头针联合神经肌肉电刺激治疗急性卒中后肩手综合征的疗效观察及对生活能力和生存质量的影响  

Therapeutic observation of scalp acupuncture plus neuromuscular electrical stimulation for shoulder-hand syndrome after acute stroke and the effects on the living ability and quality of life

作　　者：蒯旋 李红睿 胡玮璇 KUAI Xuan;LI Hongrui;HU Weixuan(Fuyang People’s Hospital of Anhui Province,Fuyang 236000,China)

机构地区：[1]安徽省阜阳市人民医院,阜阳236000

出　　处：《上海针灸杂志》2024年第12期1313-1317,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：安徽省红十字会中医药传承创新发展研究项目(2022ZYYDll)。

摘　　要：目的观察头针联合神经肌肉电刺激治疗急性卒中后肩手综合征(shoulder-hand syndrome,SHS)的临床疗效及对患者生活能力和生存质量的影响。方法将90例急性卒中后SHS患者分为对照组和观察组,每组45例。所有患者均接受常规康复治疗,对照组另予神经肌肉电刺激治疗,观察组在对照组治疗基础上联合头针治疗。比较两组临床疗效,观察两组治疗前后中医证候积分、静息和运动状态下疼痛视觉模拟量表(visual analog scale,VAS)评分、Fugl-Meyer运动功能评定量表上肢部分(Fugl-Meyer assessment scale-upper extremity,FMA-UE)评分、Barthel指数(Barthel index,BI)评分和卒中专用生活质量量表(stroke specific-quality of life,SS-QOL)评分的变化。结果治疗后,两组中医证候积分、静息和运动状态下VAS评分、FMA-UE评分、BI评分以及SS-QOL评分均优于同组治疗前(P<0.05)。治疗后,观察组肩手痛、手指屈曲受限、手部肿胀和皮肤潮红的中医证候积分以及静息和运动状态下VAS评分均低于对照组(P<0.05),FMA-UE、BI和SS-QOL评分均高于对照组(P<0.05)。观察组总有效率高于对照组(P<0.05)。结论在常规康复治疗基础上,头针联合神经肌肉电刺激治疗卒中后SHS的疗效优于单纯神经肌肉电刺激,可进一步改善患者上肢运动功能,缓解症状和疼痛,提高日常生活能力和生存质量。Objective To observe the clinical efficacy of using scalp acupuncture plus neuromuscular electrical stimulation to treat shoulder-hand syndrome(SHS)after acute stroke and the effects on the patient’s living ability and quality of life.Method Ninety patients with SHS after acute stroke were divided into a control group and an observation group,each consisting of 45 cases.All patients received conventional rehabilitation treatment.In addition,the control group was given neuromuscular electrical stimulation,and the observation group received scalp acupuncture based on the intervention in the control group.The clinical efficacy was compared between the two groups.Before and after the treatment,both groups were observed for changes in the symptom and sign score of traditional Chinese medicine(TCM),visual analog scale(VAS)score at the resting and motion states,the score of Fugl-Meyer assessment scale-upper extremity(FMA-UE),Barthel index(BI)score,and stroke specific-quality of life(SS-QOL)score.Result After the treatment,both groups gained improvements in the TCM symptom and sign score,VAS score at the resting and motion states,FMA-UE score,BI score,and SS-QOL score(P<0.05).After the treatment,the observation group was lower than the control group in comparing the TCM symptom and sign scores(shoulder-hand pain,limited flexion of fingers,hand swelling,and skin flush)and VAS score at the resting and motion states(P<0.05);the scores of FMA-UE,BI,and SS-QOL were higher in the observation group than in the control group(P<0.05).The observation group had a higher total effective rate than the control group(P<0.05).Conclusion Based on the conventional rehabilitation treatment,scalp acupuncture plus neuromuscular electrical stimulation can produce more significant efficacy than neuromuscular electrical stimulation alone in treating post-stroke SHS;it can better improve the patient’s upper-limb motor function,alleviate symptoms and pain,and enhance the living ability and quality of life.

关 键 词：针刺疗法 头针 卒中 中风后遗症 肩痛 反射性交感神经营养不良 生存质量 

分 类 号：R246.6[医药卫生—针灸推拿学]