目的 探讨针灸联合精细化体位管理治疗脑卒中后肩手综合征Ⅰ期患者的效果。方法 选取2021年7月至2023年1月于江西省人民医院康复医学科就诊的128例脑卒中后肩手综合征Ⅰ期患者为研究对象,按照随机数字表法分为对照组与观察组,每组各64例。对照组患者给予西药联合精细化体位管理治疗,观察组患者实施针灸联合精细化体位管理治疗,两组均治疗4周。比较两组患者的临床疗效、疼痛程度、上肢运动功能、生活自理能力。结果 观察组的临床疗效优于对照组,差异有统计学意义(P<0。05)。治疗前,两组患者的Fugl-Meyer评测法(FMA)、关节活动度、改良巴氏指数(BI)、视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0。05);治疗后,观察组的 FMA[(59。44±5。82)分]、关节活动度[(90。35±13。14)°]、BI[(84。79±8。44)分]均高于对照组[(50。14± 5。03)分、(80。52±11。97)°、(65。18±7。21)分],观察组的 VAS 评分[(1。14±0。22)分]低于对照组[(2。36±0。35)分],差异有统计学意义(P<0。05)。结论 针灸联合精细化体位管理可有效缓解脑卒中后肩手综合征Ⅰ期患者患肢肿胀、疼痛症状,有利于提升患者的上肢运动功能,促进患者生活自理能力提升。
Effect of acupuncture and moxibustion combined with fine body position management in stage Ⅰ of shoulder hand syndrome after stroke
Objective To investigate the effect of acupuncture and moxibustion combined with refined position management in the treatment of stage Ⅰ patients with shoulder hand syndrome after stroke.Methods A total of 128 patients with stageⅠ shoulder hand syndrome after stroke admitted to Department of Rehabilitation Medicine,Jiangxi Provincial People's Hospital from July 2021 to January 2023 were selected as subjects and divided into control group and observation group ac-cording to random number table method,with 64 patients in each group.The control group was given western medicine com-bined with refined position management treatment,and the observation group was given acupuncture combined with refined position management treatment.Both groups were treated for 4 weeks.The clinical efficacy,pain degree,upper limb motor function and self-care ability of the two groups were compared.Results The clinical efficacy of the observation group was better than that of the control group,the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in the scores of Fugl-Meyer assessment(FMA),joint range of motion,modified Barthel index(BI)and visual analogue scale(VAS)between the two groups(P>0.05).After treatment,the FMA([59.44±5.82]points),joint mo-tion([90.35±13.14]°)and BI([84.79±8.44]points)in the observation group were higher than those in the control group([50.14±5.03]points,[80.52±11.97]°,[65.18±7.21]points),the VAS score of the observation group([1.14±0.22]points)was lower than that of the control group([2.36±0.35]points),and the differences were statistically significant(P<0.05).Conclusion Acupuncture and moxibustion combined with refined position management can effectively relieve the symptoms of limb swelling and pain in stage Ⅰ patients with shoulder hand syndrome after stroke,which is conducive to improving the upper limb function and improving the self-care ability of patients.
StrokeShoulder hand syndrome stage ⅠAcupuncture and moxibustionRefined posture managementAp-plied researchClinical efficacyUpper limb motor functionSelf care ability