中药涂擦配合穴位按摩治疗脑卒中肩手综合征Ⅰ期的疗效观察

葛芳 王月英 黄雯

[摘要] 目的 探討中药涂擦配合穴位按摩治疗脑卒中肩手综合征Ⅰ期的疗效。 方法 分析我院针灸康复科2018年6月～2019年6月收治的脑卒中肩手综合征Ⅰ期的患者60例临床资料，进行随机分组，实验组30例，对照组30例。对照组予常规基础治疗和护理及物理康复治疗;实验组在对照组的基础上予以中药涂擦配合穴位按摩治疗。观察两组患者的疼痛、水肿、上肢功能改善情况，并进行综合测评。 结果 治疗4周后实验组（中药涂擦配合穴位按摩组）及对照组患者疼痛、水肿、上肢运动功能评分比较，差异有统计学意义（P<0.05），且中药涂擦配合穴位按摩组治疗效果明显优于对照组（P<0.05）;中药涂擦配合穴位按摩组有效率高于对照组，差异有统计学意义（P<0.05），对照组不良反应发生率明显高于中药涂擦配合穴位按摩组，差异有统计学意义（P<0.05）。 结论 中药涂擦配合穴位按摩治疗脑卒中肩手综合征Ⅰ期的疗效优于对照组，疗效好。

[关键词] 脑卒中;肩手综合征;中药药酒涂擦;穴位按摩;肿胀;疼痛

[中图分类号] R277.7          [文献标识码] B          [文章编号] 1673-9701（2020）15-0178-04

Observation on curative effect of traditional Chinese medicine inunction and acupressure on shoulder-hand syndrome（period Ⅰ） after stroke

GE Fang   WANG Yueying   HUANG Wen

Hangzhou Hospital of Traditional Chinese Medicine， Hangzhou   310007， China

[Abstract] Objective To investigate the curative effect of traditional Chinese medicine inunction combined with acupressure on the treatment of shoulder-hand syndrome（period Ⅰ） after stroke. Methods The clinical data of 60 patients with shoulder-hand syndrome（period Ⅰ） after stroke treated in our acupuncture rehabilitation department from June 2018 to June 2019 were analyzed. They were randomly divided into the experimental group（n=30） and the control group（n=30）. The control group was given conventional basic treatment and nursing and physical rehabilitation treatment. The experimental group was given traditional Chinese medicine inunction and acupressure treatment on the basis of the treatment in the control group. The pain， edema， and improvement of upper limb function in two groups were comprehensively evaluated. Results After 4 weeks of treatment， there were significant differences in the pain， edema， and upper limb motor function scores between the experimental group（Chinese medicine inunction and acupressure group） and the control group（P<0.05）. The treatment effect of Chinese medicine inunction and acupressure group was significantly better than that of the control group（P<0.05）. The effective rate of the traditional Chinese medicine inunction and acupressure group was higher than that of the control group， with a significant difference（P<0.05）. The incidence of adverse reactions in the control group was significantly higher than that of the traditional Chinese medicine inunction and acupressure group， and the difference was statistically significant（P<0.05）. Conclusion The curative effect of traditional Chinese medicine inunction and acupressure on stroke shoulder-hand syndrome is better than that of the control group.

[Key words] Stroke; Shoulder-hand syndrome; Traditional Chinese medicine inunction; Acupressure; Swelling; Pain

肩手综合征（Shoulder-Hand Syndrome，SHS）[1]也称反射性交感神经营养不良综合征，是指中风后肩痛运动障碍，同侧手、腕关节疼痛和肢体运动功能障碍。肩手综合征分为三个阶段，早期对肩手综合征的治疗将直接影响上肢功能康复，对患者手指、手、腕、肩关节功能和日常生活活动能力的恢复至关重要;未能及时治疗会导致肩部、肘部、手部、手指的永久性畸形，严重影响患者的生活质量，给患者的家庭和社会带来沉重的负担。目前临床上有多种治疗中风后肩手综合征的方法，主要集中在西医治疗[2];随着中医现代化进程的加快，大量临床研究表明，中医药手段的综合疗法对SHS有显著的临床疗效。本研究分析了我科收治的中风后肩手综合征患者临床资料，探讨中药涂擦配合穴位按摩治疗肩手综合征Ⅰ期的临床疗效，现报道如下。……