肌内效贴联合针刺对急性期脑卒中后肩手综合征患者血浆儿茶酚胺水平的影响  

Effect of kinesio taping combined with acupuncture on plasma catecholamine levels in patients with acute poststroke shoulder-hand syndrome

作　　者：顾玉玲 周徐 陈文雅 盛卫东 孙小星 周晓茂 俞冲 GU Yuling;ZHOU Xu;CHEN Wenya;SHENG Weidong;SUN Xiaoxing;ZHOU Xiaomao;YU Chong(Nantong Third Hospital Affiliated to Nantong University/Nantong Third People’s Hospital/Nantong Clinical Medical College of Integrated Chinese and Western Medicine of Nanjing University of Chinese Medicine,Nantong 226000,Jiangsu,China)

机构地区：[1]南通大学附属南通第三医院/南通市第三人民医院/南京中医药大学南通中西医结合临床医学院,江苏南通226000

出　　处：《现代中西医结合杂志》2024年第18期2516-2520,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：南通市科技局基础研究和社会民生科技计划(指导性)项目(MSZ20098)。

摘　　要：目的观察肌内效贴联合针刺疗法对急性期脑卒中后肩手综合征(PSHS)患者血浆儿茶酚胺水平的影响。方法选取2019年1月—2022年1月在南通大学附属南通第三医院接受治疗的急性期PSHS患者120例,按照随机数字表法分为肌内效贴+针刺组、肌内效贴组、针刺组,每组40例。3组患者均给予内科药物及一般康复治疗,在此基础上,每组给予相应治疗,均连续治疗4周。比较3组治疗前和治疗4周后血浆儿茶酚胺[肾上腺素(E)、去甲肾上腺素(NE)]水平。根据治疗4周后所有患者的治疗效果分为有效组、非有效组,比较2组一般资料、血浆E和NE水平及治疗措施。采用单因素二元Logistic回归分析寻找治疗有效的可能因素,然后纳入单因素二元Logistic回归分析中差异可能有统计学意义的指标(P<0.2),进一步采用多因素二元Logistic回归分析(逐步回归)治疗有效的相关因素。结果治疗后3组患者血浆E、NE水平均较治疗前明显下降(P均<0.05),且联合组明显低于其他2组(P均<0.05)。有效组、非有效组患者病程、治疗后血浆E及NE水平、肌内效贴+针刺治疗例数比较差异均有统计学意义(P均<0.05)。单因素二元Logistic回归分析发现病程、吸烟史、合并心血管疾病、治疗后血浆E和NE水平、肌内效贴+针刺治疗、肌内效贴治疗及针刺治疗为预警治疗有效的可能因素(P均<0.2)。多因素二元Logistic回归分析发现治疗后血浆E和NE水平、肌内效贴+针刺治疗为预警有效治疗的因素(P均<0.05),其中肌内效贴+针刺治疗患者有良好预后(OR值为4.762),且血浆E、NE水平越低提示预后越好。结论肌内效贴联合针刺治疗可促进急性期PSHS患者上肢运动功能康复,动态监测血浆儿茶酚胺水平有助于预后评估。Objective It is to observe the effect of kinesio taping combined with acupuncture on plasma catecholamine levels in patients with acute poststroke shoulder-hand syndrome(PSHS).Methods One hundred and twenty patients with acute PSHS treated in the Nantong Third Hospital Affiliated to Nantong University from January 2019 to January 2022 were selected and randomly divided into kinesio taping+acupuncture group,kinesio taping group and acupuncture group by a random number table method,with 40 patients in each group.All patients of the 3 groups were given internal medicine and general rehabilitation therapy,and each group was additionally treated with respective therapy,all continuously treated for 4 weeks.The plasma levels of catecholamine[norepinephrine(NE)and epinephrine(E)]were compared before and after 4 weeks of treatment.All the observed objects were divided into effective and ineffective groups after 4weeks of treatment based on the efficacy criteria of the“Rehabilitation Assessment”.The general information such as gender and age,plasma levels of catecholamine(E,NE),and treatment measures were compared between the two groups.One-way binary logistic regression analysis was used to find the possible factors for treatment effectiveness,then the indicators whose differences in one-way binary logistic regression analysis might be statistically significant(P<0.2)were included,and further multifactor binary logistic regression analysis(stepwise regression)was used to analyze the related factors associated with treatment effectiveness.Results After treatment,the plasma levels of E and NE of patients in the three groups were significantly decreased compared with those before treatment(all P<0.05),and the combination group was significantly lower than the other two groups(both P<0.05).The differences in disease duration,post-treatment plasma E and NE levels,and the number of cases treated with kinesio taping+acupuncture in patients were all statistically significant between the effective group and ineffective group(a

关 键 词：脑卒中后肩手综合征 肌内效贴 针刺 儿茶酚胺 

分 类 号：R743.33[医药卫生—神经病学与精神病学]