针刺结合神灯照射治疗脑卒中后肩手综合征的临床疗效观察
发布时间：2018-07-15 18:30
【摘要】：目的:观察在中医治则的指导下针刺疗法结合TDP神灯照射治疗脑卒中后肩手综合征患者的临床疗效,探究其治疗原则、安全性及有效性,为临床治疗脑卒中后肩手综合征提供更多的临床数据资料,用以更好发展针刺治疗及经络腧穴理论在本病临床治疗上的应用。材料与方法:根据中西医诊断标准,选取2014年3月至2015年12月辽宁中医药大学附属医院康复中心脑K1病房的脑卒中后肩手综合征的患者共47例,采取随机数字表法,将入选患者随机分为2组,其中观察组24例,对照组23例。2组均给予中西医常规基础药物及康复治疗,观察组在此基础上给予针刺治疗结合TDP神灯照射。针刺治疗均1次/日,每次留针30分钟,4周为一疗程,在针刺治疗基础上予TDP神灯照射。最后通过治疗前及疗程结束之后进行相关临床功能评定:临床神经功能缺损程度评分(NDS)、肩手综合征水肿程度评分、上肢简化Fugl-Meyer运动功能评分(FMA)、上肢疼痛评定视觉模拟量表(VAS)、改良Barthel指数评分等,统计各项的观察量表数据,运用SPSS20.0统计软件分别进行组内、组间比较,来系统的评价针刺结合神灯照射对脑卒中后肩手综合征的疗效。结果:1.临床共收集符合纳入标准病史47例,其中观察组24例,对照组23例。治疗前两组患者在性别、年龄、病程、上肢运动功能评分、日常生活活动能力评分、疼痛、水肿程度评估上,均无显著差异(P0.05),具有组间可比性。2.两组治疗前后相比统计差异均显著(P0.05),症状均有明显好转。3.治疗后两组相比较,VAS评分显示,治疗后评分比较统计学差异显著(P0.05),疗效明显;水肿程度评分、神经缺损程度NDS评分、上肢FMA评分、生活能力Barthel评分显示差异性不显著(P0.05)。结论:1.针刺结合神灯照射康复疗法与单纯康复疗法对脑卒中后肩手综合征均有较好的改善作用。2.针刺结合神灯康复组在疼痛评分上,疗效差异显著,明显优于对照组;在神经缺损程度评分、水肿程度评分、上肢运动功能评定和日常生活能力评分上,两组疗效均佳,观察组于疗效上略优于对照组,但差异并不显著。3.针刺结合神灯照射及康复训练均为临床治疗常用方法,在改善患者临床肿痛症状及活动能力均有极佳疗效,具有良好的可行性,协同治疗可发挥更好疗效,值得临床推广应用。
[Abstract]:Objective: to observe the clinical effect of acupuncture combined with TDP lamp irradiation on patients with shoulder and hand syndrome after stroke under the guidance of traditional Chinese medicine, and to explore the principle, safety and effectiveness of the treatment. To provide more clinical data for the treatment of shoulder and hand syndrome after stroke, and to develop the application of acupuncture therapy and meridian acupoint theory in the clinical treatment of this disease. Materials and methods: according to the diagnostic criteria of traditional Chinese and western medicine, 47 patients with post-stroke shoulder-hand syndrome were selected from the brain K1 ward of the Rehabilitation Center of Liaoning University of traditional Chinese Medicine from March 2014 to December 2015. The patients were randomly divided into two groups: the observation group (n = 24) and the control group (n = 23) were treated with traditional Chinese and western medicine and rehabilitation therapy. The observation group was treated with acupuncture combined with TDP lamp irradiation. Acupuncture treatment was done once a day for 30 minutes and 4 weeks as a course of treatment. TDP lamp irradiation was performed on the basis of acupuncture therapy. Finally, the related clinical functions were evaluated before and after the treatment: clinical neurological deficit scale (NDS), edema degree of shoulder and hand syndrome, The simplified Fugl-Meyer motor function score (FMA), visual analogue scale (VAS) and modified Barthel index (Barthel index) for upper limb pain assessment were compared between groups by SPSS 20.0 statistical software. To systematically evaluate the efficacy of acupuncture combined with lamp irradiation in the treatment of shoulder-hand syndrome after stroke. The result is 1: 1. A total of 47 cases were collected, including 24 cases in the observation group and 23 cases in the control group. Before treatment, there was no significant difference in gender, age, course of disease, upper limb motor function score, ADL score, pain and edema evaluation between the two groups (P0.05). The statistical difference between the two groups before and after treatment was significant (P0.05), the symptoms were significantly improved. 3. After treatment, the scores of VAS were significantly different (P0.05), and the scores of edema, NDS, FMA and Barthel were not significant (P0.05). Conclusion 1. Acupuncture combined with Shenlantern irradiation rehabilitation therapy and simple rehabilitation therapy have better effects on shoulder and hand syndrome after stroke. The pain score of acupuncture combined with Shen-lantern rehabilitation group was significantly different and better than that of the control group, and the two groups had good curative effect on the scores of nerve defect, edema, upper limb motor function and daily living ability. The observation group was slightly better than the control group in curative effect, but the difference was not significant. Acupuncture combined with Shenlantern irradiation and rehabilitation training are common methods in clinical treatment. They have excellent curative effect in improving the symptoms and activities of clinical swelling and pain, and have good feasibility. The synergistic treatment can play a better effect and is worthy of clinical popularization and application.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7
