“针药并举”治疗脑卒中后肩手综合征患者的疗效及对血液流变学指标的影响  

Effects of Needle Combined with Medicine in the Treatment of Patients with Shoulder-Hand Syndrome After Stroke and Its Influence on the Curative Effects and Hemorheology Indexes

作　　者：龙威力 韦殷[1] 凌建伟[1] 李捷宁 膑瑶 梁丽君 彭高伟 雷龙鸣[2] 何荷 LONG Weili;WEI Yin;LING Jianwei;LI Jiening;BIN YAO;LIANG Lijun;PENG Gaowei;LEI Longming;HE He(First People′s Hospital of Qinzhou City,Guangxi Zhuang Autonomous Region,Qinzhou 535000,China;First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,China)

机构地区：[1]广西壮族自治区钦州市第一人民医院,钦州535000 [2]广西中医药大学第一附属医院,南宁530023

出　　处：《世界中医药》2021年第8期1302-1306,共5页World Chinese Medicine

基　　金：广西医科大学青年自然科学基金项目(gxmuysf201736)。

摘　　要：目的:探讨“针药并举”治疗脑卒中后肩手综合征(Shoulder Hand Syndrome After Stroke,SHSAS)患者的疗效及对血液流变学指标及预后的影响。方法:选取2016年5月至2018年5月钦州市第一人民医院收治的SHSAS患者102例作为研究对象,按照随机数字表法分为对照组(n=49)和观察组(n=53)。对照组给予常规神经内科用药治疗,观察组在对照组基础上给予针药结合治疗,均治疗14 d;比较2组临床疗效,治疗前后FMA、NRS评分、肿胀评分和血液流变学指标观察,随访末期(治疗后6个月)SHSS、生命质量及治疗期间不良反应发生情况。结果:2组临床治疗效果差异有统计学意义(P<0.05),观察组总有效率(92.45%)显著高于对照组(77.55%)(P<0.05)。治疗后,2组FMA评分均较治疗前提高,NRS和肿胀评分均较治疗前降低(P<0.05),且观察组FMA评分(54.17±7.12)分,显著高于对照组的(49.95±9.64)分,NRS和肿胀评分为(2.57±0.85)分和(2.95±0.96)分、显著低于对照组的(0.82±0.27)分和(1.19±0.39)分(P<0.05);2组血浆黏度、全血高切黏度、全血低切黏度和血小板聚集率较治疗前均有所降低,但观察组上述指标均显著低于对照组(P<0.05);随访末期观察组SHSS评分明显低于对照组,生命质量各项评分均明显高于对照组(P<0.05);观察组和对照组不良反应发生率为11.32%和8.16%,差异无统计学意义(P>0.05)。结论:“针药并举”治疗SHSAS患者具有良好的近、远期临床疗效,可以明显减轻患者症状,有效改善血液流变学指标并提高患者的生命质量。Objective:To explore the effects of needle combined medicine in the treatment of patients with shoulder hand syndrome after stroke(SHSAS)and its influence on hemorheology indexes and prognosis.Methods:A total of 100 patients with SHSAS admitted to First People′s Hospital of Qinzhou City,Guangxi Zhuang Autonomous Region from May 2016 to May 2018 were selected as study subjects,and were divided into a control group(n=49)and an observation group(n=53)according to the random number table method,with 50 cases in each group.The control group was treated with conventional neurology,and the observation group was treated with acupuncture combined with medicine on the basis of the control group.Both groups were treated for 14 days.The clinical efficacy,FMA score,NRS score,swelling score and hemorheology index before and after treatment,SHSS and quality of life scores at the end of follow-up(6 months after treatment),and adverse events during treatment between the two groups were compared.Results:The clinical treatment effect of the 2 groups was significantly different(P<0.05),and the total effective rate of the observation group was 92.45%,which was significantly higher than that of the control group(74%,P<0.05).After treatment,the FMA scores of the 2 groups were higher than those before treatment,and the NRS and swelling scores were lower than those before treatment(P<0.05).The FMA scores of the observation group were significantly higher than those of the control group.NRS and swelling scores were(2.57±0.85)and(2.95±0.96)points,which were significantly lower than those of the control group(0.82±0.27)and(1.19±0.39)points(P<0.05).The plasma viscosity,whole blood high-viscosity,whole blood low-cut viscosity and platelet aggregation rate of the 2 groups were lower than those before treatment,and the above indexes of the observation group were significantly lower than those of the control group(P<0.05).At the end of follow-up,the SHSS score of the observation group was significantly lower than that of the control group,

关 键 词：脑卒中 肩手综合征 头针 补阳还五汤 疗效 血液流变学 预后 生命质量 

分 类 号：R255.2[医药卫生—中医内科学] R245.3[医药卫生—中医学]