摘要
目的观察星状神经节阻滞联合线性偏振光照射治疗肩手综合征(SHS)的临床疗效。方法收集滨州医学院附属医院疼痛科2015年8月至2019年8月收治的肩手综合征患者60例,性别、年龄不限,按照随机数字表法将其随机分为常规康复组与联合治疗组,每组30例。常规康复组进行常规康复治疗;联合治疗组在常规康复治疗的基础上,采用星状神经节阻滞加线性偏振光照射治疗,1次/d,10 d为1个疗程,治疗2个疗程,共20 d。分别于治疗前和治疗结束时,采用视觉模拟评分(VAS)、简式Fugl-Meyer运动功能评分(FMA)、患肢手掌周长有效改善率比较两组治疗前后疼痛程度、上肢运动功能和水肿程度;根据VAS得分于治疗结束时评价两组患者总有效率。结果两组患者一般资料比较,差异均无统计学意义(P均>0.05)。治疗前,两组患者VAS、FMA评分差异均无统计学意义(P均>0.05);治疗结束时,联合治疗组VAS、FMA评分分别为(2.3±1.8)分、(56.8±5.3)分,常规康复组分别为(4.6±2.5)分、(40.2±5.1)分,联合治疗组疗效显著优于常规康复组(P均<0.05)。联合治疗组患者治疗后VAS 0~3分例数显著多于常规康复组(23例比11例,P=0.002)。联合治疗组患者患肢手掌周长有效改善率为86.7%,显著高于常规康复组56.7%(P=0.010)。联合治疗组总有效率为93.3%,显著高于常规康复组63.3%(P=0.005)。联合治疗组不良反应发生率明显低于常规康复组(χ^(2)=4.04,P<0.05)。结论常规康复治疗及星状神经节阻滞联合线性偏振光照射治疗均能改善肩手综合征患者的临床症状及上肢功能,但联合治疗的临床疗效更显著。
Objective To evaluate the clinical efficacy of stellate ganglion block combined with linear polarized light irradiation in treatment of patients with shouder-hand syndrome.Methods Sixty patients with shouder-hand syndrome in Department of Pain Medicine,Binzhou Medical University Hospital,no gender and age limitation,from August 2015 to August 2019,were enrolled and randomly divided into conventional rehabilitation group and combined treatment group,with 30 cases in each group.Patients were treated with routine rehabilitation treatment in the conventional rehabilitation group,while patients were treated with stellate ganglion block combined with linear polarized light irradiation based on routine rehabilitation treatment in the combined treatment group.Both groups were treated once a day for 2 courses with 10 days in a course(20 days).Visual analogue scale(VAS),upper limb simplification Fugl-Meyer assessment(FMA),and the effective improvement rate of palm circumference were used to evaluate the degree of pain,upper limbs function and edema before and after the treatment.The total effective rate of the two groups was evaluated at the end of the treatment according to the VAS.Results There was no significant difference in general data between the two groups(all P>0.05).Before the treatment,there were no significant differences of VAS and FMA score between the two groups(all P>0.05).At the end of the treatment,VAS and FMA score were(2.3±1.8)and(56.8±5.3)in the combined treatment group,while(4.6±2.5)and(40.2±5.1)in the conventional rehabilitation group,respectively.The curative effect was significantly better in the combined treatment group than that in the conventional rehabilitation group(all P<0.05).The number of VAS 0-3 patients was much more in the combined treatment group than that in the conventional rehabilitation group(23 cases vs.11 cases,P=0.002).The effective improvement rate of palm circumference was significantly higher in the combined treatment group(86.7%)than that in the conventional rehabilitation group(56.7%,P=0.010).The total effective rate was 93.3%in the combined treatment group,which was significantly higher than that in the conventional rehabilitation group 63.3%(P=0.005).The incidence of adverse reactions was significantly lower in the combined treatment group than that in the conventional rehabilitation group(χ2=4.04,P<0.05).Conclusion Both stellate ganglion block combined with linear polarized light irradiation and routine rehabilitation treatment can improve the clinical symptoms and upper limb function in patients with shouder-hand syndrome,but the efficacy of the combined treatment is better.
作者
孙晶
郑华宾
于慧
高勇
Sun Jing;Zheng Huabin;Yu Hui;Gao Yong(Department of Pain Medicine,Binzhou Medical University Hospital,Binzhou City,Shandong Province 256603,China)
出处
《中华疼痛学杂志》
2022年第2期259-264,共6页
Chinese Journal Of Painology
基金
山东省自然科学基金资助项目(ZR2017MH125)。
