摘要
目的:观察毫火针针刺结筋病灶点联合徒手淋巴引流治疗脑卒中后肩手综合征Ⅰ期患者的临床疗效及可能的分子机制。方法:72例脑卒中后肩手综合征Ⅰ期患者按照随机数字表法分为观察组和对照组,每组36例。两组患者均给予常规用药及康复治疗,对照组联合徒手淋巴引流治疗,观察组在对照组基础上加用毫火针针刺结筋病灶点治疗,2组疗程均为3周。观察并比较2组患者治疗前后中医证候积分、肩手综合征评估量表(SHSS)评分、水肿分级评分、疼痛视觉模拟评分法(VAS)评分、上肢Fugl-Meyer功能量表(FMA)评分及脑卒中专门化生活质量量表(SS-QOL)评分,检测2组治疗前后降钙素基因相关肽(CGRP)、一氧化氮(NO)、内皮素-1(ET-1)水平,并评估临床疗效。结果:观察组总有效率为97.22%(35/36),明显高于对照组的80.56%(29/36),差异有统计学意义(P<0.05)。2组患者治疗后中医证候积分、SHSS评分、水肿分级评分、VAS评分及ET-1水平较治疗前明显降低(P<0.05),FMA评分、SS-QOL评分、CGRP及NO水平较治疗前显著提高(P<0.05);观察组对上述各项指标改善程度明显优于对照组(P<0.05)。结论:毫火针针刺结筋病灶点联合徒手淋巴引流能够显著改善脑卒中后肩手综合征Ⅰ期患者的肢体功能,减轻疼痛肿胀,调节血管功能,提高临床疗效及生活质量。
Objective:To observe the clinical effect and possible molecular mechanism of filiform fire needling focal points of knot tendon combined with manual lymphatic drainage(MLD)in the treatment of post-stroke shoulder-hand syndrome(SHS)of phase I.Methods:72 patients with post-stroke SHS of phase I were randomly divided into the observation group and the control group,with 36 cases in each group.The two groups were treated with routine medication and rehabilitation therapy,the control group was also treated with MLD,and the observation group was treated with filiform fire needling focal points of knot tendon combined with MLD.The treatment duration was 3 weeks in the two groups.TCM syndrome integral,the scores of SHSS,edema,VAS,FMA of upper limb and SS-QOL,as well as the levels of CGRP,NO and ET-1 were compared before and after the treatment in the two groups.The clinical efficacy was assessed and compared between the two groups.Results:The total effective rate of the observation group was 97.22%(35/36),which was significantly higher than 80.56%(29/36)of the control group(P<0.05).The TCM syndrome integral,the scores of SHSS,edema and VAS,as well as the level of ET-1 were significantly decreased after the treatment in the two groups(P<0.05);whereas the scores of FMA and SS-QOL,as well as the levels of CGRP and NO were significantly increased after the treatment in the two groups(P<0.05);the improvements of the above indexes were more significant in the observation group than those in the control group(P<0.05).Conclusion:Filiform fire needling focal points of knot tendon combined with MLD can significantly improve limb function,relieve pain and swelling,regulate vascular function and improve clinical effect and quality of life in patients with post-stroke SHS of Phase I.
作者
张金朋
王亚楠
宋君瑶
李宏玉
朱路文
唐强
关莹
刘凯
陈慧杰
ZHANG Jinpeng;WANG Yanan;SONG Junyao;LI Hongyu;ZHU Luwen;TANG Qiang;GUAN Ying;LIU Kai;CHEN Huijie(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,China)
出处
《中医药学报》
CAS
2021年第12期76-81,共6页
Acta Chinese Medicine and Pharmacology
基金
黑龙江省应用技术研究与开放计划项目(GA19C110)
黑龙江省中医药科研项目(ZHY19-043)
黑龙江省中医药科研项目(ZHY19-045)
孙申田青年人才基金项目(2020KY-13)。
关键词
毫火针
结筋病灶点
徒手淋巴引流
脑卒中
肩手综合征
Filiform fire needling
Focal points of knot tendon
Manual lymphatic drainage
Stroke
Shoulder-hand syndrome
