眼针熥疗技术联合康复训练治疗痰瘀阻络型中风后肩手综合征:多中心随机对照试验  

Post-stroke shoulder-hand syndrome of phlegm-stasis obstruction treated with the combined therapy of eye acupuncture,Tengliao and rehabilitation training:a multi-central randomized controlled trial

作　　者：王梅[1] 王鹏琴[2] 于丽华 王晨阳 邵妍[2] WANG Mei;WANG Peng-qin;YU Li-hua;WANG Chen-yang;SHAO Yan(College of Integrated Traditional Chinese and Western Medicine of Liaoning University of TCM,Shenyang 110847,China;Affiliated Hospital of Liaoning University of TCM,Shenyang 110032;Fuxin Municipal Center Hospital;Graduate School of Liaoning University of TCM)

机构地区：[1]辽宁中医药大学中西医结合学院,沈阳110847 [2]辽宁中医药大学附属医院,沈阳110032 [3]阜新市中心医院 [4]辽宁中医药大学研究生学院

出　　处：《中国针灸》2022年第4期385-389,共5页Chinese Acupuncture & Moxibustion

基　　金：国家中医药管理局中医药行业科研专项项目:201407001;国家自然科学基金青年基金项目:82004477;辽宁省自然科学基金计划项目:2019-MS-229;辽宁省教育厅科学技术研究项目:L202013。

摘　　要：目的:比较眼针熥疗技术联合康复训练与熥疗技术联合康复训练、单纯康复训练改善中风后肩手综合征(痰瘀阻络证)疼痛和提高肩关节活动度的疗效。方法:将356例中风后肩手综合征(痰瘀阻络证)患者随机分为眼针+熥疗+康复组(122例,脱落2例)、熥疗+康复组(120例,脱落3例)和康复组(114例,脱落1例)。康复组予基础治疗和常规康复训练;熥疗+康复组在康复组治疗基础上予熥疗,即将20余味中药制成的药袋加热后敷于患侧,每次30 min,每周5次;眼针+熥疗+康复组在熥疗+康复组治疗基础上予眼针疗法,穴取心区、肾区、上焦区和下焦区,每次30 min,每周5次,3组均治疗28 d。分别于治疗前,治疗第7、14、21、28天及治疗后14d随访观察各组患者疼痛视觉模拟量表(VAS)评分、永久残损评定指南(GEPI)评分和美国国立卫生院神经功能缺损(NIHSS)评分。结果:3组VAS、GEPI、NIHSS评分均随治疗时间延长有所改善(P<0.0001);眼针+熥疗+康复组VAS评分在治疗第7、14、21、28天及随访均低于康复组(P<0.05),治疗14 d后眼针+熥疗+康复组GEPI评分有高于、NIHSS评分有低于熥疗+康复组的趋势。眼针+熥疗+康复组治疗前GEPI评分低于、NIHSS评分高于康复组(P<0.05),提示眼针+熥疗+康复组患者病情偏重。经倾向性评分匹配后,治疗第14、21、28天及随访,眼针+熥疗+康复组GEPI评分均高于康复组(P<0.05);眼针+熥疗+康复组与康复组各时间点NIHSS评分比较差异均无统计学意义(P>0.05)。结论:眼针熥疗技术联合康复训练治疗中风后肩手综合征(痰瘀阻络证)疗效优于康复训练。Objective To assess the efficacy on relieving pain and improving the range of motion of shoulder joint in post-stroke shoulder-hand syndrome of phlegm-stasis obstruction in treatment of the combined therapy of eye acupuncture,Tengliao(Chinese herbal warm dressing technique)and rehabilitation training(eye acupuncture+Tengliao+rehabilitation)as compared with the combined treatment of Tengliao and rehabilitation training(Tengliao+rehabilitation)and the simple rehabilitation training(rehabilitation).Methods A total of 356 patients with post-stroke shoulder-hand syndrome of phlegm-stasis obstruction were randomized into an eye acupuncture+Tengliao+rehabilitation group(group A,122cases,2 cases dropped off),a Tengliao+rehabilitation group(group B,120 cases,3 cases dropped off)and a rehabilitation group(group C,114 cases,1 case dropped off).In the group C,the basic treatment was combined with routine rehabilitation training.In the group B,on the base of the treatment as the group C,Tengliao was exerted.A medical bag composed of over 20 Chinese herbal materials was heated and dressed at the affected area,30 min each time,5 times weekly.In the group A,besides the treatment as the group B,eye acupuncture was applied to heart region,kidney region,upper jiao region and lower jiao region,30 min each time,5 times weekly.The treatment lasted 28 days in all of three groups.Separately,before treatment,in 7,14,21 and 28 days of treatment,as well as in 14 days after treatment of follow-up,the score of visual analogue scale(VAS)for pain,the score of guides to evaluation of permanent impairment(GEPI)and the score of National Institutes of Health stroke scale(NIHSS)were observed in each group.Results The scores of VAS,GEPI and NIHSS were all improved with the treatment lasting in the three groups(P<0.0001).In 7,14,21 and 28 days of treatment and in follow-up as well,VAS scores in the group A were all lower than the group C(P<0.05).After 14 days of treatment,GEPI score showed increasing trend,while NIHSS score showed decreasing trend in

关 键 词：中风 肩手综合征 眼针 熥疗 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]