疏血通脉汤联合傍针刺对中风后肩手综合征患者肢体痉挛、血液流变学及活动能力的影响

目的:探讨疏血通脉汤联合傍针刺治疗中风后肩手综合征(shoulder-hand syndrome after stroke,SHSAS)的临床疗效,并观察其对患者上肢肢体痉挛程度、血液流变学以及上肢活动能力的影响。方法:110例痰瘀阻络型SHSAS患者按照随机数字表法分为对照组与联合组,每组55例。两组患者均给予神经内科常规药物和肢体功能康复训练治疗。对照组联合傍针刺法治疗,联合组在对照组治疗基础上给予疏血通脉汤。两组患者均以4周为1个疗程,治疗1个疗程。记录比较两组患者治疗前后上肢肢体痉挛程度(Ashworth)、上肢活动能力(FMA)、肩手综合征量表(shoulder hand syndrome scale,SHSS)、视觉模拟评分(visual simulation scoring,VAS)、中医证候评分,高切全血黏度、低切全血黏度、血浆黏度和血小板聚集率等血液流变学指标,并比较治疗效果。结果:联合组有效率为96.36%,对照组有效率为83.64%,两组患者有效率比较,差异有统计学意义(P<0.05)。治疗后,联合组高切全血黏度、低切全血黏度、血浆黏度与血小板聚集率水平均低于对照组,差异有统计学意义(P<0.05);联合组Ashworth评分低于对照组、上肢FMA评分高于对照组,差异有统计学意义(P<0.05);联合组SHSS评分和中医证候评分均低于对照组,差异有统计学意义(P<0.05);联合组VAS评分低于对照组,差异有统计学意义(P<0.05)。结论:疏血通脉汤联合傍针刺治疗SHSAS患者疗效显著,能有效改善患者血液流变学,缓解疼痛程度和上肢痉挛,提高上肢活动能力。

Effects of Shuxue Tongmai Decoction and Needling of Limb Spasm,Hemorheology and Activity in Patients with Shoulder-Hand Syndrome After Stroke

Objective:To explore the clinical efficacy of Shuxue Tongmai Decoction combined with acupuncture in the treatment of shoulder-hand syndrome after stroke(SHSAS),and to observe the degree of upper limb limb spasm,hemorheology and Influence of upper limb mobility.Methods:110 patients with phlegm and blood stasis type SHSAS were divided into control group and combined group according to random number table method,with 55 cases in each group.Both groups of patients were given conventional medicine in neurology and rehabilitation training for limb function.The control group was treated with acupuncture,and the combined group was given Shuxue Tongmai Decoction based on the treatment of the control group.Both groups of patients took 4 weeks as a course of treatment and treated for 1 course of treatment.Record and compare the degree of upper limb extremity spasm(Ashworth),upper extremity mobility(FMA),shoulder hand syndrome scale(SHSS),visual simulation scoring(VAS),TCM certifi-cate before and after treatment Pending score,high-cut whole blood viscosity,low-cut whole blood viscosity,plasma viscosity and platelet aggregation rate and other blood rheology indicators,and evaluate the treatment effect.Results:The effective rate of the combined group was 96.36%,and the effective rate of the control group was 83.64%.There was a statistically significant difference between the effective rates of the two groups(P<0.05).After treatment,the high-cut whole blood viscosity,low-cut whole blood viscosity,plasma viscosity and platelet aggregation rate of the combined group were lower than the control group,the difference was statistically significant(P<0.05);the Ashworth score of the combined group was lower than the control group,The upper limb FMA score was higher than the control group,the difference was statistically significant(P<0.05);the combined group's SHSS score and TCM syndrome score were lower than the control group,the difference was statistically significant(P<0.05);the combined group's VAS score was low In the control group,the difference was statistically significant(P<0.05).Conclusion:Shuxue Tongmai Decoction combined with acupuncture is effective in the treatment of patients with SHSAS.It can effectively improve the hemorheology of patients,relieve pain and upper limb spasm,and improve upper limb mobility.