巨刺针法治疗脑卒中后肩手综合征疗效观察

目的:观察巨刺针法与常规刺法治疗脑卒中后肩手综合征Ⅰ期的疗效差异.方法:将60例患者随机分为巨刺组(30例)、患侧组(30例).两组均穴取肩偶、肩髎、曲池、合谷等,巨刺组取健侧,患侧组取患侧.采用Fugl-Meyer量表评价患肢运动功能;采用ADL量表评定日常生活活动能力;采用目测类比评分(VAS)评价疼痛及观察治疗前后肿胀程度.结果:上肢Fugl-Meyer运动功能和日常生活活动能力ADL评分,两组治疗前和治疗2个疗程后比较,差异均有统计学意义(均P＜0.05),两组间比较,巨刺组优于患侧组(P＜0.05);两组治疗前后肿胀和疼痛评分都有下降(均P＜0.05),组间比较,肿胀程度改善巨刺组优于患侧组(P＜0.05),但疼痛改善两组相当(P＞0.05);巨刺组总有效率为93.3%,患侧组为90.0%,两组疗效比较,差异具有统计学意义(P＜0.05).结论:巨刺针法治疗脑卒中后肩手综合征在减轻肿胀、改善运动功能方面优于常规针刺法.

Observation on therapeutic effect of opposing needling for treatment of poststroke shoulder-hand syndrome

Objective To compare the therapeutic effects of opposing needling and routine acupuncture for treatment of poststroke shoulder-hand syndrome. Methods Sixty cases were randomly divided into an opposing needling group and a routine acupuncture group, 30 cases in each group. In the two groups, Jianyu (LI 15) , Jianliao (TE 14) , Quchi (LI 11) , Hegu (LI 4) , etc. were selected, with on the healthy side selected for the opposing needling group and on the affected side selected for the routine acupuncture group. The motor function of the affected limb was evaluated by Fugl-Meyer scale, activity of daily living by ADL scale, and pain by VAS, and the edema degree was investigated before and after treatment. Results There were significant differences before treatment and after 2 therapeutic courses in the scores of Fugl-Meyer for the upper limb motor function and the ADL score for activity of daily living (both P<0. 05), with the opposing needling group being significantly better than the routine acupuncture group (P<0. 05) ; after treatment, both the edema degree and the pain scores significantly decreased (both P<0. 05) , with the opposing needling group in improvement of the edema degree being better the routine acupuncture group (P<0. 05), and with no significant difference between the two groups in improvement of pain (P>0. 05) ; the total effective rate was 93. 3% in the opposing needling group and 90. 0% in the routine acupuncture group with a significant difference between the two groups (P<0. 05). Conclusion The clinical therapeutic effect of the opposing needling is better than that of routine acupuncture therapy for treatment of poststroke shoulder-hand syndrome.