【摘要】 目的 探讨电针联合独活寄生汤加减治疗脑卒中后Ⅰ期肩手综合征(SHS)患者的临床疗效。方法 选取脑卒中后Ⅰ期肩手综合征患者90例,采用随机数表法分为对照组与治疗组,各45例。对照组接受常规康复训练,治疗组在对照组基础上联合电针与独活寄生汤加减方治疗。2组均治疗4周。比较2组治疗前后视觉模拟评分(VAS)、Fugl-Meyer上肢运动功能评分(FMA-UE)、改良Barthel指数(MBI)及手部肿胀率,血清超敏C反应蛋白(hs-CRP)、白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)等炎症因子水平、血液流变学参数,评价2组临床疗效与治疗安全性。结果 治疗后2组VAS评分、手部肿胀率、各项炎症指标(hs-CRP、IL-6、TNF-α)及血液流变学指标均较治疗前显著下降(P <0.05);FMA-UE评分、MBI评分均明显提高(P <0.05);治疗组以上指标改善幅度均优于对照组(P <0.05)。治疗组临床疗效结果总有效率(93.33%,42/45)高于对照组(77.78%,35/45)(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论 电针联合独活寄生汤加减可有效缓解脑卒中后Ⅰ期肩手综合征患者疼痛及水肿,改善上肢运动功能、日常生活活动能力,抑制炎症反应,优化血液流变学状态,疗效显著,安全性良好。更多还原

【Abstract】 Objective To explore the clinical efficacy of electroacupuncture combined with modified Duhuo Jisheng Decoction in patients with stage Ⅰ shoulder-hand syndrome(SHS) after stroke.Methods A total of 90 patients with stage Ⅰ SHS after stroke were selected and randomly divided into the treatment group and the control group according to random number table method,with 45 cases in each group.The control group received conventional rehabilitation training,while the treatment group received electroacupuncture and modified Duhuo Jisheng Decoction on the basis of the treatment of the control group.The intervention period for both groups was 4 weeks.Visual analogue scale(VAS) scores,Fugl-Meyer assessment of upper extremity motor function(FMA-UE) scores,modified Barthel index(MBI),and hand swelling rate in patients before and after treatment were compared between two groups,and the levels of inflammatory factors such as high-sensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α),as well as hemorheological parameters were compared.Clinical efficacy and safety of both groups were evaluated.Results After treatment,both groups exhibited significant reductions in VAS scores,hand swelling rate,inflammatory markers(hs-CRP,IL-6,TNF-α),and hemorheological parameters compared to before treatment(P<0.05);FMA-UE and MBI showed significant increases(P<0.05).The treatment group showed significantly greater improvement in all the above indicators compared to the control group(P<0.05).The total effective rate in the treatment group(93.33%,42/45) was higher than that in the control group(77.78%,35/45)(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion The combination of electroacupuncture and modified Duhuo Jisheng Decoction can effectively alleviate pain and edema,improve upper limb motor function and activities of daily living,inhibit inflammatory responses,and optimize hemorheological status in patients with stage I SHS after stroke.This therapy demonstrates significant therapeutic efficacy with good safety.更多还原