电针与穴位注射联合康复技术对脑出血后肩手综合征患者上肢功能障碍及日常生活能力的影响  

Therapeutic effect of acupoint injection and rehabilitation training program on upper limb function and daily life activities of patients with shoulder-hand syndrome after cerebral hemorrhage

作　　者：王东雁[1] 刘杰 陈敬德[3] 王明[5] 王勇[4] 邵文泽[4] 王蒙[5] 李辉[2] Wang Dongyan;Liu Jie;Chen Jingde;Wang Ming;Wang Yong;Shao Wenze;Wang Meng;Li Hui(Department of Traditional Chinese Medicine,People＇s Hospital of Jiuquan,Jiuquan 735000,Chin)

机构地区：[1]甘肃省酒泉市人民医院中医科,735000 [2]甘肃省酒泉市人民医院门诊部,735000 [3]甘肃省酒泉市人民医院皮肤科,735000 [4]甘肃省酒泉市人民医院神经外科,735000 [5]甘肃省酒泉市人民医院老年科,735000

出　　处：《国际中医中药杂志》2018年第7期600-604,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的 探讨电针、穴位注射与康复技术对脑出血后肩手综合征（shoulder-hard syndrome, SHS）上肢功能障碍及日常生活能力的影响。方法 将符合入选标准的96例脑出血后SHS患者按随机数字表法分为观察组56例和对照组40例，2组患者均给予相同的脑出血常规治疗，待生命体征稳定后2周，观察组结合电针、穴位注射及康复技术治疗，对照组加用中频理疗。2组均治疗1个月。采用Fugl-Meye运动功能评分法（Fugl-Meyer Assessment, FMA）评价上肢运动功能，采用改良的Barthel指数（modified Barthel index, MBI）评价日常生活能力（Activities of Daily Living, ADL），采用VAS量表评价肩关节疼痛程度，采用测角计测量肩关节活动度（Range of Motion, ROM），采用排水法检测SHS手肿胀的发展及恢复情况，评价临床疗效。结果 治疗后，观察组FMA[（60.1±6.4）分比（41.8±18.7）分，t＝6.799]、MBI[（65.2±3.5）分比（50.6±2.1）分，t＝23.512]评分高于对照组，VAS评分[（2.7±1.4）分比（4.9±1.3）分，t＝7.817]、水肿体积差[（2.1±2.1）cm3比（4.8±1.2）cm3，t＝7.316]低于对照组（P＜0.01）。观察组前屈[（163.1±6.7）°比（56.0±10.9）°，t＝59.516]、后伸[（39.6±5.8）°比（23.2±6.7）°，t＝12.799]、外展[（168.1±9.6）°比（52.1±8.9）°，t＝60.148]、内收[（52.1±3.6）°比（29.8±4.3）°，t＝27.580]、外旋[（49.8±7.6）°比（23.2±5.2）°，t＝19.151]、内旋[（107.0±8.5）°比（60.2±6.1）°，t＝29.758]活动度均高于对照组（P＜0.01）。观察组总有效率为91.1%（52/56）、对照组为70.0%（28/40），2组比较差异有统计学意义（χ2＝7.209，P＜0.01）。结论 针刺与穴位注射联合康复技术可减轻脑出血后SHS患者疼痛，消除水肿，提高上肢运动功能及ADL。Objective To investigate the effect of acupuncture point injection and rehabilitation on the functional recovery of upper limbs and daily living ability of shoulder-hard syndrom （SHS） after cerebral hemorrhage. Methods A total of 96 patients SHS after cerebral hemorrhage were divided into the observation group （n=56） and the control group （n=40）. Both groups recieved the routine treatment for cerebral hemorrhage and rehabilitation technique training. Besides, the control group was treated with intermediate frequency physiotherapy, and the observation group was treated with electroacupuncture and acupoint injection of Salvia miltiorrhiza and ligustrazine. After 1 months of treatment, the the upper limb movement function, daily living ability （ADL）, shoulder joint pain, joint activity degree, and the degree of joint swelling were evaluated and compared. Results After treatment, the FMA （60.1 ± 6.4 vs. 41.8 ± 18.7, t=6.799）, MBI （65.2 ± 3.5 vs. 50.6 ± 2.1, t=23.512） scores of the observation group were significantly higher than those of the control group. The VAS （2.7 ± 1.4 vs. 4.9 ± 1.3, t=7.817）, edema volume （2.1 ± 2.1 cm3 vs. 2.1 ± 2.1 cm3, t=7.316） of the observation group were significantly lower than those of the control group （ P〈0.01）. The anterior flexion （163.1 ± 6.7°vs. 56 ± 10.9°, t=59.516）, extension （39.6 ± 5.8°vs. 23.2 ± 6.7°, t=12.799）, abduction （168.1 ± 9.6°vs. 52.1 ± 8.9°, t=60.148）, adduction （52.1 ± 3.6° vs. 29.8 ± 4.3°, t=27.580）, external rotation （49.8 ± 7.6°vs. 23.2 ± 5.2°, t=19.151）, internal rotation （107.0 ± 8.5°vs. 60.2 ± 6.1°, t=29.758） of the observation group were significantly higher than those of the control group （P〈0.01）. The total effective rate of the observation group was 91.1% （52/56） and the control group was 70% （28/40）, and the difference between the 2 groups was statistically significant （χ2=7.209, P〈0.01）. Conclusions Acupuncture combined with acupoint injec

关 键 词：脑出血 肩手综合征 电针 注射 穴位 康复日常生活活动 

分 类 号：R246.6[医药卫生—针灸推拿学]