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贺涟漪,廖若夷,蔡喆燚,张诚诚,李振东,张月娟.虎符铜砭刮痧治疗脑卒中后肩手综合征Ⅰ期的临床观察及对血清BK、ET-1的影响[J].湖南中医药大学学报,2023,43(1):148-152[点击复制] |
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虎符铜砭刮痧治疗脑卒中后肩手综合征Ⅰ期的临床观察及对血清BK、ET-1的影响 |
贺涟漪,廖若夷,蔡喆燚,张诚诚,李振东,张月娟 |
(湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南中医药大学, 湖南 长沙 410208) |
摘要: |
目的 观察虎符铜砭刮痧对脑卒中后肩手综合征(shoulder-hand syndrome,SHS)Ⅰ期的临床疗效,并探寻其治疗机制。方法 选取2020年1月至2021年6月于湖南中医药大学第一附属医院针灸推拿康复科、神经内科、神经外科住院部及门诊收治符合入组条件的60例脑卒中后SHS患者。采用随机数字表法分为试验组和对照组,各30例。对照组采取常规康复治疗,试验组在对照组的基础上采用虎符铜砭刮痧疗法,每日2次,每次40min,每周5d。连续治疗2个月后,观察巴氏量表(Barthel)指数、痛觉视觉模拟评分(visual analogue scale,VAS)、水肿度、缓激肽(bradykinin,BK)及内皮素-1(endothelin-1,ET-1)含量的变化,并评价2组的临床疗效。结果 两组患者Barthel指数较治疗前均明显提高(P<0.01),且试验组提高程度明显优于对照组(P<0.05)。两组患者VAS评分、水肿评分、BK和ET-1含量较治疗前均明显降低(P<0.01),且试验组明显低于对照组(P<0.05)。试验组总有效率为96.67%,愈显率为60.00%;对照组总有效率为90.00%,愈显率为33.33%。两组患者的总有效率比较,差异无统计学意义,但试验组愈显率明显优于对照组(P<0.01)。结论 虎符铜砭刮痧可有效改善脑卒中后SHS Ⅰ期患者的Barthel指数、VAS评分、水肿度,疗效明显,其作用机制可能与降低BK和ET-1水平有关。 |
关键词: 脑卒中 肩手综合征 虎符铜砭刮痧 缓激肽 内皮素-1 临床疗效 |
DOI:10.3969/j.issn.1674-070X.2023.01.024 |
投稿时间:2021-12-16 |
基金项目:湖南省中医药科研计划项目(2020004);湖南省院士专家工作站(石学敏)开放基金项目(201917)。 |
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Stage Ⅰ shoulder-hand syndrome after stroke treated by Hufu Copper-bian Guasha and the effects on serum BK and ET-1 |
HE Lianyi,LIAO Ruoyi,CAI Zheyi,ZHANG Chengcheng,LI Zhendong,ZHANG Yuejuan |
(The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
Abstract: |
Objective To observe the clinical efficacy of Hufu Copper-bian Guasha on stage Ⅰ shoulder-hand syndrome (SHS) after stroke, and explore its mechanism. Methods We selected 60 cases with SHS after stroke from patients enrolled in the inpatient and outpatient of Acupuncture and Tuina, and Rehabilitation Department, Neurology Department, and Neurosurgery Department in the First Hospital of Hunan University of Chinese Medicine from January 2020 to June 2021. They were randomly divided into experimental group and control group, with 30 cases each. The control group was treated with conventional rehabilitation, and the experimental group was treated with Hufu Copper-bian Guasha Therapy twice a day, 40 min each time, 5 d per week. After 2 months of continuous treatment, the Barthel index, the visual analogue scale (VAS) score, edema, bradykinin (BK) and endothelin-1 (ET-1) content were observed and the clinical efficacy of the two groups was evaluated. Results The Barthel index of both groups was significantly higher than that before treatment (P<0.01), and the experimental group was significantly better than that of the control group (P<0.05). The VAS score, edema score, BK and ET-1 content of the two groups were significantly lower than those before treatment (P<0.01), and the experimental group was significantly lower than that of the control group (P<0.05). The total effective rate of the experimental group was 96.67%; while the recovery and apparent recovery rate was 60.00%. The total effective rate of the control group was 90.00%, while the recovery and apparent recovery rate was 33.33%. The total effective rates of the two groups were not statistically significant, but that of the experimental group was significantly better than the control group (P<0.01). Conclusion Hufu Copper-bian Guasha Therapy can effectively optimize the Barthel index, VAS score and edema in SHS stage Ⅰ patients after stroke. The mechanism of action may be related to reducing BK and ET-1 levels. |
Key words: stroke shoulder-hand syndrome Hufu Copper-bian Guasha bradykinin endothelin-1 clinical efficacy |
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