眼针结合熥疗治疗356例中风后肩手综合征的平行随机对照研究  

Effects of eye acupuncture combined with external application of warm Chinese herbs on post-stroke shoulder-hand syndrome:a parallel randomized controlled trial of 356 cases

作　　者：邵妍[1] 鞠庆波[1] 刘建平[2] 康健 崔聪[1] 安太健[1] 徐辉[1] 赵霞[1] 高晨[1] 王鹏琴[1] Shao Yan;Ju Qingbo;Liu Jianping;Kang Jian;Cui Cong;An Taijian;Xu Hui;Gao Chen;Zhao Xia;Wang Pengqin(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Liaoning 110032,China;Center for Evidence-Based Medicine,Beijing University of Chinese medicine,Beijing 100029,China)

机构地区：[1]辽宁中医药大学附属医院,辽宁110032 [2]北京中医药大学循证医学中心

出　　处：《北京中医药大学学报》2020年第7期599-605,共7页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药行业科研专项(No.201407001);国家中医药管理局中医学术流派传承工作室建设项目(No.LPGZS2012-09);辽宁省自然科学基金项目(No.2019-MS-229);国家自然科学基金青年科学基金项目(No.81703993)。

摘　　要：目的观察眼针结合熥疗干预中风后肩手综合征I期的临床疗效评价。方法将中风后肩手综合征I期(痰瘀阻络证)患者356例采用分层区组随机的方法分成康复组114例,熥疗组120例,眼针熥疗组122例。康复组采用基础治疗;熥疗组在基础治疗上用中药包加热外敷患侧肩部;眼针熥疗组在熥疗组基础上加上眼针治疗,眼针穴区选择双侧上焦区、下焦区、心区、肾区。3组疗程均为4周。采用疼痛的视觉模拟评分(VAS评分)、日常生活活动能力量表(ADL)、上肢运动功能的Fugl-Meyer量表、中医证候量表评分对3组患者治疗前后患侧上肢的疼痛、运动功能、日常生活能力、中医证候的疗效进行评价和比较,并对3组治疗的安全性进行评价,总结该技术临床疗效及副反应情况。结果3组治疗后VAS评分均降低,与治疗前比较差异有统计学意义(P<0.05),其中眼针熥疗组降分明显,与熥疗组、康复组比较差异有统计学意义(P<0.05);3组肩部疼痛疗效比较差异有统计学意义(P<0.05)。3组治疗前后Fugl-Meyer、ADL、中医证候评分比较差异有统计学意义(P<0.05);治疗前后差值比较,熥疗组和眼针熥疗组Fugl-Meyer评分均高于康复组(P<0.05),且眼针熥疗组优于熥疗组(P<0.05);ADL评分3组比较差异无统计学意义(P>0.05);中医证候评分眼针熥疗组高于康复组(P<0.05)。结论眼针结合熥疗对中风后肩手综合征(痰瘀阻络证)I期患者止痛效果显著,明显改善患侧肩关节活动度,提高上肢日常生活的能力,安全且无副作用。Objective To observe the effects of eye acupuncture combined with external application of warm Chinese herbs on pain relief in patients with post-stroke shoulder-hand syndrome(SHS)at stage I.Methods A total of 356 SHS participants at stage I were assigned randomly to external warm application group(n=120),eye-acupuncture therapy combined with external warm application(combination therapy)group(n=122),and rehabilitation control group(n=114).The rehabilitation group received usual care while the external warm application group adds external application of warm Chinese herbs.The combination therapy group combined with extra eye acupuncture points on upper and lower jiao areas,heart and kidney.The treatment duration was all 4 weeks in three groups.Visual analogue scale(VAS)score,activities of daily livings(ADL)scale,Fugl-meyer scale and TCM syndrome scores were used to evaluate the pain and mobility of the affected upper limbs,daily living activities and efficacy of syndrome treatment in TCM.Safety was also evaluated in all groups to characterize the efficacy and safety profile of this combination technique.Results VAS scores were significantly reduced in all three groups after treatment when compared with before treatment(P<0.05).The combination therapy group had the most significant score reduction compared with external warm application group and rehabilitation group respectively(P<0.05).Shoulder pain relief was also significantly different among the three groups(P<0.05).Fugl-Meyer and ACL scores increased in all groups after treatment when compared with before treatment(P<0.05).The combination group had the most significant increase with marked difference from those in the external warm application therapy or rehabilitation alone.TCM syndrome scores were also reduced in all three groups after treatment(P<0.05),with the combination group having the most significant reduction of scores in comparison to the external warm application group and rehabilitation group.Conclusion Eye-acupuncture combined with external app

关 键 词：眼针熥疗 中风后肩手综合征 针刺疗法 随机对照试验 止痛 康复 副作用 

分 类 号：R246[医药卫生—针灸推拿学]