Wang Mei, Wang Peng-Qin, Yu Li-Hua, Wang Chen-Yang, Shao Yan
College of Integrated Traditional Chinese and Western Medicine of Liaoning University of TCM, Shenyang 110847, China.
Affiliated Hospital of Liaoning University of TCM, Shenyang 110032.
Zhongguo Zhen Jiu. 2022 Apr 12;42(4):385-9. doi: 10.13703/j.0255-2930.20210426-0003.
To assess the efficacy on relieving pain and improving the range of motion of shoulder joint in post-stroke shoulder-hand syndrome of phlegm-stasis obstruction in treatment of the combined therapy of eye acupuncture, (Chinese herbal warm dressing technique) and rehabilitation training (eye acupuncture + + rehabilitation) as compared with the combined treatment of and rehabilitation training ( + rehabilitation) and the simple rehabilitation training (rehabilitation).
A total of 356 patients with post-stroke shoulder-hand syndrome of phlegm-stasis obstruction were randomized into an eye acupuncture + + rehabilitation group (group A, 122 cases, 2 cases dropped off), a + rehabilitation group (group B, 120 cases, 3 cases dropped off) and a rehabilitation group (group C, 114 cases, 1 case dropped off). In the group C, the basic treatment was combined with routine rehabilitation training. In the group B, on the base of the treatment as the group C, was exerted. A medical bag composed of over 20 Chinese herbal materials was heated and dressed at the affected area, 30 min each time, 5 times weekly. In the group A, besides the treatment as the group B, eye acupuncture was applied to heart region, kidney region, upper region and lower region, 30 min each time, 5 times weekly. The treatment lasted 28 days in all of three groups. Separately, before treatment, in 7, 14, 21 and 28 days of treatment, as well as in 14 days after treatment of follow-up, the score of visual analogue scale (VAS) for pain, the score of guides to evaluation of permanent impairment (GEPI) and the score of National Institutes of Health stroke scale (NIHSS) were observed in each group.
The scores of VAS, GEPI and NIHSS were all improved with the treatment lasting in the three groups (<0.000 1). In 7, 14, 21 and 28 days of treatment and in follow-up as well, VAS scores in the group A were all lower than the group C (<0.05). After 14 days of treatment, GEPI score showed increasing trend, while NIHSS score showed decreasing trend in the group A compared with the group B. Before treatment, GEPI score was lower and NIHSS score was higher in the group A compared with the group C (<0.05). It was suggested that the illness was slightly serious in the group A. After propensity score matching, in 14, 21 and 28 days as well as in follow-up, GEPI scores in the group A were higher than the group C respectively (<0.05). Regarding NIHSS score at each time point, the difference had no statistical significance between the group A and the group C (>0.05).
The combined therapy of eye acupuncture, and rehabilitation training obtains a better efficacy on post-stroke shoulder-hand syndrome of phlegm-stasis obstruction as compared with rehabilitation training.
评估眼针、中药热敷技术与康复训练联合治疗(眼针+中药热敷+康复)对中风后肩手综合征痰瘀阻络型患者缓解疼痛及改善肩关节活动度的疗效,并与中药热敷与康复训练联合治疗(中药热敷+康复)及单纯康复训练(康复)进行比较。
将356例中风后肩手综合征痰瘀阻络型患者随机分为眼针+中药热敷+康复组(A组,122例,脱落2例)、中药热敷+康复组(B组,120例,脱落3例)和康复组(C组,114例,脱落1例)。C组采用基础治疗并结合常规康复训练。B组在C组治疗基础上施加中药热敷,将由20余味中药组成的药袋加热后敷于患区,每次30分钟,每周5次。A组在B组治疗基础上,加用眼针,针刺心区、肾区、上肢区、下肢区,每次30分钟,每周5次。三组均治疗28天。分别于治疗前、治疗第7、14、21、28天及治疗后随访14天观察各组视觉模拟评分法(VAS)疼痛评分、永久性损伤评定指南(GEPI)评分及美国国立卫生研究院卒中量表(NIHSS)评分。
三组患者VAS、GEPI及NIHSS评分均随治疗时间延长而改善(P<0.000 1)。治疗第7、14、21、28天及随访时,A组VAS评分均低于C组(P<0.05)。治疗14天后,A组GEPI评分呈上升趋势,NIHSS评分呈下降趋势,与B组比较差异有统计学意义。治疗前,A组GEPI评分低于C组,NIHSS评分高于C组(P<0.05),提示A组病情稍重。倾向得分匹配后,治疗第14、21、28天及随访时,A组GEPI评分分别高于C组(P<0.05)。各时间点A组与C组NIHSS评分比较,差异无统计学意义(P>0.05)。
与康复训练相比,眼针、中药热敷与康复训练联合治疗中风后肩手综合征痰瘀阻络型疗效更佳。