 ± 18.63, Z=8.043）, vigor （79.28 ± 11.92 vs. 70.22 ± 10.69, Z=3.216）, social function （85.78 ± 20.12 vs. 74.71 ± 19.22, Z=4.128）, emotional function （36.66 ± 23.79 vs. 28.11 ± 18.21, Z=6.052） and mental health （81.17 ± 9.72 vs. 74.61 ± 11.25, Z=5.367） eight dimensions of higher score in the observation group were also significantly better than the control group （P〈0.05）. The total effective rate （94.0% vs. 76.0%） in the observation group was significantly better than the control group （χ2=5.020, P=5.020）. Conclusion Yaoyi-Shenhuojiu combined with comprehensive rehabilitation therapy can effectively improve limb movement function in patients with SHSAS, besides its improving the life self-care ability and life quality.

关 键 词：肩手综合征 中风后遗症 瑶医药学 间接灸 康复 

分 类 号：R732.2[医药卫生—肿瘤]