“三位一体”针法联合冷热中药液交替浸泡治疗脑卒中后肩-手综合征Ⅰ期上肢水肿疗效及对上肢静脉血流速度的影响  

Effect of “three-in-one” acupuncture combined with cold and hot traditional Chinese medicine for alternant soaking on upper limb edema at Ⅰ stage of shoulder-hand syndrome after stroke and its effect on venous blood flow velocity of upper limb

作　　者：刘洁[1] 周立明 王超凡[1] LIU Jie;ZHOU Liming;WANG Chaofan(Beijing Aerospace General Hospital, Beijing 100076)

机构地区：[1]北京航天总医院

出　　处：《现代中西医结合杂志》2019年第18期1964-1968,1974,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察“三位一体”针法联合冷热中药液交替浸泡治疗脑卒中后肩-手综合征Ⅰ期上肢水肿的疗效及对上肢静脉血流速度的影响。方法将97例脑卒中后肩-手综合征Ⅰ期上肢水肿患者随机分为观察组49例和对照组48例,对照组给予常规治疗,观察组在对照组治疗基础上给予“三位一体”针法+冷热中药液交替浸泡治疗,2组疗程为4周。比较2组临床疗效,观察2组治疗前后上肢水肿分级、疼痛评分、上肢关节功能、日常生活能力及肩手关节活动度、上肢静脉血流速度的变化情况。结果观察组治疗总有效率显著高于对照组(P<0.05);2组治疗后上肢水肿分级和腋静脉、肱静脉、肘正中静脉、桡静脉内径及最大血流速度均较治疗前显著改善(P均<0.05),且观察组改善情况显著优于对照组(P均<0.05);2组治疗后疼痛视觉模拟评分(VAS)、上肢周径均明显低于治疗前(P均<0.05),上肢Fugl-Meyer量表评分、改良Barthel指数量表评分均明显高于治疗前(P均<0.05),肩关节前屈、后伸、外展、内旋活动度和掌指关节屈曲、近端指间关节屈曲、远端指间关节屈曲、拇指指间关节屈曲角度均明显大于治疗前(P均<0.05),且观察组上述指标改善情况均显著优于对照组(P均<0.05)。结论“三位一体”针法联合冷热中药液交替浸泡治疗脑卒中后肩-手综合征Ⅰ期上肢水肿疗效确定,不仅能促进上肢水肿消退,缓解疼痛,提高肩手关节活动度,还能改善上肢功能与日常活动能力,其机制可能与改善上肢静脉血流、促进静脉回流有关。Objective It is to observe the effect of “three-in-one” acupuncture combined with cold and hot Chinese medicine for alternant soaking on upper limb edema at Ⅰ stage of shoulder-hand syndrome after stroke and its effect on venous blood flow velocity of upper limb.Methods 97 patients with upper limb edema at Ⅰ stage of shoulder-hand syndrome after stroke were randomly divided into observation group (49 cases) and control group (48 cases).The control group received routine treatment.The observation group was given“three-in-one” acupuncture combined with cold and hot Chinese medicine for alternant soaking.Both groups were treated for 4 weeks.The clinical efficacy of the two groups was compared.The changes of classification of upper limb edema, pain score, upper limb joint function, daily living ability, shoulder joint activity and venous blood flow velocity of upper limb were observed before and after treatment in the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group ( P <0.05).The edema classification of the upper extremity, internal diameter and maximum blood flow velocity of axillary vein, brachial vein, median elbow vein, radial vein were significantly improved after treatment in the two groups( P <0.05), and the improvement of the observation group was significantly better than that of the control group ( P <0.05).The visual analog scale (VAS) and upper limb circumference of the two groups were significantly lower than those before treatment ( P <0.05), the upper limb Fugl-Meyer scale score and the modified Barthel index scale score were significantly higher than those before treatment ( P <0.05), shoulder joint activity of flexion, extension, abduction, internal rotation and flexion angle of metacarpophalangeal joint, near interphalangeal joint, distal interphalangeal joint, and interphalangeal joint were significantly greater than those before treatment ( P <0.05), and the improvement of the above indicators in the observati

关 键 词：针刺疗法 中药浸泡 脑卒中 肩-手综合征 肢体水肿 上肢静脉 

分 类 号：R743.33[医药卫生—神经病学与精神病学]