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浙江省建德市第一人民医院康复科,建德 311600
浙江省建德市第一人民医院针灸科,建德 311600
浙江省建德市第一人民医院高压氧科,建德 311600
应明军,副主任中医师。E-mail:454095391@qq.com
收稿:2024-11-22,
网络首发:2025-09-16,
纸质出版:2025-12-12
移动端阅览
应明军, 袁敏, 赖志良, 等. 经筋结点恢刺法对脑卒中后肩手综合征Ⅰ期的影响[J]. 中国针灸, 2025,45(12):1699-1704.
YING Mingjun, YUAN Min, LAI Zhiliang, et al. Effect of relaxing needling at the contracted sites of meridian-muscle regions in the patients with post-stroke shoulder-hand syndrome at acute stage[J]. Chinese Acupuncture & Moxibustion, 2025, 45(12): 1699-1704.
应明军, 袁敏, 赖志良, 等. 经筋结点恢刺法对脑卒中后肩手综合征Ⅰ期的影响[J]. 中国针灸, 2025,45(12):1699-1704. DOI: 10.13703/j.0255-2930.20241122-0001.
YING Mingjun, YUAN Min, LAI Zhiliang, et al. Effect of relaxing needling at the contracted sites of meridian-muscle regions in the patients with post-stroke shoulder-hand syndrome at acute stage[J]. Chinese Acupuncture & Moxibustion, 2025, 45(12): 1699-1704. DOI: 10.13703/j.0255-2930.20241122-0001.
目的:
2
观察经筋结点恢刺法对脑卒中后肩手综合征Ⅰ期患者的影响。
方法:
2
将80例脑卒中后肩手综合征Ⅰ期患者随机分为观察组(40例,脱落1例)和对照组(40例,剔除1例)。对照组给予常规药物、基础康复训练及高压氧治疗,观察组在对照组治疗基础上,加用经筋结点恢刺法治疗,主要选取患侧上肢手三阴、三阳经循行部位的经筋结点,每日1次,每周5次,共治疗4周。观察两组患者治疗前后患肢疼痛视觉模拟量表(VAS)评分、水肿程度评分、改良Barthel指数(MBI)评分、Fugl-Meyer运动功能评估量表(FMA)评分和表面肌电图(sEMG)积分肌电值(iEMG),并于治疗后及治疗后2个月随访评定两组临床疗效。
结果:
2
治疗后,两组患者患肢疼痛VAS评分、水肿程度评分均较治疗前降低(
P
<
0.05),且观察组低于对照组(
P
<
0.05);两组患者MBI评分、FMA评分均较治疗前升高(
P
<
0.05),且观察组高于对照组(
P
<
0.05)。治疗后,两组患者肱二头肌、肱三头肌、腕伸肌iEMG均较治疗前增加(
P
<
0.05),且观察组大于对照组(
P
<
0.05)。治疗后,观察组总有效率为92.3%(36/39),高于对照组的74.4%(29/39,
P
<
0.05);随访时,观察组总有效率为97.4%(38/39),高于对照组的82.1%(32/39,
P
<
0.05)。
结论:
2
经筋结点恢刺法治疗脑卒中后肩手综合征Ⅰ期可改善患者上肢疼痛、肿胀、痉挛等症状及运动功能,提高日常生活能力。
Objective
2
To investigate the effect of relaxing needling at the contracted sites of meridian-muscle regions in the patients with post-stroke shoulder-hand syndrome (SHS) at acute stage.
Methods
2
Eighty patients with post-stroke SHS at acute stage were randomized into an observation group (40 cases
1 case dropped out) and a control group (40 cases
1 case was eliminated). In the control group
the routine medication
basic rehabilitation training
and hyperbaric oxygen therapy were administered. In the observation group
besides the treatment as the control group
relax
ing needling was delivered at the contracted sites of meridian-muscle regions. These contracted sites were distributed along three
yin
meridians of hand and three
yang
meridians of hand on the affected upper limbs. The intervention was given once daily
5 times a week and for 4 weeks. Before and after treatment
the scores of visual analogue scale (VAS) for pain
edema degree
modified Barthel index (MBI)
and Fugl-Meyer assessment (FMA) for motor function
and the integrated electromyography (iEMG) of surface electromyogram (sEMG) were observed in the two groups. The curative effect was evaluated after treatment and in follow-up of 2 months after treatment in the two groups.
Results
2
After treatment
VAS scores and the scores of edema degree were reduced when compared with those before treatment in the two groups (
P
<
0.05)
and the scores in the observation group were lower than those in the control group (
P
<
0.05). MBI and FMA scores increased after treatment compared with those before treatment in the two groups (
P
<
0.05)
and the scores in the observation group were higher than those in the control group (
P
<
0.05) after treatment. The iEMG values of the biceps brachii
triceps brachii
and wrist extensors were elevated after treatment in comparison with those before treatment (
P
<
0.05) in the two groups
and the values in the observation group were larger than those in the control group after treatment (
P
<
0.05). The total clinical effective rate in the observation group was 92.3% (36/39)
which was better than that of the control group (74.4%
29/39
P
<
0.05) after treatment; and that of the observation group was 97.4% (38/39)
which was better than 82.1% (32/39) in the control group (
P
<
0.05) in follow-up.
Conclusion
2
Relaxing needling at the contracted sites of meridian-muscle regions in treatment of post-stroke SHS at acute stage can attenuate the symptoms such as upper limb pain
swelling and spasm
improve motor function and the activity of daily living of patients.
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