套针循经针刺治疗中风后肩手综合征Ⅰ期的临床疗效分析  

Analysis of the clinical effect on post-stroke shoulder hand syndrome stageⅠtreated with the along-meridian trochar acupuncture therapy

作　　者：曹丽娟[1] 谭琰 周炜[1] 李源[1] 胡海[1] 刘倩[1] 何玉伟[1] 谭双[1] 陈紫微 CAO Li-juan;TAN Yan;ZHOU Wei;LI Yuan;HU Hai;LIU Qian;HE Yu-wei;TAN Shuang;CHEN Zi-wei(Huguosi Hospital of Traditional Chinese Medicine Affiliated to Beijing University of Chinese Medicine,Beijing 100035,China;School of Life Sciences,Beijing University of Chinese Medicine,Beijing 100029;School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029)

机构地区：[1]北京中医药大学附属护国寺中医医院针灸科,北京100035 [2]北京中医药大学生命科学学院,北京100029 [3]北京中医药大学中医学院,北京100029

出　　处：《针刺研究》2020年第8期657-661,666,共6页Acupuncture Research

基　　金：北京中医药大学附属护国寺中医医院院级课题(No.YJ-7);国家自然科学基金青年项目(No.81904049);中华中医药学会青年人才托举项目(No.CACM-2018-QNRC2-C06);中央高校基本科研业务费新教师启动基金项目(No.2018-JYBZZ-XJSJJ011)。

摘　　要：目的:比较套针循经针刺法与常规毫针针刺法治疗中风后肩手综合征的临床疗效差异。方法:将80例中风后肩手综合征Ⅰ期患者按照随机数字表法分为对照组和治疗组,其中治疗组41例、对照组39例。对照组采用普通毫针针刺肩髃、肩髎、肩贞、肩中俞、肩外俞,每周治疗5次,3周为1个疗程;治疗组采用套针循经针刺,每周治疗3次,3周为1个疗程;两组患者均接受基础疾病药物治疗及进行常规康复训练治疗。分别于治疗前、治疗结束后、随访时观察两组患者的上肢疼痛程度、上肢水肿程度、上肢运动功能、日常生活能力,在治疗结束后、随访时分别对两组患者进行疗效评价。结果:与治疗前比较,两组患者治疗后上肢VAS评分明显降低(P<0.001),上肢运动功能评分、Barthel指数明显升高(P<0.001,P<0.05),治疗组患者治疗后患肢水肿程度评分明显降低(P<0.001)。与对照组比较,治疗组患者上肢VAS评分、患肢水肿程度评分明显降低(P<0.001);上肢运动功能评分、Barthel指数明显升高(P<0.001)。治疗组治疗后总有效率为66.7%(26/39)、随访时总有效率为74.4%(29/39),对照组分别为20.5%(8/39)、28.2%(11/39),治疗组治疗后、随访时总有效率均明显高于对照组(P<0.001)。结论:应用套针循经针刺治疗中风后肩手综合征能够明显缓解患者的疼痛、水肿,改善患者的上肢功能及日常生活能力,临床疗效确切。Objective To compare the differences in the clinical effect on post-stroke shoulder hand syndrome(SHS)stageⅠbetween the along-meridian trochar acupuncture therapy and the routine acupuncture therapy with filiform needles.Me-thods A total of 80 patients with post-stroke SHS stage I were divided into a treatment group(41 cases)and a control group(39 cases)according to the random number table.In the control group,the common filiform needles were used to stimulate Jianyu(LI15),Jianliao(TE14),Jianzhen(SI9),Jianzhongshu(SI15),Jianwaishu(SI14),5 times a week,3 weeks as 1 course.In the treatment group,along-meridian trochar acupuncture therapy was applied,3 times a week,3 weeks as 1 course.The patients in both groups were all treated with basic medications and routine rehabilitation training.Pain degree,edema degree,upper limb motor function and activity of daily living were observed in the two groups before the treatment,at the end of the treatment and in follow-up.At the end of treatment and in follow-up,the therapeutic effect was evaluated respectively in the patients of the two groups.Results Compared with the values before treatment,the VAS score of the upper limb was reduced obviously(P<0.001),the score of the upper limb motor function and Barthel index were increased obviously(P<0.001,P<0.05)in the patients of the two groups,the score of edema degree of the affected limb was reduced after treatment in the patients of the treatment group(P<0.001).Compared with the control group,VAS score of the upper limb and the score of edema degree of the affected limb were obviously lower(P<0.001),and the score of the upper limb motor function and Barthel index were obviously higher in the treatment group(P<0.001).The total effective rate was 66.7%(26/39)after treatment and was 74.4%(29/39)in follow-up in the treatment group and they were 20.5%(8/39)and 28.2%(11/39)respectively in the control group.The total effective rates after treatment and in follow-up in the treatment group were all obviously higher than those in the con

关 键 词：中风 肩手综合征 临床疗效 循经针刺 

分 类 号：R246.6[医药卫生—针灸推拿学]