加味黄芪桂枝五物汤联合靳三针治疗脑卒中后反射性交感神经营养不良疗效观察  

Observation on the curative effect of modified Huangqi Guizhi Wuwu Decoction combined with Jin-San-Zhen acupuncture on reflex sympathetic dystrophy after stroke

作　　者：尹春玲 张大炯 王娟 YIN Chunling;ZHANG Dajiong;WANG Juan(Ma’anshan Hospital of Traditional Chinese Medicine,Ma’anshan 243000,Anhui,China)

机构地区：[1]马鞍山市中医院,安徽马鞍山243000

出　　处：《现代中西医结合杂志》2021年第19期2084-2088,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察加味黄芪桂枝五物汤联合靳三针治疗脑卒中后反射性交感神经营养不良的临床疗效。方法将2017年5月—2019年12月马鞍山市中医院治疗的80例脑卒中后反射性交感神经营养不良患者随机分为2组,对照组40例给予常规康复疗法治疗,观察组40例在对照组治疗基础上给予加味黄芪桂枝五物汤联合靳三针治疗,2组均治疗2周后统计临床疗效,比较2组治疗前后水肿、疼痛、无痛关节活动度、手功能、日常生活能力的差异。结果观察组治疗总有效率为90.0%(36/40),对照组为70.0%(28/40),观察组明显高于对照组(P<0.05);治疗后2组手肿胀程度、疼痛视觉模拟评分(VAS)、外展和外旋评分均较治疗前明显降低(P均<0.05),且治疗后观察组上述指标均低于对照组(P均<0.05)。治疗后2组肌力分级、手功能使用能力均显著改善(P均<0.05),Fugl-Meyer运动功能评分法(FMA)中的手功能评分、日常生活能力评定量表(ADL)评分均明显增加(P均<0.05),且治疗后观察组上述指标改善情况均明显优于对照组(P均<0.05)。结论加味黄芪桂枝五物汤联合靳三针治疗脑卒中后反射性交感神经营养不良疗效确定,可明显缓解水肿和疼痛,提高关节活动度与肌力,改善手功能和日常生活能力。Objective It is to observe the clinical effect of modified Huangqi Guizhi Wuwu Decoction combined with Jin-San-Zhen acupuncture on reflex sympathetic dystrophy after stroke.Methods Eighty patients with post-stroke reflex sympathetic dystrophy treated in Ma’anshan Hospital of Traditional Chinese Medicine from May 2017 to December 2019 were randomly divided into 2 groups.40 patients in the control group were treated with conventional rehabilitation therapy,and 40 patients in the observation group were treated with modified Huangqi Guizhi Wuwu Decoction combined with Jin-San-Zhen acupuncture on the basis of the control group.Both groups were treated for 2 weeks.The clinical efficacy was evaluated in the two groups after treatment.The differences in edema,pain,painless joint range of motion,hand function,and ability of daily living between the two groups before and after treatment were compared.Results The total effective rate of treatment in the observation group was 90.0%(36/40),and that in the control group was 70.0%(28/40),the observation group was significantly higher than the control group(P<0.05).After treatment,the degree of hand swelling,pain visual analogue score(VAS),abduction and external rotation scores in the two groups were significantly lower than those before treatment,and the above indicators in the observation group were lower than those in the control group(all P<0.05).After treatment,the muscle strength classification and use ability of hand function of the two groups were significantly improved,the hand function score in the Fugl-Meyer motor assessment(FMA)and the ability of daily living(ADL)scores were significantly increased(all P<0.05),and the improvement of the above indicators in the observation group was significantly better than that in the control group(P<0.05).Conclusion Modified Huangqi Guizhi Wuwu Decoction combined with Jin-San-Zhen acupuncture has a definite therapeutic effect on reflex sympathetic dystrophy after stroke.It can significantly relieve edema and pain,improve joint mo

关 键 词：加味黄芪桂枝五物汤 靳三针 脑卒中 反射性交感神经营养不良 手功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]