【作者】 张琳；

【导师】 金弘；

【作者基本信息】 黑龙江中医药大学 ， 针灸推拿学（专业学位）， 2024， 硕士

【摘要】 目的:观察“龙虎交战”针刺法治疗中风后肩手综合征Ⅰ期临床疗效,探讨“龙虎交战”针刺法及常规针刺治疗的选用依据,通过“龙虎交战”针刺法与常规针刺的疗效对比,进一步提高临床疗效,以减轻患者症状,提高生活质量。方法:将64例中风后肩手综合征Ⅰ期的患者随机分为对照组(常规针刺)和治疗组(常规针刺联合“龙虎交战”针刺法),各32例。诊疗期间对照组脱落2例,最终完成30例;治疗组脱落1例,最终完成31例。对照组采用常规针刺,治疗组在对照组的基础上联合“龙虎交战”针刺法治疗。治疗时间:每日1次,每周6次,共治疗2周。观察治疗前和治疗2周后视觉模拟评分量表(Visual analogue scale,VAS)、Fug l-Meyer上肢运动功能评定(FMA)评分、血清P物质(SP)、血清降钙素缓激肽(CGRP)、缓激肽(BK)。观察并标记两组数据评分变化,治疗后评价对比两组的临床治疗效果。结果:1.两组患者治疗前VAS评分、FMA评分、SHSS评分、血清P物质(SP)、血清降钙素缓激肽(CGRP)、缓激肽(BK)差异无显著统计学意义(p>0.05),存在可比性。2.两组患者治疗后VAS评分、SHSS评分、SP指数、BK指数评分均有下滑,FMA评分、CGRP指数均有上升,具有统计学意义(p<0.05);治疗后两组患者组内比较均有统计学意义(p<0.05);治疗后,两组VAS评分、FMA评分、SHSS评分、SP指数、CGRP指数、BK指数进行组间比较,治疗组均优于对照组差异有统计学意义(p<0.05)。3.疗效评价:治疗组总有效率(96.77%)优于对照组总有效率(86.33%),比较有统计学意义(p<0.05)。结论:1.常规针刺、常规针刺联合“龙虎交战”针刺法均能有效改善中风后肩手综合征Ⅰ期患者的临床症状,包括疼痛、上肢功能活动等症状以及实验室指标。2.常规针刺联合“龙虎交战”针刺法治疗中风后肩手综合征Ⅰ期可有效缓解炎症水平,减轻疼痛和水肿等症状,提高患者上肢运动功能,其临床疗效明显优于常规针刺。更多还原

【Abstract】 Objective:Observing the clinical efficacy of the "Dragon Tiger Battle" acupuncture method in treating post-stroke shoulder hand syndrome stage I,exploring the selection basis of the "Dragon Tiger Battle" acupuncture method and conventional acupuncture treatment,comparing the efficacy of the "Dragon Tiger Battle" acupuncture method with conventional acupuncture,further improving clinical efficacy,in order to alleviate patient symptoms and improve quality of life.Methods:64 patients with post-stroke shoulder hand syndrome stage I were randomly divided into a control group(conventional acupuncture)and a treatment group(conventional acupuncture combined with "Dragon Tiger Battle" acupuncture method),with 32 cases in each group.During the diagnosis and treatment period,there were 2 cases of dropout in the control group,and 30 cases were ultimately completed;One case fell out of the treatment group,and 31 cases were ultimately completed.The control group received routine acupuncture,while the treatment group received a combination of "Dragon Tiger Battle" acupuncture on the basis of the control group.Treatment time: once a day,6 times a week,for a total of 2 weeks.Observe the Visual Analog Scale(VAS),Fug l Meyer Upper Limb Motor Function Assessment(FMA)score,serum substance P(SP),serum calcitonin bradykinin(CGRP),and bradykinin(BK)before and 2 weeks after treatment.Observe and mark the changes in the scores of the two groups of data,and evaluate and compare the clinical treatment effects of the two groups after treatment.Results:1.There was no significant statistical difference(p>0.05)in the pre treatment VAS score,FMA score,SHSS score,serum substance P(SP),serum calcitonin bradykinin(CGRP),and bradykinin(BK)between the two groups of patients,indicating comparability.2.The VAS score,SHSS score,SP index,and BK index scores of both groups of patients decreased before and after treatment,while the FMA score and CGRP index increased,with statistical significance(p<0.05);After treatment,there was a statistically significant difference(p<0.05)between the two groups of patients;After treatment,the VAS score,FMA score,SHSS score,SP index,CGRP index,and BK index between the two groups were compared,and the treatment group was superior to the control group with statistically significant differences(p<0.05).3.Efficacy evaluation: The total effective rate of the treatment group(96.77%)was better than that of the control group(86.33%),with statistical significance(p<0.05).Conclusion:1.Conventional acupuncture,combined with the "Dragon Tiger Battle" acupuncture method,can effectively improve symptoms such as pain,upper limb functional activity,and laboratory indicators in patients with post-stroke shoulder hand syndrome stage I.2.The combination of conventional acupuncture and "Dragon Tiger Battle" acupuncture method has a significantly better therapeutic effect on stage I shoulder hand syndrome after stroke than conventional acupuncture.更多还原