中药药蜡热熨结合常规康复训练治疗脑卒中后肩手综合征临床研究  

Clinical Study on Heat Ironing of Chinese Herbal Wax Combined with Routine Rehabilitation for Shoulder-Hand Syndrome After Stroke

作　　者：任锟[1] 魏桂梅[2] 程红[1] 韩磊 REN Kun;WEI Guimei;CHENG Hong;HAN Lei

机构地区：[1]河南省中医院,河南郑州450002 [2]河南中医药大学第三附属医院,河南郑州450002

出　　处：《新中医》2020年第16期62-65,共4页New Chinese Medicine

基　　金：河南省中医药科学研究专项课题(2018ZY2092)。

摘　　要：目的:观察中药药蜡热熨结合常规康复训练治疗脑卒中后肩手综合征(SHS)的临床疗效。方法:选取80例脑卒中后SHS患者,按照随机数字表法将患者分成观察组与对照组各40例。对照组除基础治疗外给予常规康复治疗(促通技术及神经肌肉本体感觉疗法),观察组在基础治疗时配合中药药蜡热熨,热熨后给予常规康复治疗(同对照组)。比较2组治疗前后疼痛、水肿、关节活动度积分及改良Barthel指数(MBI)、Fugl-Meyer评定法(FMA)评分,比较2组临床疗效及不良反应情况。结果:治疗4周后,观察组总有效率为92.50%,对照组总有效率为70.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组疼痛、水肿、关节活动度积分均较治疗前降低(P<0.05),观察组疼痛、水肿、关节活动度积分均低于对照组(P<0.05);2组FMA、MBI评分均较治疗前升高(P<0.05),观察组FMA、MBI评分均高于对照组(P<0.05)。2组治疗期间均未发生明显不良反应。结论:中药药蜡热熨结合常规康复治疗对脑卒中后SHS具有较好的治疗效果,安全可靠,经济实用,患者易于接受。Objective:To observe the clinical effect of the therapy of heat ironing of Chinese herbal wax combined with routine rehabilitation for shoulder-hand syndrome(SHS)after stroke.Methods:A total of 80 patients with SHS after stroke were selected and divided into the observation group and the control group according to the random number table method,40 patients in each group.The control group was treated with routine rehabilitation therapy(facilitation technology and propriocepitive neuromuscular facilitation)in addition to basic therapy;the observation group was additionally treated with heat ironing of Chinese herbal wax in addition to basic therapy;after heat ironing,the observation group was treated with the same routine rehabilitation therapy as the control group.The scores of pain,edema,range of joint motion,Modified Barthel Index(MBI)and Fugl-Meyer Assessment(FMA)before and after treatment,and the clinical effect,adverse reactions were compared between the two groups.Results:After four weeks of treatment,the total effective rate was 92.50% in the observation group and 70.00% in the control group,the difference being significant(P<0.05).After treatment,the scores of pain,edema and range of joint motion were decreased in both groups(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).The scores of FMA and MBI were increased in both groups(P<0.05),and the above two scores in the observation group were higher than those in the control group(P<0.05).No obvious adverse reactions occurred in the two groups during the treatment.Conclusion:The therapy of heat ironing of Chinese herbal wax combined with routine rehabilitation has significant therapeutic effect in treating SHS after stroke,which is safe,reliable,economical and practical,and easy to be accepted by patients.

关 键 词：肩手综合征 脑卒中 中药蜡疗 促通技术 神经肌肉本体感觉疗法 改良BARTHEL指数 Fugl-Meyer评定法 

分 类 号：R743.3[医药卫生—神经病学与精神病学]