中医定向透药联合超声引导下星状神经节阻滞术治疗脑卒中后肩手综合征临床疗效观察  

Clinical efficacy observation on TCM directional transdermal medication combined with ultrasound-guided stellate ganglion block surgery in treatment of shoulder hand syndrome after stroke

作　　者：周文娟[1] 周石刊 唐锦忠 潘江[1] 王琼[1] ZHOU Wen-juan;ZHOU Shi-kan;TANG Jin-zhong;PAN Jiang;WANG Qiong(The First Affiliated Hospital of Hu'nan University of Chinese Medicine,Changsha 410007)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《湖北中医药大学学报》2024年第3期58-61,共4页Journal of Hubei University of Chinese Medicine

基　　金：湖南省中医药科研计划项目(项目编号:D2022021)。

摘　　要：目的观察中医定向透药联合超声引导下星状神经节阻滞术(UGSGBS)治疗脑卒中后肩手综合征(SHSAS)的临床疗效。方法将我院86例SHSAS患者随机分为对照组与治疗组各43例。对照组行UGSGBS治疗,治疗组行中医定向透药联合UGSGBS治疗。比较肩关节活动度,比较自我妨碍量表(SHS)、疼痛视觉模拟量表(VAS)、简化Fugl-Meyer量表(FMA)评分,测量大脑中动脉(MCA)峰值流速,比较生活质量(SF-36)量表评分。结果治疗后,治疗组总有效率高于对照组(P<0.05);两组肩关节活动度高于治疗前,治疗组肩关节活动度高于对照组(P<0.05);两组SHS、VAS评分低于治疗前,FMA评分、MCA、SF-36量表评分中生理功能、生理职能、躯体疼痛、总体健康、活力、精神健康评分高于治疗前,治疗组SHS、VAS评分低于对照组,FMA评分、MCA、SF-36量表评分中生理功能、生理职能、躯体疼痛、总体健康、活力评分高于对照组(P<0.05),两组社会功能、情感职能、精神健康评分差异无统计学意义(P>0.05)。结论中医定向透药联合UGSGBS治疗SHSAS疗效显著,可扩大肩关节活动度,减轻水肿和疼痛,改善上肢功能和脑血流,进而提高生活质量。Objective To observe the clinical efficacy of TCM directional transdermal medication combined with ultrasoundguided stellate ganglion block surgery(UGSGBS)in treatment of shoulder hand syndrome(SHSAS)after stroke.Methods 86 patients with SHSAS were randomly divided into control group and treatment group,with 43 cases in each group.Control group received UGSGBS,while treatment group received TCM targeted transdermal therapy on the basis of control group.The joint mobility,Self Obstruction Scale(SHS),Visual Analogue Scale(VAS),and Simplified Fugl Meyer Scale(FMA)scores,peak flow velocity of the middle cerebral artery(MCA),and Quality of Life Scale(SF-36)scores of the two groups were compared.Results After treatment,the total effective rate of treatment group was higher than that of control group(P<0.05);the shoulder joint mobility of both groups was higher than before treatment,and was higher in treatment group than control group(P<0.05);the SHS and VAS scores of both groups were lower than before treatment,and were lower in treatment group than control group,while the FMA score,MCA,and SF-36 scale scores for physiological function,physiological function,physical pain,overall health,vitality and mental health were higher than before treatment,and were all higher in observation group than control group except mental health score(P<0.05);there was no statistically significant difference in social and emotional function and mental health scores between the two groups(P>0.05).Conclusion TCM targeted transdermal medication combined with UGSGBS has a significant therapeutic effect on SHSAS,expanding shoulder joint mobility,reducing edema and pain,improving upper limb function and cerebral blood flow,and ultimately improving quality of life.

关 键 词：脑卒中 肩手综合征 中医定向透药 超声引导 星状神经节阻滞术 

分 类 号：R277.7[医药卫生—中医学]