，
本文编号：2125000
[Abstract]:Objective: to observe the clinical effect of acupuncture combined with TDP lamp irradiation on patients with shoulder and hand syndrome after stroke under the guidance of traditional Chinese medicine, and to explore the principle, safety and effectiveness of the treatment. To provide more clinical data for the treatment of shoulder and hand syndrome after stroke, and to develop the application of acupuncture therapy and meridian acupoint theory in the clinical treatment of this disease. Materials and methods: according to the diagnostic criteria of traditional Chinese and western medicine, 47 patients with post-stroke shoulder-hand syndrome were selected from the brain K1 ward of the Rehabilitation Center of Liaoning University of traditional Chinese Medicine from March 2014 to December 2015. The patients were randomly divided into two groups: the observation group (n = 24) and the control group (n = 23) were treated with traditional Chinese and western medicine and rehabilitation therapy. The observation group was treated with acupuncture combined with TDP lamp irradiation. Acupuncture treatment was done once a day for 30 minutes and 4 weeks as a course of treatment. TDP lamp irradiation was performed on the basis of acupuncture therapy. Finally, the related clinical functions were evaluated before and after the treatment: clinical neurological deficit scale (NDS), edema degree of shoulder and hand syndrome, The simplified Fugl-Meyer motor function score (FMA), visual analogue scale (VAS) and modified Barthel index (Barthel index) for upper limb pain assessment were compared between groups by SPSS 20.0 statistical software. To systematically evaluate the efficacy of acupuncture combined with lamp irradiation in the treatment of shoulder-hand syndrome after stroke. The result is 1: 1. A total of 47 cases were collected, including 24 cases in the observation group and 23 cases in the control group. Before treatment, there was no significant difference in gender, age, course of disease, upper limb motor function score, ADL score, pain and edema evaluation between the two groups (P0.05). The statistical difference between the two groups before and after treatment was significant (P0.05), the symptoms were significantly improved. 3. After treatment, the scores of VAS were significantly different (P0.05), and the scores of edema, NDS, FMA and Barthel were not significant (P0.05). Conclusion 1. Acupuncture combined with Shenlantern irradiation rehabilitation therapy and simple rehabilitation therapy have better effects on shoulder and hand syndrome after stroke. The pain score of acupuncture combined with Shen-lantern rehabilitation group was significantly different and better than that of the control group, and the two groups had good curative effect on the scores of nerve defect, edema, upper limb motor function and daily living ability. The observation group was slightly better than the control group in curative effect, but the difference was not significant. Acupuncture combined with Shenlantern irradiation and rehabilitation training are common methods in clinical treatment. They have excellent curative effect in improving the symptoms and activities of clinical swelling and pain, and have good feasibility. The synergistic treatment can play a better effect and is worthy of clinical popularization and application.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7
，
本文编号：2125000
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