本文選題：腦卒中 + 肩手綜合征�。� 參考：《山東中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察董氏奇穴治療腦卒中后肩手綜合征的臨床療效。方法:將60例腦卒中后肩手綜合征患者,采用隨機(jī)數(shù)字表法分為董氏奇穴治療組(簡(jiǎn)稱(chēng)治療組)和常規(guī)針刺組(簡(jiǎn)稱(chēng)對(duì)照組),每組各30例。治療組:董氏奇穴取患者健側(cè)靈骨、大白、四花中穴、雙側(cè)腎關(guān)穴。采用華佗牌一次性無(wú)菌針灸針,大白向同側(cè)靈骨齊刺15mm~25mm,四花中穴直刺25mm~50mm后,左右兩旁各開(kāi)1寸并向其齊刺;腎關(guān)穴應(yīng)向后腎經(jīng)方向直刺,一般15mm~40mm,得氣后留針,時(shí)間為30min,每隔5min行針1次;在行針的同時(shí)囑患者主動(dòng)或被動(dòng)活動(dòng)其患側(cè)的上肢。對(duì)照組:取局部肩毭、肩毼、肩貞、曲池、外關(guān)、合谷針刺。每日1次,電針治療30min,10次為1療程,連續(xù)治療3療程。治療前后分別采用疼痛視覺(jué)模擬評(píng)分法(VAS)、上肢Fugl-Meyer運(yùn)動(dòng)功能評(píng)分量表、水腫評(píng)分與日常生活功能(Barthel)量表等來(lái)評(píng)定兩組在疼痛、上肢運(yùn)動(dòng)功能、水腫及日常生活功能等的變化,從而進(jìn)行療效分析。結(jié)果:1.臨床療效:治療組總有效率為93.33%,對(duì)照組總有效率為73.33%,兩組統(tǒng)計(jì)學(xué)分析具有顯著性差異(P0.05),治療組優(yōu)于對(duì)照組。2.VAS評(píng)分:兩組治療后VAS評(píng)分與治療前比較,有非常顯著性差異(P0.01),兩組治療后比較有顯著性差異(P0.05)。3.Fugl-Meyer積分:兩組治療后Fugl-Meyer評(píng)分與治療前比較均有非常顯著性差異(P0.0l),兩組間比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.水腫評(píng)分:兩組治療后水腫評(píng)分較治療前有顯著性差異(P0.05),兩組間比較無(wú)顯著性差異(P0.05)。5.日常生活活動(dòng)能力ADL評(píng)分:兩組治療后較治療前有顯著性差異(P0.01,P0.05),兩組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論:董氏奇穴治療組治療腦卒中后肩手綜合征,可有效緩解疼痛,減輕水腫,改善患者上肢運(yùn)動(dòng)功能和日常生活活動(dòng)能力,且療效優(yōu)于常規(guī)針刺組。董氏奇穴療法體現(xiàn)了奇法奇效,為針灸治療腦卒中后肩手綜合征提供了一種新的方法,以供臨床醫(yī)生參考。
[Abstract]:Objective: to observe the clinical effect of Dong Shiqi on shoulder-hand syndrome after stroke. Methods: sixty patients with shoulder and hand syndrome after stroke were randomly divided into two groups: the treatment group (treatment group) and the routine acupuncture group (30 cases in each group). In the treatment group, the healthy side Linggu, Daqing, Sihuazhong point and bilateral Shenguan point were taken from the patients. Using a disposable sterile acupuncture needle of Huatuo brand, Dabai needled 15mm or 25mm to the same side of the spirit bone, 1 inch on each side of the left and right sides and 1 inch on the left side after the point of Sihuazhong was punctured directly, and the point of Shenguan should be pricked directly to the direction of the posterior kidney meridian, generally 15mm or 40mm, so that the needle could be kept after getting qi. The time was 30 minutes, once every 5min, and the patient was told to move the upper limb of the affected side actively or passively. In the control group, local shoulder, chestnut, Quchi, Waiguan and Hegu acupuncture were taken. Once a day, 10 times electroacupuncture treatment for 30 mins as a course of treatment, 3 consecutive courses of treatment. Before and after treatment, the changes of pain, upper limb motor function, edema score and daily life function were evaluated by visual analogue score, Fugl-Meyer motor function scale, edema score and daily life function scale respectively, and the changes of pain, upper limb motor function, edema and daily life function were evaluated before and after treatment. So as to carry on the curative effect analysis. The result is 1: 1. Clinical efficacy: the total effective rate of the treatment group was 93.33 and the total effective rate of the control group was 73.33. There was a significant difference between the two groups in statistical analysis. The treatment group was superior to the control group in the score of .2.VAS: the VAS score of the two groups after treatment was compared with that before treatment. There was a very significant difference between the two groups after treatment. There was a significant difference between the two groups after treatment. 3. Fugl-Meyer score: there was a very significant difference in Fugl-Meyer score between the two groups after treatment and before treatment. The difference between the two groups was statistically significant. Edema score: there was significant difference in edema score after treatment between the two groups (P 0.05), but there was no significant difference between the two groups (P 0.05). Activity of daily living (ADL) score: there was a significant difference between the two groups after treatment than before treatment P0.01and P0.05, the difference between the two groups was statistically significant (P 0.01). Conclusion: the treatment group of Dong Shiqi acupoint can effectively relieve pain, relieve edema, improve upper limb motor function and activity of daily life in treating shoulder and hand syndrome after stroke, and the curative effect is better than that of routine acupuncture group. The therapy of Dong's Qi points embodies the strange effect of Qifa and provides a new method for acupuncture and moxibustion in the treatment of shoulder-hand syndrome after stroke for the reference of clinicians.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R246.6

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