摘要
目的探讨应用悬艾结合手法淋巴引流(MLD)技术对脑卒中后肩手综合征Ⅰ期患者的临床疗效。方法120例神经内科患者,随机分为常规治疗组、悬艾组、手法淋巴引流组、悬艾+手法淋巴引流组,每组30例。常规治疗组采用基本的康复治疗,悬艾组在基本的康复治疗基础上联合悬艾治疗,手法淋巴引流组在基本的康复治疗基础上联合淋巴引流。悬艾+手法淋巴引流组在基本的康复治疗基础上联合悬艾+手法淋巴引流治疗。比较两组视觉模拟评分法(VAS)评分、肿胀程度、Fugl-Meyer上肢运动功能评分法(FMA)评分、总被动关节活动度(TPM)、改良Barthel指数(MBI)评分以及临床效果。结果悬艾组与悬艾+手法淋巴引流组的VAS评分分别为(4.90±1.12)、(3.54±1.78)分,均低于常规治疗组的(6.21±0.78)分和手法淋巴引流组的(5.92±1.08)分,差异均具有统计学意义(P<0.05)。悬艾+手法淋巴引流组与手法淋巴引流组的肿胀程度分别为(5.31±1.54)、(7.21±1.87)ml,均低于悬艾组的(11.09±2.08)ml和常规治疗组的(12.56±1.22)ml,差异具有统计学意义(P<0.05)。悬艾+手法淋巴引流组的FMA评分(23.76±4.67)分和TPM(227.17±10.18)°高于悬艾组的(13.57±4.12)分、(198.87±11.34)°,常规治疗组的(14.11±3.24)分、(192.34±14.23)°和手法淋巴引流组的(15.23±2.78)分、(197.42±17.07)°,差异具有统计学意义(P<0.05)。治疗前后四组MBI评分比较,差异均无统计学意义(P>0.05)。悬艾+手法淋巴引流组治疗总有效率93.33%高于常规治疗组的50.00%、悬艾组的56.67%、手法淋巴引流组的60.00%,差异均具有统计学意义(P>0.05)。结论利用悬艾的温热效应结合手法淋巴引流的消肿作用对脑卒中后肩手综合征Ⅰ期患者进行结合治疗,能够对肩手综合征患者上肢功能的康复起到非常显著的疗效,此方法安全有效,值得临床推广。
Objective To discuss the clinical efficacy of Chinese mugwort therapy combined with manual lymphatic drainage(MLD)on patients with stage I shoulder-hand syndrome after stroke.Methods A total of 120 patients with stageⅠshoulder-hand syndrome after stroke were randomly divided into conventional treatment group,Chinese mugwort group,manual lymphatic drainage group,and Chinese mugwort+manual lymphatic drainage group,with 30 cases in each group.The conventional group received basic rehabilitation therapy,Chinese mugwort group received Chinese mugwort therapy on the basis of basic rehabilitation therapy,manual lymphatic drainage group received manual lymphatic drainage on the basis of basic rehabilitation therapy,and Chinese mugwort+manual lymphatic drainage group received Chinese mugwort+manual lymphatic drainage on the basis of basic rehabilitation therapy.The visual analogue scale(VAS)score,edema degree,Fugl-Meyer assessment scale(FMA)score,total passive motion(TPM),modified Barthel index(MBI)score and clinical effect were compared between the two groups.Results The VAS score were(4.90±1.12)and(3.54±1.78)points in Chinese mugwort group and Chinese mugwort+manual lymphatic drainage group,which were all lower than(6.21±0.78)points in conventional group and(5.92±1.08)points in manual lymphatic drainage group,and their difference was statistically significant(P<0.05).The edema degree were(5.31±1.54)and(7.21±1.87)ml in Chinese mugwort+manual lymphatic drainage group and manual lymphatic drainage group,which were all lower than(11.09±2.08)ml in Chinese mugwort group and(12.56±1.22)ml in conventional group,and their difference was statistically significant(P<0.05).The FMA score(23.76±4.67)points and TPM(227.17±10.18)°in Chinese mugwort+manual lymphatic drainage group were higher than(13.57±4.12)points,(198.87±11.34)°in Chinese mugwort group,(14.11±3.24)points,(192.34±14.23)°in conventional group,and(15.23±2.78)points and(197.42±17.07)°in manual lymphatic drainage group.Their difference was statistically significant(P<0.05).Before and after treatment,there was no statistically significant difference in MBI score among four groups(P>0.05).The total effective rate of treatment 93.33%in Chinese mugwort+manual lymphatic drainage group was higher than 50.00%in conventional group,56.67%in Chinese mugwort group and 60.00%in manual lymphatic drainage group.Their difference was statistically significant(P>0.05).Conclusion For patients with stageⅠshoulderhand syndrome after stroke,warm effect of Chinese mugwort combined with the detumescence effect of manual lymphatic drainage plays a very significant role in the rehabilitation of upper limb function of shoulder-hand syndrome patients.This method is safe and effective,and is worthy of clinical promotion.
作者
李豪
李霞
LI Hao;LI Xia(Department of Rehabilitation Medicine,Panyu District Central Hospital,Guangzhou 511400,China)
出处
《中国实用医药》
2020年第3期1-4,共4页
China Practical Medicine
基金
广州市番禺区科技计划项目一般项目(项目编号:2018-Z04-49)。
关键词
悬艾
淋巴引流
脑卒中
肩手综合征Ⅰ期
Chinese mugwort therapy
Lymphatic drainage
Stroke
StageⅠshoulder-hand syndrome
