微波结合运动疗法治疗肩手综合征临床观察

目的：评估微波结合运动疗法治疗肩手综合症的临床疗效。方法：①将40例脑卒中患者随机分为微波结合运动治疗组和运动治疗组，每组20例。两组男女比例、年龄差异无显著性意义。②微波结合运动治疗组采用日本伊藤株式会社型号为PM800的微波治疗仪，工作频率为2450mHz。辐射器距离皮肤5—7cm左右，采用脉冲方式，输出功率为30W，辐射剂量为温热量。治疗时间一般为20分钟左右，每日1次，10次为1个疗程。同时加强患侧上肢无痛范围的被动和主动运动，保持良好的坐卧姿势，避免长时间手处于下垂位，依次从患侧肩，肘，腕关节至掌指，指间各关节，使关节囊和关节周围肌腱充分伸展。注意肩关节外展的同时配合外旋，被动活动肩关节范围为90o，手法保持轻柔，用力由大到小，2次每日，每次25分钟。对照组予以上述运动治疗，2次每日，每次25分钟。不予微波治疗。③两组患者治疗4周后，应用VAS评分比较两组患者疼痛改善情况。结果：按实际处理分析，微波结合运动治疗组20例患者和运动治疗组20例患者全部进入结果分析。①治疗前后两组疼痛评分情况：对照组治疗后VAS评分与治疗前相比差异无统计学意义（P>0.05），治疗组治疗后VAS评分与治疗前相比差异有统计学意义（P<0.01），两组治疗后组间VAS相比差异有统计学意义（P<0.01）。②两组疗效分析：对照组和治疗组总有效率分别为45.00％和85.00％，两组疗效差异相比有统计学意义（P<0.01）。结论：微波结合运动治疗可显著减轻疼痛，对患肢功能改善具有积极作用。

Clinical observation of microwave irradiation combined with kinesiotherapy for shoulder-hand syndrome

①Totally 40 patients with stroke ，between May 2005 and May 2007, were divided into microwave irradiation combined with cinesiotherapy group and cinesiotherapy group randomly with 20 patients in each group. There was no significant difference in proportion of males and females as well as age.②The PM800 microwave equipment manufactured by Japan ITO Corporation was used. The frequency was 2450 MHz. Keeping a distance of5－7cm from the skin, and than treated with continuous microwave hyperthermia and 30w outputting power. Undertake that for 20 minutes pre time and 1 times per day (10 days as one therapeutic course). Simultaneously，strengthens the passive and the initiative movement on pain-free range of trouble-side upper limb. Keep favourable sitting and lying posture, avoids the long time being in the sagging position, Stretch thoroughly articular capsule and muscle tendon surrounding arthrosis from shoulder orderly to elbow、wrist joint and each fingerweb. Attent to match external rotation when shoulder joint were abducting. Passive activity extent of shoulder joint were 90o.Keep light and soft manoeuvre and strong－to－feeble stength. Undertake that for 25 minutes pre time and 2 times per day. The controlled group was administed above-mentioned cinesiotherapy. Microwave therapy was not supplied. After 4 weeks, Ache amelioration was evaluated by VAS score. Result: 40 patients were all analyzed. ①Ache score state pretreatment and post-treatment：There was not significant difference in VAS score between pretreatment and post-treatment in controlled group（P>0.05）.There was obvious significance between pretreatment and post-treatment in treated group. The difference in VAS score of post-treatment of two groups has statistical significance. ②Therapy analysis between two groups: Total effective rate were respective 45.00％ and 85.00％.The difference in therapeutic effect has statistical significance between groups. Conclusion: microwave irradiation combined with cinesiotherapy may striking relieve ache. It has active effect to function improvement of troubled limb.