针刺筋结点联合康复训练治疗卒中后肩关节半脱位随机平行对照研究  

Acupuncture combined with Rehabilitation Therapy for Stroke Tendons Node Subluxation After Randomized Controlled Study

作　　者：赵丹[1] 董宝强[1] 

机构地区：[1]辽宁中医药大学针灸推拿学院,沈阳110032

出　　处：《实用中医内科杂志》2016年第11期97-100,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察针刺筋结点联合康复治疗卒中后肩关节半脱位疗效。[方法]使用随机平行对照方法,将90例住院患者按病志号抽签方法简单随机分三组。康复组30例治疗脑卒中配合康复训练：1体位控制、2上肢负重、3患侧躯干牵张训练、4肩胛骨主动运动训练、5冈上肌刺激手法,训练时间45~50min/次。经穴组30例针刺患侧肩髃、肩髎、肩贞、臑会、曲池、合谷、外关,留针30min,1次/d;康复训练同康复组。经筋组30例按《中国经筋学》查找筋结点方法在患侧肩关节及上肢循按,针刺疼痛较重或伴肿胀黏连、条索状部位筋结点,重点循按筋结点：肩峰、天髎次、天宗次、肩内陵次、极泉次、肩痛点次、举肩次、肩前,留针30min,1次/d;康复训练同康复组。连续治疗7d为1疗程。观测临床症状、运动功能FuglMeyer（FMA）评价、肩峰与肱骨头间隙、肩关节复位率、不良反应。连续治疗6疗程,判定疗效。[结果]经筋组显效20例,有效7例,无效3例,总有效率90.00%;经穴组显效11例,有效9例,无效11例,总有效率63.30%;康复组显效9例,有效9例,无效12例,总有效率60.00%。临床疗效经筋组优于经穴组和康复组（P〈0.05）。Fugl-Meyer（FMA）评分三组均有改善（P〈0.05）,经筋组优于经穴组和康复组（P〈0.05）。复位率经筋组优于经穴组和康复组（P〈0.05）。[结论]针刺筋结点联合康复治疗卒中后肩关节半脱位,疗效满意,无严重不良反应,值得推广。[Objective] To observe the effect of acupuncture combined with rehabilitation therapy after stroke tendons node shoulder subluxation. [Method] Using random parallel control method, 90 cases of hospitalized patients were randomly divided into three groups according to the random number of the disease. Rehabilitation group of 30 cases of active treatment of primary stroke on the basis of rehabilitation therapy：（1）position control, （2）Upper limb loading,（3）Ipsilateral trunk stretch training,（4）Scapula active exercise training,（5）Hills muscle stimulation technique, Training time 45-50 min/times. Acupuncture group of 30 cases taken ipsilateral Jianyu, jianliao, Jianzhen, tb-13, Quchi, Hegu, Waiguan,the conventional acupuncture, needle 30min, 1 times/d; Rehabilitation therapy and rehabilitation group. Jingjin group 30 cases in accordance with the ＂Chinese meridian sinews＂ find the tendons node method in the ipsilateral shoulder and upper limb to abide by and in pain in the corresponding heavier or accompanied by swelling adhesion, cord like parts of the tendons node acupuncture; key cycle according to the tendons node： Jianfeng, Tianliaoci, Tianzongci, shoulder Ling, Jiquan, shoulder pain point, lift shoulder, shoulder before and routine acupuncture, 30rain, 1 times/d. Rehabilitation therapy and rehabilitation group. Continuous treatment for 1 courses of 7d. Observation of clinical symptoms and motor functions of Fugl Meyer assessment （FMA） evaluation method, the acromion and humeral bones between clearance, shoulder joint reposition rate and adverse reactions. Continuous treatment for 6 courses of treatment, to determine efficacy. [Results] The rebar group, 20 cases were markedly effective, effective in 7 cases, 3 cases were invalid, effective rate was 90.00%; acupoint group of 11 cases were markedly effective, 9 cases were effective, 11 cases were ineffective, 63.30% efficiency; rehabilitation group, 9 cases markedly effective, effective in 9 cases, 12 cases were ineffective, 60.00% ef

关 键 词：卒中后肩关节半脱位 脱骱 肩痹 针刺 筋结点 康复训练 运动功能Fugl—Meyer(FMA)评价法 肩峰与肱骨头间隙 肩关节复位率 中医药治疗 随机平行对照研究 

分 类 号：R743.3[医药卫生—神经病学与精神病学]