摘要
Objective To evaluate the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke. Methods Sixty cases were randomly divided into an acupuncture rehabilitation group （33 cases） and a routine treatment group （27 cases）. Both two groups received rehabilitation exercise, acupuncture rehabilitation group was treated with scalp acupuncture and body acupuncture, and in body acupuncture, Pishu（脾俞 BL 20）, Weishu （胃俞 BE 21）, Zusanli （足三里 ST 36）, Fenglong （丰隆 ST 40）, Xuehai （血海 SP 10）, and accompanying points according to the symptoms were selected; in scalp acupuncture, Baihui （百会 GV 20）, Sishencong （四神聪EX-HN 1）, motor area, vascular dilation and constriction area were selected. Routine treatment group was treated with western drugs, including dehydration with mannitol to reduce intracranial pressure, control blood pressure, and brain cell protective agent was given, triamcinolone acetate solution for shoulder pain or cortisone acetate solution for blocking treatment. The treatment was given once a day, four weeks were one course, and four courses were given in all. The hemorheological indices and the clinical effect of two groups were compared. Results The effective rate of acupuncture rehabilitation group was 90.9% （30/33）, better than that of 70.4% （19/27） in routine treatment group （P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment became lowered than those before the treatment in acupuncture rehabilitation group （all P〈0.05）; whole blood viscosity and plasma viscosity after the treatment was also lowered than those before the treatment in routine treatment group （both P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment in acupuncture rehabilitation group were obviously lowered than those of routine treatment group （all P〈0.05）. Conclusion With good therapeutic effect and better efficacy than routine medical treatment, scalp acupuncture and body acupuncture in combination with rehabilitation exercise can improve the movement, sensation and hemorheology of extremities of patients with hemiplegia and shoulder pain after stroke.
目的:评价头针、体针配合康复训练治疗中风后偏瘫肩痛的疗效。方法:60例患者随机分为针康组(33例)和常规治疗组(27例)。两组均采用康复训练治疗,针康组采用头针配合体针治疗,体针穴取脾俞、胃俞、足三里、丰隆、血海等,并随症配穴;头针穴取百会、四神聪、头穴运动区和血管舒缩区。常规治疗组以西药常规治疗,甘露醇脱水降颅压,调控血压,并给予脑细胞保护剂,肩痛以醋酸确炎舒松药液或醋酸考的松药液封闭治疗。每日治疗1次,4周为一疗程,共治疗4个疗程。比较两组血液流变学指标和临床疗效。结果:针康组有效率为90.9%(30/33),优于常规治疗组的70.4%(19/27)(P<0.05);针康组治疗后全血黏度低中切、血浆黏度、血细胞比容各指标较治疗前均明显降低(均P<0.05);常规治疗组治疗后全血黏度、血浆黏度亦降低(均P<0.05);针康组治疗后全血粘度低中切、血浆粘度、血细胞比容各指标较常规治疗组降低更明显(均P<0.05)。结论:头针、体针结合康复训练治疗在改善中风后偏瘫肩痛患者肢体运动、感觉和血液流变学方面,具有良好的临床疗效,优于常规西医治疗。
