百会透曲鬓穴针法联合悬吊疗法治疗中风后复杂性区域疼痛综合征Ⅰ型效果观察

王静; 王瑞平; 薛洋; 宋宇锦; 谷玉静; 朱琳

doi:10.16766/j.cnki.issn.1674-4152.003263

百会透曲鬓穴针法联合悬吊疗法治疗中风后复杂性区域疼痛综合征Ⅰ型效果观察

doi: 10.16766/j.cnki.issn.1674-4152.003263

河南中医药大学第一附属医院康复科, 河南郑州 450000

基金项目:

河南省中医药科学研究专项课题 2019JDZX2066

详细信息

通讯作者:
朱琳，E-mail: zhulin98712@163.com

中图分类号: R245.3 R255.2
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出版历程
- 收稿日期: 2023-03-23
- 网络出版日期: 2024-01-13

Observation on the curative effect of Baihui penetrating Qubin acupuncture combined with suspension therapy in the treatment of complex regional pain syndrome type Ⅰ after stroke

Department of Rehabilitation, First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan 450000, China

摘要

摘要: 目的观察百会透曲鬓穴针法联合悬吊疗法对中风后复杂性区域疼痛综合征Ⅰ型(CRPS-Ⅰ)患者疼痛、上肢功能、肩关节活动、手部肿胀及日常生活能力的影响。方法选取2021年7月—2022年12月河南中医药大学第一附属医院收治的中风后CRPS-Ⅰ患者120例，按随机数表法分为对照组、头针组、悬吊组及联合组，每组30例。对照组采用常规康复训练，头针组、悬吊组及联合组在此基础上分别给予百会透曲鬓穴针法、悬吊疗法及二者联合治疗。比较各组治疗前后的疼痛评分(VAS)、上肢功能评分Fugl-Meyer(FMA-UE)、手部肿胀程度、肩关节被动活动角度(PROM)和改良Barthel指数(MBI)。结果治疗前各组患者VAS评分[(8.14±1.06)分、(8.07±1.01)分、(8.11±1.10)分、(8.06±1.13)分，F=0.082，P=0.756]、FMA-UE评分、手部肿胀程度、PROM及MBI评分的差异无统计学意义(均P>0.05)。治疗后2、4周，各组患者VAS评分、手部肿胀程度低于治疗前，同时经组间比较头针组、悬吊组、联合组低于对照组，联合组则低于头针组、悬吊组，差异有统计学意义(均P < 0.05)；各组患者治疗后2周与4周的FMA-UE评分、MBI评分及治疗后4周的PROM均高于治疗前，同时经组间比较头针组、悬吊组、联合组高于对照组，联合组则高于头针组、悬吊组，差异有统计学意义(均P < 0.05)。结论百会透曲鬓穴针法联合悬吊疗法能改善中风后CRPS-Ⅰ患者的复杂性区域疼痛，增强关节活动程度，减少手部肿胀，提高生活能力，值得推广。
- 百会透曲鬓穴针法 /
- 悬吊疗法 /
- 中风 /
- 复杂性区域疼痛综合征
Abstract: Objective To observe the effects of Baihui penetrating Qubin acupuncture combined with suspension therapy on pain, upper limb function, shoulder joint movement, hand swelling, and activities of daily living in patients with complex regional pain syndrome type Ⅰ (CRPS-Ⅰ) after stroke. Methods A total of 120 patients with post-stroke CRPS-Ⅰ admitted to the First Affiliated Hospital of Henan University of Chinese Medicine from July 2021 to December 2022 were selected and divided into control group, head acupuncture group, suspension group and combination group according to the random number table method, with 30 cases in each group. The control group received routine rehabilitation training, and the head acupuncture group, suspension group and combination group received Baihui penetrating Qubin acupuncture, suspension therapy and the combination treatment, respectively, and the pain score (VAS), upper limb function score Fugl-Meyer (FMA-UE), hand swelling degree, passive shoulder motion angle (PROM) and modified Barthel index (MBI) were compared before and after treatment. Results Before treatment, there were no significant differences in VAS score[(8.14±1.06) points, (8.07±1.01) points, (8.11±1.10) points, (8.06±1.13) points, F=0.082, P=0.756], FMA-UE score, hand swelling degree, PROM and MBI score among all groups (all P>0.05). At 2 weeks and 4 weeks after treatment, the VAS score and hand swelling degree of all groups were lower than before treatment, and the intergroup comparison showed that the head acupuncture group, suspension group and combined group were lower than the control group, and the combined group was lower than the head acupuncture group and suspension group, with statistical significance (all P < 0.05). The FMA-UE score and MBI score at 2 and 4 weeks after treatment and PROM at 4 weeks after treatment were all higher than before treatment, and the head acupuncture group, suspension group and combined group were higher than the control group, and the combined group was higher than the head acupuncture group and suspension group, the difference was statistically significant (all P < 0.05). Conclusion Baihui penetrating Qubin acupuncture combined with suspension therapy can improve complex regional pain in post-stroke CRPS-Ⅰ patients, improve the degree of joint mobility, reduce hand swelling and improve life ability, which is worth promoting.
- Baihui penetrating Qubin acupuncture /
- Suspension therapy /
- Stroke /
- Complex regional pain syndrome

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表 1 4组中风后CRPS-Ⅰ患者一般资料比较

Table 1. Comparison of general data in 4 groups of patients with CRPS-Ⅰ after stroke

