膏肓穴刺血联合越婢加术汤治疗脑卒中后复杂性区域疼痛综合征Ⅰ型的疗效观察  

Clinical Observation on Bl 43 Acupoint Bloodletting Combined with Yuebi Jiazhu Decoction for Complex Regional Pain Syndrome Type Ⅰ after Stroke

作　　者：傅海群 宋丰军[1] 叶必宏[1] 蒋越 朱文宗[1] Fu Haiqun;Song Fengjun;Ye Bihong;Jiang Yu;Zhu Wen-zong(Zhejiang Chinese Medical University,Wenzhou 325000,China.)

机构地区：[1]浙江中医药大学附属温州市中医院,浙江温州325000 [2]温州医科大学附属第一医院,浙江温州325000

出　　处：《中国中医急症》2023年第10期1786-1789,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：浙江省自然科学基金一般项目(LY18H270001);温州市科技局基础性科研项目(Y20211094);温州市科技局基础性医疗卫生科技项目(Y20180212)。

摘　　要：目的 观察膏肓穴刺血联合越婢加术汤治疗脑卒中后区域疼痛综合征Ⅰ型(CRPSⅠ)的临床疗效。方法 将76例患者采用随机数字表法分为治疗组与对照组。对照组采用膏肓放血,治疗组采用膏肓穴刺血联合越婢加术汤治疗,共治疗28 d。在治疗前、治疗后第28天,对患者进行复杂区域性疼痛综合征严重程度(CSS)评分、手指周径测量、视觉模拟量表(VAS)评分;在第1天、第28天治疗前后进行肩关节活动度的评价。结果 治疗后两组CSS评分均显著降低(P <0.01),组间差异有统计学意义(P <0.01);健患侧手指周径之差,两组均有显著降低(P <0.01),且治疗组优于对照组(P <0.01)。治疗组VAS评分较治疗前显著降低(P <0.05);第1天治疗前后两组肩关节活动度(外展、上举、后伸)较前均有改善(P <0.01);治疗第28天前,治疗组肩关节活动度(外展、上举、后伸)优于对照组(P <0.05)。结论 膏肓放血联合越婢加术汤能有效缓解复杂性区域CRPSI,包括减轻患肢手部肿胀、肩部疼痛,缓解复杂区域性疼痛综合征严重程度,膏肓放血能即刻改善患者肩关节活动度,且联合越婢加术汤有更明显的远期疗效。Objective:To observe the clinical efficacy of Yuebi Jiazhu Decoction combined with Bl 43 acupoint bloodletting in treating complex regional pain syndrome typeⅠ(CRPSI)after stroke.Methods:A total of 76 patients were included and randomly divided into the treatment group and the control group.The treatment group was treated with Bl 43 acupoint bloodletting combined with Yuebi Jiazhu Decoction,and the control group was treat⁃ed with the Bl 43 acupoint bloodletting only,for a total of 28 days.Before and 28 days after treatment,finger circumference measurement,VAS,and CSS were performed to evaluate the therapeutic effect.Before and after 1 day and 28 days of treatment,the shoulder range of motion(SROM)was evaluated.Results:The CSS was signifi⁃cantly lower in both groups after treatment(P<0.01),and there were significant differences between the two groups(P<0.01);the difference of the circumference of the finger on the healthy side was significantly decreased in both groups(P<0.01)and the treatment group was better than that of the control group(P<0.01);the VAS score of the treatment group was significantly lower than that before treatment(P<0.01).On the first day after treatment,the SROM(abductor,lift,extension)in the two groups was improved compared with before treatment(P<0.01).On the 28th day of treatment,the SROM(abduction,lift,extension)in the treatment group was better than that of the control group(P<0.05).Conclusion:Bl 43 acupoint bloodletting combined with Yuebi Jiazhu Decoction can effec⁃tively relieve the symptoms of CRPSⅠ,including reducing the hand swelling,shoulder pain,and alleviating the severity of CRPSI.Blind bloodletting can immediately improve the patient’s SROM,and its combination with Yuebi Jiazhu Decoction has a more obvious long-term effect.

关 键 词：脑卒中 复杂性区域疼痛综合征Ⅰ型 膏肓穴 越婢加术汤 

分 类 号：R743.9[医药卫生—神经病学与精神病学]