基于关节活动度和日常生活活动能力探讨青龙摆尾针法不同针刺间隔时间对脑梗塞后肩手综合征的疗效  

Efficacy Analysis of Different Acupuncture Intervals of Qinglong Baiwei Acupuncture in Treatment of SHS after Cerebral Infarction Based on ROM and ADL

作　　者：颜业龙 蒋励 叶贵文 YAN Yelong;JIANG Li;YE Guiwen(People's Hospital of Wanning,Wanning 571500,China;Qionghai Hospital of Traditional Chinese Medicine,Qionghai 571400,China)

机构地区：[1]万宁市人民医院,海南万宁571500 [2]琼海市中医院,海南琼海571400

出　　处：《针灸临床杂志》2023年第2期48-53,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：海南省卫生健康行业科研项目,编号:20A200516。

摘　　要：目的:基于关节活动度和日常生活活动能力探讨青龙摆尾针法不同针刺间隔时间对脑梗塞后肩手综合征疗效。方法:选取2020年1月—2022年1月万宁市人民医院针灸科收治的脑梗塞后肩手综合征92例患者为研究对象,采用随机分组法,分为观察组与对照组各46例患者。两组均采用青龙摆尾针法,对照组采取每周行针3次,观察组每周行针6次。观察两组患者治疗前与治疗1周后上肢关节活动度评分、生活质量评分、神经功能NIHSS评分、VAS评分、中医症候积分、手臂肿胀评分与NO、ET-1、CGRP水平变化,比较两组患者临床疗效与不良反应。结果:两组患者治疗前屈、伸、外展、内旋、内收和外旋评分比较差异无统计学意义(P>0.05),治疗1周后观察组屈、伸、外展、内旋、内收和外旋评分均显著高于对照组(P<0.05)。两组患者治疗前躯体、角色、情绪和社会评分比较差异均无统计学意义(P>0.05),治疗后观察组躯体、角色、情绪和社会评分均显著高于对照组(P<0.05)。两组患者治疗前NIHSS、VAS评分比较差异均无统计学意义(P>0.05);治疗1周后观察组NIHSS、VAS评分比对照组显著较低(P<0.05)。观察组总有效率82.60%(38/46),显著高于对照组的69.55%(32/46)。两组患者治疗前手部肿胀评分差异无统计学意义(P>0.05),治疗后观察组手部肿胀评分显著低于对照组(P<0.05)。两组患者治疗前活动受限、肩关节疼痛和肢体瘫痪评分差异无统计学意义(P>0.05),治疗后观察组活动受限、肩关节疼痛和肢体瘫痪评分显著低于对照组(P<0.05)。两组患者治疗前NO、ET-1与CGRP水平比较差异无统计学意义(P>0.05),治疗后观察组NO、CGRP水平较对照组显著升高,但ET-1较对照组显著降低(P<0.05)。两组患者治疗后观察组总不良反应发生率为6.51%(3/46),略低于对照组的8.68%(4/46),两组患者总不良反应发生率差异无统计学意义(P>0.05)。结论:青龙�Objective:To investigate the clinical efficacy of different needling intervals of Qinglong Baiwei(green dragon swinging tails)acupuncture in treatment of shoulder-hand syndrome(SHS)after cerebral infarction based on range of motions(ROM)and activities of daily living(ADL).Methods:92 patients with SHS after cerebral infraction were randomly divided into the observation group and the control group,with 46 cases in each group.Both groups received Qinglong Baiwei acupuncture,the acupuncture frequency was 3 times per week in the control group,and it was 6 times per week in the observation group.The scores of ROM,ADL,National Institutes of Health Stroke Scale(NIHSS),visual analogue scale(VAS),TCM symptoms and arm swelling,the levels of nitric oxide(NO),endothelin-1(ET-1),calcitonin gene-related peptide(CGRP)were observed before and after the treatment in the two groups.Clinical efficacy and adverse reactions were also compared between the two groups.Results:There were no statistical differences in the scores of flexion,extension,abduction,internal rotation,adduction and external rotation between the two groups before the treatment(P>0.05),and the scores were significantly higher in the observation group than that in the control group after the treatment(P<0.05).There were no statistical differences in the QLQ-C30 scores in terms of physical function,physical role,emotion state and social role between the two groups before the treatment(P>0.05),whereas the scores were significantly higher in the observation group than those in the control group(P<0.05).There were no statistical differences in the scores of NIHSS and VAS between the two groups before the treatment(P>0.05),whereas the scores were significantly lower in the observation group than those in the control group after the treatment(P<0.05).The total effective rate was 82.60%(38/46)in the observation group,which was higher than 69.55%(32/46)in the control group.There was no statistical difference in the score of arm swelling between the two groups before the trea

关 键 词：关节活动度 日常生活活动能力 青龙摆尾针法 针刺 间隔时间 脑梗塞 肩手综合征 

分 类 号：R246.6[医药卫生—针灸推拿学]