| 宗彦霞,张卓,李宁,等.活血通络汤联合利脑通络针刺法治疗气虚血瘀型卒中后肩手综合征对运动功能和血流动力学的影响[J].安徽医药,2025,29(2):368-372. |
| 活血通络汤联合利脑通络针刺法治疗气虚血瘀型卒中后肩手综合征对运动功能和血流动力学的影响 |
| Effects of Huoxue Tongluo decoction combined with acupuncture method of promoting brain circulation and dredging collaterals on motor function and hemodynamics in the treatment of shoulder hand syndrome after stroke of qi deficiency and blood stasis type |
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| DOI：10.3969/j.issn.1009-6469.2025.02.032 |
| 中文关键词: 反射性交感神经营养障碍 活血通络汤 利脑通络针刺法 卒中后肩手综合征 运动功能 血流动力学 |
| 英文关键词: Reflex sympathetic dystrophy Huoxue Tongluo decoction Acupuncture method of promoting brain circulation and dredging collaterals Shoulder hand syndrome after stroke Motor function Hemodynamics |
| 基金项目:河南省医学科技攻关计划联合共建项目( LHGJ20200797) |
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| 中文摘要: |
| 目的探讨活血通络汤联合利脑通络针刺法治疗气虚血瘀型卒中后肩手综合征对运动功能和血流动力学的影响。方法选取 2021年 1月至 2022年 12月南阳市第二人民医院收治的 90例气虚血瘀型卒中后肩手综合征病人，利用随机数字表法分为联合组、中药组、针刺组，每组各 30例，中药组予活血通络汤治疗，针刺组予利脑通络针刺法治疗，联合组予活血通络汤联合利脑通络针刺法治疗，比较三组治疗前后疼痛程度［视觉模拟评分法( VAS)］、肩手综合征量表( SHSS)、运动功能［上肢 Fugl-Meyer评定(FMA)］、日常生活能力［Barthel指数( BI)］、炎症因子［降钙素基因相关肽( CGRP)、缓激肽( BK)］及血流动力学［峰值血流速度( PBFV)、循环系统外周阻力( PR)］。观察三组临床疗效。结果联合组总有效率( 93.33%)较中药组(63.33%)、针刺组( 67.67%)高( P=0.017)；三组治疗后 VAS评分、 SHSS评分均较治疗前降低，且联合组较中药组、针刺组低( P<0.05)；三组治疗后 FMA评分、 BI评分均较治疗前升高，且联合组较中药组、针刺组高( P<0.05)；三组治疗后 CGRP、PBFV均较治疗前升高，且联合组较中药组、针刺组高( P<0.05)；三组治疗后 BK、PR较治疗前降低，且联合组较中药组、针刺组低( P<0.05)。结论活血通络汤联合利脑通络针刺法治疗气虚血瘀型卒中后肩手综合征疗效确切，可缓解临床症状及疼痛程度，提高运动功能和日常生活能力，改善血流动力学，减轻炎症反应。 |
| 英文摘要: |
| Objective To explore the effect of Huoxue Tongluo decoction combined with acupuncture method of promoting brain cir-culation and dredging collaterals on motor function and hemodynamics in the treatment of shoulder hand syndrome after stroke of qi de-ficiency and blood stasis type.Methods A total of 90 patients with shoulder hand syndrome after stroke of qi deficiency and blood sta-sis type admitted to Nanyang Second People's Hospital from January 2021 to December 2022 were randomly divided into a combina-tion group, a traditional chinese medicine group, and an acupuncture group using a random number table method, with 30 patients ineach group. The traditional chinese medicine group was treated with Huoxue Tongluo Decoction, the acupuncture group was treated with Li Nao Tongluo acupuncture method, and the observation group was treated with Huoxue Tongluo decoction combined with Li Nao Tongluo acupuncture method. The pain degree [visual analogue scores (VAS) ], shoulder hand syndrome scale (SHSS), motor function[upper limb Fugl-Meyer Assessment (FMA)], daily living ability [Barthel Index (BI)], inflammatory factors [calcitonin gene related pep‐tide (CGRP), bradykinin (BK)], and hemodynamics [peak blood flow velocity (PFV), peripheral resistance (PR)] were compared amongthe three groups before and after treatment. The clinical efficacy of three groups was observed.Results The total effective rate of the combined group (93.33%) were higher than those of the traditional chinese medicine group (63.33%) and the acupuncture group(67.67%) (P=0.017). After treatment, the VAS scores and SHSS scores of the three groups were lower than before treatment, and thecombined group was lower than the traditional chinese medicine group and acupuncture group (P<0.05). After treatment, the FMAscores and BI scores of the three groups were higher than before treatment, and the combined group was higher than the traditional chi-nese medicine group and acupuncture group (P<0.05). After treatment, CGRP and PBFV in the three groups increased compared to those before treatment, and the combined group was higher than those in the traditional chinese medicine group and acupuncture group(P<0.05). After treatment, BK and PR in the three groups decreased compared to those before treatment, and the combined group waslower than those in the traditional chinese medicine group and acupuncture group (P<0.05).Conclusion Huoxue Tongluo decoctioncombined with acupuncture method of promoting brain circulation and dredging collaterals has a definite therapeutic effect on shoulderhand syndrome after stroke of qi deficiency and blood stasis type, which can reduce clinical symptoms and pain levels, improve motorfunction and daily living ability, improve hemodynamics, and reduce inflammatory reactions. |
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