摘要
目的探讨中医针灸联合个性化运动康复处方对脑卒中后肩手综合征自发性疼痛及上肢运动功能的影响。方法选取我院2015年6月—2016年12月收治的脑卒中后肩手综合征病人90例作为研究对象,按数字表法随机分为针灸组(n=30)、运动康复组(n=30)和联合组(n=30)。针灸组给予单纯针灸治疗;运动康复组给予个性化运动康复训练;联合组给予针灸结合个性化运动康复训练,均干预3个月。采用视觉模拟评分(VAS)对3组病人干预前后上肢自发性疼痛进行评定,并于干预前后测定水肿程度,采用上肢简化Fugl-Meyer评估量表(FMA)评定3组干预前后上肢运动功能,采用改良Barthel指数(MBI)对肩手综合征的综合疗效进行评定。结果 3组干预前VAS评分及水肿程度相比差异无统计学意义(P>0.05),但干预后联合组VAS评分及水肿程度均明显低于针灸组和运动康复组(P<0.05);3组干预前FMA及MBI评分相比差异均无统计学意义(P>0.05);但干预后联合组FMA及MBI评分均明显高于针灸组和运动康复组(P<0.05);联合组肩手综合征的治疗有效率为86.67%,明显高于针灸组的60.00%(18/30)及运动康复组的63.33%,差异有统计学意义(P<0.05)。结论中医针灸联合个性化运动康复处方能有效缓解脑卒中后肩手综合征病人上肢自发性疼痛,减轻水肿程度,改善上肢运动功能。
Objective To investigate the effect of acupuncture and individualized exercise rehabilitation prescription on the spontaneous pain and motor function of upper limb in patients with shoulder hand syndrome after stroke.Methods Ninety patients with shoulder hand syndrome(SHS)after stroke in our hospital from June 2015 to December 2016 were selected,and randomly divided into 3 goups:acupuncture group(n=30)treated with acupuncture,exercise rehabilitation group(n=30)treated with individualized exercise rehabilitation training,and combination group(n=30)treated with acupuncture and individualized exercise rehabilitation training for 3 months.The Visual Analogue Scale(VAS)was used to assess the spontaneous pain of upper limbs in three groups before and after intervention.The degree of edema was measured before and after the intervention.The motor function of upper limb was evaluated by Fugl-Meyer Assessment,(FMA)in three groups before and after intervention.The Modified Barthel Index,(MBI)was used to evaluate the comprehensive effect of SHS.Results After intervention,VAS scores and the degree of edema were significantly lower in combination group than that in acupuncture group and exercise rehabilitation group(P<0.05).After intervention,FMA and MBI scores were significantly higher in combination group than that in acupuncture group and exercise rehabilitation group(P<0.05).The effective rate was 86.67%in acupuncture group,which were significantly higher than that in acupuncture group and exercise rehabilitation group(60.00%and 63.33%,P<0.05).Conclusion Acupuncture and individualized exercise rehabilitation prescription can effectively relieve the spontaneous pain,relieve edema,and improve the motor function of upper limb in patients with SHS after stroke.
作者
向珊
Xiang Shan(The Affiliated Baiyun Hospital,Guizhou Medical University,Guiyang 550000,Guizhou,China)
出处
《中西医结合心脑血管病杂志》
2018年第6期699-702,共4页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
关键词
脑卒中
肩手综合征
针灸
个性化运动康复
自发性疼痛
上肢运动功能
stroke
shoulder hand syndrome
acupuncture
individualized exercise rehabilitation
spontaneous pain
upper limb motor function
