低温热塑板材结合针灸推拿治疗偏瘫后腕手关节挛缩的临床疗效观察  

Observation on clinical efficacy of low-temperature thermoplastic sheet combined with acupuncture and massage in treatment of wrist and hand joint contracture after hemiplegia

作　　者：王雪峰 徒强 杨春玲 Wang Xuefeng;Tu Qiang;Yang Chunling(Worker's Hospital of Qiqihar Second Machine Tool Group co.,ltd,Qiqihar,Heilongjiang 161000,China)

机构地区：[1]齐二机床集团有限公司职工医院,黑龙江齐齐哈尔161000

出　　处：《齐齐哈尔医学院学报》2024年第13期1239-1244,共6页Journal of Qiqihar Medical University

基　　金：齐齐哈尔市科技计划创新激励项目(CSFGG-2023150)。

摘　　要：目的探讨低温热塑板材结合针灸推拿治疗偏瘫后腕手关节挛缩的临床疗效。方法选择2023年1—12月本院收治的46例偏瘫后腕手关节挛缩患者作为研究对象,等量随机分为实验组和对照组两组,每组各23例。两组均给与常规康复训练,包括运动疗法、作业疗法、上肢神经功能重建治疗系统、课后自我康复训练、良肢位摆放,实验组在此基础上佩戴低温热塑功能位矫形器(WHO)结合针灸推拿等中医传统手法治疗。定时记录患者情况。比较两组在入组时、入组后1个月后及入组后2个月后的偏瘫手握力、改良Ashworth(modified Ashworth scale,MAS)、Brunnstrom评定量表手功能部分、腕关节AROM的变化情况。结果入组治疗1个月后,实验组及对照组在腕关节屈曲AROM、Brunnstrom评分均明显改善(P<0.05);入组治疗2个月后,两组患者腕关节背伸AROM较治疗1个月后提高,具有明显性差异(P<0.05),实验组在腕关节AROM、Brunnstrom评分、改良Ashworth评分、握力改善明显,优于对照组(P<0.05)。结论低温热塑板材结合针灸推拿能有效地缓解偏瘫后腕手关节挛缩,能有效改善偏瘫患者腕手关节功能,提高生活质量。Objective To investigate the clinical efficacy of low-temperature thermoplastic sheet combined with acupuncture and massage in the treatment of wrist and hand joint contracture after hemiplegia.Methods A total of 46 patients with wrist and hand joint contracture after hemiplegia who were admitted to our hospital from from January 2023 to December 2023,were selected as research subjects and equally randomized into the experimental group and the control group,with 23 cases in each group.Patients in both groups were given conventional rehabilitation training,including exercise therapy,occupational therapy,and upper limb nerve function reconstruction treatment system,after-school self-rehabilitation training,good limb position,the experimental group wore a low-temperature thermoplastic functional orthosis(WHO)combined with acupuncture and massage and other traditional Chinese medicine manual treatments,and the patient's condition was regularly recorded.The changes of grip strength of hemiplegic hand,modified Ashworth scale(MAS),hand function part of the Brunnstrom scale,and wrist joint AROM were compared between the two groups at the time of enrollment,1 month after enrollment and 2 months after enrollment.Results After 1 month of treatment,the grip strength,Brunnstrom score and wrist joint buckling AROM of the experimental group and the control group were improved compared with those before treatment(P<0.05).After 2 months of treatment,AROM of wrist joint dorsalis extension of the two groups were higher than those at 1 month of treatment,with significant difference(P<0.05).Conclusions Low-temperature thermoplastic sheets combined with acupuncture and massage can effectively alleviate wrist and hand joint contracture after hemiplegia,and can effectively improve joint function and quality of life of patients.

关 键 词：低温热塑 针灸推拿 偏瘫 腕手关节挛缩 

分 类 号：R483[医药卫生—临床医学]