眼针联合康复训练治疗缺血性中风后肩手综合征Ⅰ期的临床研究  

Clinical Study of Eye Acupuncture Combined with Rehabilitation Training in Treating SHS of Stage Ⅰ after Ischemic Stroke

作　　者：董岩[1] 郭倩 刘峻[1] DONG Yan;GUO Qian;LIU Jun(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 100032, China)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《针灸临床杂志》2021年第8期25-29,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家中医药管理局中医药行业科研专项项目,编号:201407001-7;辽宁省自然科学计划,编号:20180550633;辽宁省教育厅科学技术研究项目,编号:L201910。

摘　　要：目的:探讨眼针联合康复训练治疗缺血性中风后肩手综合征Ⅰ期的临床疗效。方法:将本院收治的118例缺血性中风后肩手综合征Ⅰ期患者根据随机数字表法随机分为常规针刺组和眼针组,各59例,在患侧康复训练的基础上,常规针刺组选取肩髃、肩髎和肩贞等进行常规针刺操作;眼针组取穴心区、肾区、下焦区、上焦区、肝区与脾区,两组均治疗1个月。以两组患者中医症状积分、简化麦吉尔疼痛量表(McGill)、肩手综合征评估量表(SHSS)、简化Fugl-Meyer运动功能量表(FMA)和相关理化指标作为观察指标并比较,观察患者治疗前后肢体疼痛症状、损伤程度、综合运动能力和各指标变化情况,治疗结束后评价两组的临床疗效。结果:治疗后,两组PRI、VAS、PPI及SHSS评分均明显下降,FMA评分升高,中医症状积分均降低(P<0.05),且眼针组较常规针刺组各评分改善更显著(P<0.05);治疗后,两组降钙素基因相关肽(CGRP)均上升,P物质(SP)及血浆缓激肽(BK)均呈下降趋势(P<0.05),且组间比较,眼针组各指标改善更明显(P<0.05);治疗后,眼针组和常规针刺组临床总有效率分别为88.14%(52/59)和74.58%(44/59),眼针组临床疗效更好(P<0.05)。结论:眼针联合康复训练疗法可以明显改善中风后肩手综合征患者临床症状和体征,减轻肢体疼痛,提高患者上肢活动度,恢复上肢运动能力,优于传统针刺联合康复训练疗法,对于中风后肩手综合征有较好的治疗效果。Objective:To explore the clinical effect of eye acupuncture combined with rehabilitation training in the treatment of shoulder-hand syndrome(SHS)of stageⅠafter ischemic stroke.Methods:118 patients with SHS of stage I after ischemic stroke were randomly divided into the conventional acupuncture group(group A)and eye acupuncture group(group B),with 59 patients in each group.Group A was treated with conventional needling Jianyu(LI15),Jianliao(SJ14)and Jianzhen(SI9)on the basis of rehabilitation training on the affected side;group B was treated with eye needling Heart zone,Kidney zone,Lower-jiao zone and Upper-jiao zone,Liver zone and Spleen zone.Both groups were treated for one month.The scores of TCM symptom,the simplified McGill,SHSS and FMA were observed and compared between the two groups after the treatment.The limb pain symptoms,injury degree and comprehensive motor ability of the patients were assessed before and after the treatment in the two groups.The clinical efficacy was evaluated and compared between the two groups.Results:After the treatment,VAS,PPI and SHSS decreased significantly and FMA scores increased significantly in the two groups(P<0.05),of which the improvements were more significant in group B(P<0.05).The level of CGRP was increased and the levels of SP and BK were decreased in the two groups after the treatment(P<0.05);of which the improvements in group B were more significant(P<0.05).The clinical total effective rate was 88.14%(52/59)in group B,which was significantly higher than 74.58%(44/59)in group A(P<0.05).Conclusion:Eye acupuncture combined with rehabilitation training can obviously improve the clinical symptoms and signs of patients with SHS after stroke,it can relieve limb pain,improve and recover the upper limb mobility of the patients.The therapy is superior to the conventional acupuncture combined with rehabilitation training,which has better therapeutic effect on SHS after stroke.

关 键 词：中风 肩手综合征 眼针 康复训练 

分 类 号：R246.6[医药卫生—针灸推拿学]