董氏奇穴治疗脑卒中后肩手综合征的临床研究

发布时间：2018-05-29 01:43

本文选题：脑卒中 + 肩手综合征　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:观察董氏奇穴治疗脑卒中后肩手综合征的临床疗效。方法:将60例脑卒中后肩手综合征患者,采用随机数字表法分为董氏奇穴治疗组(简称治疗组)和常规针刺组(简称对照组),每组各30例。治疗组:董氏奇穴取患者健侧灵骨、大白、四花中穴、双侧肾关穴。采用华佗牌一次性无菌针灸针,大白向同侧灵骨齐刺15mm~25mm,四花中穴直刺25mm~50mm后,左右两旁各开1寸并向其齐刺;肾关穴应向后肾经方向直刺,一般15mm~40mm,得气后留针,时间为30min,每隔5min行针1次;在行针的同时嘱患者主动或被动活动其患侧的上肢。对照组:取局部肩毭、肩毼、肩贞、曲池、外关、合谷针刺。每日1次,电针治疗30min,10次为1疗程,连续治疗3疗程。治疗前后分别采用疼痛视觉模拟评分法(VAS)、上肢Fugl-Meyer运动功能评分量表、水肿评分与日常生活功能(Barthel)量表等来评定两组在疼痛、上肢运动功能、水肿及日常生活功能等的变化,从而进行疗效分析。结果:1.临床疗效:治疗组总有效率为93.33%,对照组总有效率为73.33%,两组统计学分析具有显著性差异(P0.05),治疗组优于对照组。2.VAS评分:两组治疗后VAS评分与治疗前比较,有非常显著性差异(P0.01),两组治疗后比较有显著性差异(P0.05)。3.Fugl-Meyer积分:两组治疗后Fugl-Meyer评分与治疗前比较均有非常显著性差异(P0.0l),两组间比较,差异有统计学意义(P0.05)。4.水肿评分:两组治疗后水肿评分较治疗前有显著性差异(P0.05),两组间比较无显著性差异(P0.05)。5.日常生活活动能力ADL评分:两组治疗后较治疗前有显著性差异(P0.01,P0.05),两组间比较差异有统计学意义(P0.01)。结论:董氏奇穴治疗组治疗脑卒中后肩手综合征,可有效缓解疼痛,减轻水肿,改善患者上肢运动功能和日常生活活动能力,且疗效优于常规针刺组。董氏奇穴疗法体现了奇法奇效,为针灸治疗脑卒中后肩手综合征提供了一种新的方法,以供临床医生参考。
[Abstract]:Objective: to observe the clinical effect of Dong Shiqi on shoulder-hand syndrome after stroke. Methods: sixty patients with shoulder and hand syndrome after stroke were randomly divided into two groups: the treatment group (treatment group) and the routine acupuncture group (30 cases in each group). In the treatment group, the healthy side Linggu, Daqing, Sihuazhong point and bilateral Shenguan point were taken from the patients. Using a disposable sterile acupuncture needle of Huatuo brand, Dabai needled 15mm or 25mm to the same side of the spirit bone, 1 inch on each side of the left and right sides and 1 inch on the left side after the point of Sihuazhong was punctured directly, and the point of Shenguan should be pricked directly to the direction of the posterior kidney meridian, generally 15mm or 40mm, so that the needle could be kept after getting qi. The time was 30 minutes, once every 5min, and the patient was told to move the upper limb of the affected side actively or passively. In the control group, local shoulder, chestnut, Quchi, Waiguan and Hegu acupuncture were taken. Once a day, 10 times electroacupuncture treatment for 30 mins as a course of treatment, 3 consecutive courses of treatment. Before and after treatment, the changes of pain, upper limb motor function, edema score and daily life function were evaluated by visual analogue score, Fugl-Meyer motor function scale, edema score and daily life function scale respectively, and the changes of pain, upper limb motor function, edema and daily life function were evaluated before and after treatment. So as to carry on the curative effect analysis. The result is 1: 1. Clinical efficacy: the total effective rate of the treatment group was 93.33 and the total effective rate of the control group was 73.33. There was a significant difference between the two groups in statistical analysis. The treatment group was superior to the control group in the score of .2.VAS: the VAS score of the two groups after treatment was compared with that before treatment. There was a very significant difference between the two groups after treatment. There was a significant difference between the two groups after treatment. 3. Fugl-Meyer score: there was a very significant difference in Fugl-Meyer score between the two groups after treatment and before treatment. The difference between the two groups was statistically significant. Edema score: there was significant difference in edema score after treatment between the two groups (P 0.05), but there was no significant difference between the two groups (P 0.05). Activity of daily living (ADL) score: there was a significant difference between the two groups after treatment than before treatment P0.01and P0.05, the difference between the two groups was statistically significant (P 0.01). Conclusion: the treatment group of Dong Shiqi acupoint can effectively relieve pain, relieve edema, improve upper limb motor function and activity of daily life in treating shoulder and hand syndrome after stroke, and the curative effect is better than that of routine acupuncture group. The therapy of Dong's Qi points embodies the strange effect of Qifa and provides a new method for acupuncture and moxibustion in the treatment of shoulder-hand syndrome after stroke for the reference of clinicians.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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