循经刮痧联合雷火灸对缺血性脑卒中后肩手综合征患者运动功能和血液流变学的影响  

Influence of scraping along meridians combined with thunder-fire moxibustion on motor function and hemorheology in patients with shoulder-hand syndrome after ischemic stroke

作　　者：周建华 王坤[1] 商晓波 王叶 李帆 张丽曼[1] 李敏菊[1] Zhou Jianhua;Wang Kun;Shang Xiaobo;Wang Ye;Li Fan;Zhang Liman;Li Minju(Third Department of Encephalopathy,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050051,China)

机构地区：[1]石家庄市中医院脑病三科,石家庄050051

出　　处：《中国实用护理杂志》2025年第4期260-266,共7页Chinese Journal of Practical Nursing

基　　金：河北省中医药管理局科研计划项目(2021241)。

摘　　要：目的分析循经刮痧联合雷火灸干预对改善缺血性脑卒中后肩手综合征(SHS)患者运动功能和血液流变学等方面的效果,以期为临床缺血性脑卒中后SHS患者的临床干预提供参考。方法采用简单随机抽样方法选取石家庄市中医院2020年1月至2023年6月收治的缺血性脑卒中后SHS患者进行前瞻性研究。采用随机数字表法分为2组,雷火灸组给予常规护理与雷火灸疗法,联合组在雷火灸组的基础上实施循经刮痧疗法。比较2组患者干预前后Fugl-Meyer运动功能评定量表上肢部分(U-FMA)评分、疼痛视觉模拟量表(VAS)评分、上肢动作研究量表(ARAT)评分、肩关节活动程度评分、血液流变学指标水平(血细胞比容、血浆黏度、血小板黏附率)及日常生活活动能力(Barthel指数)等。结果最终纳入86例缺血性脑卒中后SHS患者,雷火灸组42例,男25例,女17例,年龄(59.37±7.64)岁;联合组44例,男24例,女20例,年龄(59.52±7.61)岁。干预前,2组患者U-FMA评分、VAS评分、ARAT评分、肩关节活动程度评分、血液流变学指标水平、Barthel指数比较差异均无统计学意义(均P>0.05)。干预后,联合组患者U-FMA评分、ARAT评分、Barthel指数分别为(48.21±4.85)、(40.22±4.64)、(56.43±9.76)分,均高于雷火灸组的(44.56±4.23)、(35.98±4.37)、(51.97±8.31)分,差异均有统计学意义(t=3.71、4.36、2.28,均P<0.05);联合组患者VAS评分、肩关节活动程度评分、血细胞比容、血浆黏度、血小板黏附率分别为(2.44±0.87)分、(1.23±0.25)分、0.44±0.02、(1.35±0.32)mPa·s、(53.56±5.71)%,均低于雷火灸组的(3.05±0.99)分、(1.58±0.22)分、0.46±0.02、(1.72±0.36)mPa·s、(62.53±5.94)%,差异均有统计学意义(t值为3.04~7.14,均P<0.05)。结论循经刮痧联合雷火灸疗法护理缺血性脑卒中后SHS患者可获得良好的干预效果,改善患者上肢运动功能和血液流变学,提高其日常生活活动能力。ObjectiveTo analyze the effect of meridian scraping combined with thunder fire moxibustion in improving the motor function and hemorheology of patients with shoulder hand syndrome(SHS)after ischemic stroke,in order to provide reference for clinical intervention of SHS patients after ischemic stroke.MethodsA prospective study was conducted using a simple random sampling method to select SHS patients after ischemic stroke admitted to Shijiazhuang Hospital of Traditional Chinese Medicine from January 2020 to June 2023,and were randomly divided into two groups.The thunder-fire moxibustion group were given routine nursing and thunder-fire moxibustion therapy,and the combined group were additionally given scraping therapy along meridians on the basis of thunder-fire moxibustion group.The Upper Limb Fugl-Meyer Motor Function Assessment Scale(U-FMA)score,Visual Analogue Scale(VAS)score,Action Research Arm Test(ARAT)score,shoulder joint activity score,hemorheological indicators(hematocrit,plasma viscosity,platelet adhesion rate)and activities of daily living(Barthel Index),etc.were compared between two groups before and after intervention.ResultsFinally,86 patients with SHS after ischemic stroke were included,with 42 patients in the thunder-fire moxibustion group,including 25 males and 17 females,aged(59.37±7.64)years;44 patients in the combined group,including 24 males and 20 females,aged(59.52±7.61)years.Before intervention,there was no statistical significance in U-FMA score,VAS score,ARAT score,shoulder joint activity score,hemorheology index level and Barthel Index between two groups(all P>0.05).After intervention,the U-FMA score,ARAT score and Barthel Index in the combined group were(48.21±4.85),(40.22±4.64),(56.43±9.76)points,respectively,which were higher than(44.56±4.23),(35.98±4.37),(51.97±8.31)points in the thunder-fire moxibustion group,the differences were statistically significant(t=3.71,4.36,2.28,all P<0.05).The VAS score,shoulder joint mobility score,blood cell volume,plasma viscosity and platelet

关 键 词：血液流变学 肩手综合征 循经刮痧 雷火灸 缺血性脑卒中 运动功能 

分 类 号：R277.7[医药卫生—中医学]