腕踝针联合耳穴贴压治疗脑卒中后肩手综合征Ⅰ期临床观察OA
Clinical observation of wrist-ankle acupuncture plus auricular point sticking for poststroke shoulder-hand syndrome in phase Ⅰ
目的:观察腕踝针联合耳穴贴压治疗脑卒中后肩手综合征(PS-SHS)Ⅰ期的临床疗效及对疼痛及关节活动度的影响.方法:纳入90例PS-SHS Ⅰ期患者,根据不同治疗方法分为常规组、耳穴组和联合组,每组30例.常规组采用常规康复训练;耳穴组在常规康复训练基础上加用耳穴贴压法;联合组在耳穴组的基础上加用腕踝针治疗.每周连续治疗5 d,休息2 d,每组均连续治疗6周.比较三组临床疗效、疼痛评分、关节活动度指标、血清内皮素-1(ET-1)、一氧化氮(NO)和缓激肽(BK)水平,以及生活质量和不良反应发生率.结果:治疗后联合组总有效率为96.7％,显著高于常规组的70.0％和耳穴组的83.3％(P<0.05).治疗3周和6周后,三组患者的疼痛评分均降低(P<0.05),且联合组明显低于同时间点常规组和耳穴组(P<0.05).治疗后,三组患者上肢关节活动度及生活质量评分均上升(P<0.05),且联合组显著高于常规组和耳穴组(P<0.05).治疗6周后三组患者的血清ET-1及BK水平均较治疗前下降,血清NO水平均较治疗前上升(P<0.05).联合组血清ET-1和BK水平明显低于常规组和耳穴组(P<0.05),血清NO水平明显高于常规组和耳穴组(P<0.05).三组患者治疗期间无不良反应发生.结论:腕踝针联合耳穴贴压治疗PS-SHS Ⅰ期患者的临床疗效优于其他两种治疗方案,在减轻患者疼痛程度,促进关节活动功能恢复,提高生活质量方面优势明显,且安全性高.
Objective:To observe the clinical efficacy of wrist-ankle acupuncture plus auricular point sticking for poststroke shoulder-hand syndrome(PS-SHS)in phase Ⅰ and its effect on pain and range of motion(ROM). Methods:A total of 90 patients with PS-SHS in phase Ⅰ were enrolled and divided into a conventional group,an auricular point group,and a combination group according to different treatment methods,with 30 cases in each group.The conventional group was treated with conventional rehabilitation training,and the auricular point group was treated with additional auricular point sticking.The combination group was treated with additional wrist-ankle acupuncture on the basis of the auricular point group treatment.The treatment was performed consecutively for 5 d per week,followed by 2 d of rest,with each group undergoing consecutive treatment for 6 weeks.The clinical efficacy,pain score,ROM indicator,serum levels of endothelin-1(ET-1),nitric oxide(NO),and bradykinin(BK),quality of life(QOL),and adverse reaction incidence rate were compared among the three groups. Results:After treatment,the total effective rate of the combination group was 96.7%,which was significantly higher than 70.0%of the conventional group and 83.3%of the auricular point group(P<0.05).After 3 weeks and 6 weeks of treatment,the pain score in all three groups decreased(P<0.05),and the score in the combination group was significantly lower than that in the conventional group and auricular point group at the same time point(P<0.05).After treatment,the ROM of the upper limbs,and the QOL score in all three groups increased(P<0.05),and the scores in the combination group were significantly higher than those in the conventional group and auricular point group(P<0.05).After 6 weeks of treatment,the serum levels of ET-1 and BK in all three groups were decreased compared with those before treatment,while the serum NO level increased(P<0.05).The serum levels of ET-1 and BK in the combination group were significantly lower than those in the conventional group and auricular point group(P<0.05),and the serum NO level in the combination group was significantly higher than that in the other two groups(P<0.05).No adverse reactions occurred during treatment in the three groups. Conclusion:Wrist-ankle acupuncture combined with auricular point sticking treatment has better clinical efficacy in the treatment of PS-SHS in phase Ⅰ than the other two treatment protocols,and has significant advantages in relieving pain,improving the recovery of articular activity function,and enhancing QOL,with good safety.
周英;金林珍;刘海飞;夏小云;宋丰军;张馥晴
医药卫生
腕踝针耳穴贴压疼痛测评日常生活活动活动范围,关节中风后遗症肩痛肩手综合征
Wrist-ankle AcupunctureAuricular Point StickingPain MeasurementActivities of Daily LivingRange of Motion,ArticularPoststroke SyndromeShoulder PainShoulder-hand Syndrome
《针灸推拿医学（英文版）》 2026 (3)
247-254,8
This study was supported by Basic Public Welfare Research Project of Wenzhou Science and Technology Bureau(温州市科技局基础公益科研项目,No.Y2023953).
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