组别	例数	年龄(x±s，岁)	性别(男性/女性，例)	CRPS病程(x±s，d)
对照组	30	56.4±10.6	20/10	22.4±4.2
头针组	30	55.8±10.8	21/9	23.1±3.7
悬吊组	30	55.3±11.3	21/9	22.6±3.9
联合组	30	56.7±10.4	20/10	22.9±3.9
统计量		0.101^a	0.150^b	0.188^a
P值		0.959	0.985	0.904
注：^a为F值，^b为χ²值。

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表 2 4组中风后CRPS-Ⅰ患者治疗前后的VAS评分比较(x±s，分)

Table 2. Comparison of VAS scores before and after treatment in 4 groups of patients with CRPS-Ⅰ after stroke (x±s, points)

组别	例数	治疗前	治疗后2周	治疗后4周
对照组	30	8.14±1.06	5.87±0.89^a	3.78±0.53^a
头针组	30	8.07±1.01	4.73±0.72^ab	2.79±0.51^ab
悬吊组	30	8.11±1.10	5.09±0.78^ab	3.10±0.58^ab
联合组	30	8.06±1.13	4.29±0.63^abcd	2.13±0.45^abcd
F值		0.082	22.134	24.896
P值		0.756	< 0.001	< 0.001
注：与同组治疗前比较，^aP < 0.05；与对照组比较，^bP < 0.05；与头针组比较，^cP < 0.05；与悬吊组比较，^dP < 0.05。

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表 3 4组中风后CRPS-Ⅰ患者治疗前后的FMA-UE评分比较(x±s，分)

Table 3. Comparison of FMA-UE before and after treatment in 4 groups of patients with CRPS-Ⅰ after stroke (x±s, points)

组别	例数	治疗前	治疗后2周	治疗后4周
对照组	30	22.39±2.37	25.32±3.11^a	31.62±3.27^a
头针组	30	22.17±2.56	28.25±3.16^ab	35.81±3.15^ab
悬吊组	30	22.52±2.62	27.22±3.23^ab	34.56±3.28^ab
联合组	30	21.92±2.47	30.82±3.39^abcd	39.70±3.33^abcd
F值		0.132	26.663	31.826
P值		0.626	< 0.001	< 0.001
注：与同组治疗前比较，^aP < 0.05；与对照组比较，^bP < 0.05；与头针组比较，^cP < 0.05；与悬吊组比较，^dP < 0.05。

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表 4 4组中风后CRPS-Ⅰ患者治疗前后手指肿胀程度比较(x±s，mL)

Table 4. Comparison of finger swelling degree before and after treatment in 4 groups of patients with CRPS-Ⅰ after stroke (x±s, mL)

组别	例数	治疗前	治疗后2周	治疗后4周
对照组	30	172.65±9.82	156.71±9.88^a	135.66±7.59^a
头针组	30	171.29±10.38	146.47±8.64^ab	127.40±5.39^ab
悬吊组	30	173.32±10.25	149.55±9.31^ab	129.04±6.11^ab
联合组	30	172.60±10.03	143.82±7.45^abcd	124.92±5.17^abcd
F值		0.146	10.723	12.093
P值		0.601	< 0.001	< 0.001
注：与同组治疗前比较，^aP < 0.05；与对照组比较，^bP < 0.05；与头针组比较，^cP < 0.05；与悬吊组比较，^dP < 0.05。

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表 5 4组中风后CRPS-Ⅰ患者治疗前后MBI评分比较(x±s，分)

Table 5. Comparison of MBI scores before and after treatment in 4 groups of patients with CRPS-Ⅰ after stroke (x±s, points)

组别	例数	治疗前	治疗后2周	治疗后4周
对照组	30	39.83±5.75	51.53±6.70^a	69.74±7.46^a
头针组	30	40.62±5.69	57.92±6.81^ab	76.53±6.83^ab
悬吊组	30	41.11±5.22	55.75±7.13^ab	74.50±6.88^ab
联合组	30	39.89±5.83	61.36±6.73^abcd	81.87±6.35^abcd
F值		0.157	15.803	13.680
P值		0.531	< 0.001	< 0.001
注：与同组治疗前比较，^aP < 0.05；与对照组比较，^bP < 0.05；与头针组比较，^cP < 0.05；与悬吊组比较，^dP < 0.05。

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表 6 4组中风后CRPS-Ⅰ患者治疗前后PROM比较(x±s, °)

Table 6. Comparison of PROM before and after treatment in 4 groups of patients with CRPS-Ⅰ after stroke (x±s, °)

组别	例数	内旋		外旋		外展
组别	例数	治疗前	治疗后4周	治疗前	治疗后4周	治疗前	治疗后4周
对照组	30	13.72±3.25	51.04±4.89^a	12.83±3.09	53.66±4.12^a	15.63±3.70	111.55±6.39^a
头针组	30	12.63±3.20	57.43±5.83^ab	12.97±3.17	58.21±4.55^ab	16.71±3.83	120.40±6.99^ab
悬吊组	30	13.22±3.09	55.65±5.21^ab	13.13±3.11	56.72±4.43^ab	16.15±3.92	118.62±6.71^ab
联合组	30	12.97±3.15	64.31±5.92^abcd	12.80±3.17	67.27±4.63^abcd	14.86±3.77	128.31±6.22^abcd
F值		0.162	25.760	0.092	36.943	0.212	39.717
P值		0.498	< 0.001	0.894	< 0.001	0.353	< 0.001
注：与同组治疗前比较，^aP < 0.05；与对照组比较，^bP < 0.05；与头针组比较，^cP < 0.05；与悬吊组比较，^dP < 0.05。

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