腕踝针治疗中风后肩手综合征Ⅰ期临床疗效观察  

Clinical observation on wrist-ankle acupuncture for shoulder-hand syndrome phase Ⅰ after stroke

作　　者：李瑞青 王艺莹 梅紧紧 张丽红 张建云 李婧雯 张裴景 郭健 LI Rui-qing;WANG Yi-ying;MEI Jin-jin;ZHANG Li-hong;ZHANG Jian-yun;LI Jing-wen;ZHANG Peijing;GUO Jian(Rehabilitation Center,First Affiliated Hospital of Henan University of CM,Zhengzhou 450000,China;School of Rehabilitation Medicine,Henan University of CM,Zhengzhou 450000)

机构地区：[1]河南中药大学第一附属医院康复中心,郑州450000 [2]河南中医药大学康复医学院,郑州450000

出　　处：《中国针灸》2022年第7期721-725,共5页Chinese Acupuncture & Moxibustion

基　　金：河南省中医药科学研究专项课题项目:2019ZY2129、2017JDZX027;河南省高等学校重点科研项目计划项目:21A360023。

摘　　要：目的:比较腕踝针与常规针刺治疗中风后肩手综合征Ⅰ期的临床疗效。方法:将64例中风后肩手综合征Ⅰ期患者随机分为腕踝针组和常规针刺组,各32例。在内科和常规康复治疗基础上,腕踝针组予腕踝针治疗,穴取患侧上4区、上5区、上6区;常规针刺组予针刺患侧肩髃、曲池、手三里等,两组均每次30 min,每天治疗1次,每周5次,共治疗3周。分别于治疗前后观察两组患者视觉模拟量表(VAS)评分、手部肿胀程度、肩手综合征评估量表(SHSS)评分、Fugl-Meyer上肢运动功能评定(FMA-UE)评分、改良Barthel指数(MBI)评分,并评定两组临床疗效。结果:治疗后,两组患者VAS评分、手部肿胀程度、SHSS评分均较治疗前降低(P<0.05),FMA-UE、MBI评分均较治疗前提高(P<0.05);腕踝针组VAS评分、手部肿胀程度、SHSS评分低于常规针刺组(P<0.05),FMA-UE、MBI评分高于常规针刺组(P<0.05)。腕踝针组总有效率为96.9%(31/32),高于常规针刺组的90.6%(29/32,P<0.05)。结论:腕踝针可有效减轻中风后肩手综合征Ⅰ期患者疼痛及手部肿胀程度,提高患者上肢运动功能及日常生活自理能力,疗效优于常规针刺。Objective To compare the clinical efficacy between wrist-ankle acupuncture and conventional acupuncture on shoulder-hand syndrome(SHS)phase Ⅰ after stroke.Methods A total of 64 patients with SHS phase Ⅰ after stroke were randomized into a wrist-ankle acupuncture group and a conventional acupuncture group,32 cases in each group.On the basis treatment of internal medicine and conventional rehabilitation,wrist-ankle acupuncture was applied at upper 4 area,upper 5 area and upper 6 area on the affected side in the wrist-ankle acupuncture group,while acupuncture was applied at Jianyu(LI 15),Quchi(LI 11),Shousanli(LI 10),etc.on the affected side in the conventional acupuncture group.The treatment was given 30 min each time,once a day,5 days a week for 3 weeks in both groups.Before and after treatment,the visual analogue scale(VAS)score,degree of hand swelling,shoulder-hand syndrome scale(SHSS)score,Fugl-Meyer assessment for upper extremity(FMA-UE)score and modified Barthel index(MBI)score were observed,and the clinical therapeutic effect was evaluated in both groups.Results After treatment,the VAS scores,degree of hand swelling and SHSS scores were decreased(P<0.05),and the FMA-UE scores and MBI scores were increased(P<0.05)compared before treatment in both groups;in the wrist-ankle acupuncture group,the VAS score,degree of hand swelling and SHSS score were lower(P<0.05),and the FMA-UE score and MBI score were higher(P<0.05)than those in the conventional acupuncture group.The total effective rate was 96.9%(31/32)in the wrist-ankle acupuncture group,which was superior to 90.6%(29/32)in the conventional acupuncture group(P<0.05).Conclusion Wrist-ankle acupuncture can effectively relieve pain and hand swelling,improve motor function of upper extremity and self-care ability of daily life in patients with shoulder-hand syndrome phaseⅠafter stroke,the therapeutic effect is superior to conventional acupuncture.

关 键 词：中风后肩手综合征Ⅰ期 腕踝针 针刺 临床症状 日常生活自理能力 

分 类 号：R246.6[医药卫生—针灸推拿学]