Objective: To compare the clinical efficacy between wrist-ankle acupuncture and conventional acupuncture on shoulder-hand syndrome (SHS) phaseⅠafter stroke.
Methods: A total of 64 patients with SHS phaseⅠafter stroke were randomized into a wrist-ankle acupuncture group and a conventional acupuncture group, 32 cases in each group. On the basis treatment of internal medicine and conventional rehabilitation, wrist-ankle acupuncture was applied at upper 4 area, upper 5 area and upper 6 area on the affected side in the wrist-ankle acupuncture group, while acupuncture was applied at Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), etc. on the affected side in the conventional acupuncture group. The treatment was given 30 min each time, once a day, 5 days a week for 3 weeks in both groups. Before and after treatment, the visual analogue scale (VAS) score, degree of hand swelling, shoulder-hand syndrome scale (SHSS) score, Fugl-Meyer assessment for upper extremity (FMA-UE) score and modified Barthel index (MBI) score were observed, and the clinical therapeutic effect was evaluated in both groups.
Results: After treatment, the VAS scores, degree of hand swelling and SHSS scores were decreased (P<0.05), and the FMA-UE scores and MBI scores were increased (P<0.05) compared before treatment in both groups; in the wrist-ankle acupuncture group, the VAS score, degree of hand swelling and SHSS score were lower (P<0.05), and the FMA-UE score and MBI score were higher (P<0.05) than those in the conventional acupuncture group. The total effective rate was 96.9% (31/32) in the wrist-ankle acupuncture group, which was superior to 90.6% (29/32) in the conventional acupuncture group (P<0.05).
Conclusion: Wrist-ankle acupuncture can effectively relieve pain and hand swelling, improve motor function of upper extremity and self-care ability of daily life in patients with shoulder-hand syndrome phaseⅠafter stroke, the therapeutic effect is superior to conventional acupuncture.
目的：比较腕踝针与常规针刺治疗中风后肩手综合征Ⅰ期的临床疗效。方法：将64例中风后肩手综合征Ⅰ期患者随机分为腕踝针组和常规针刺组，各32例。在内科和常规康复治疗基础上，腕踝针组予腕踝针治疗，穴取患侧上4区、上5区、上6区；常规针刺组予针刺患侧肩髃、曲池、手三里等，两组均每次30 min，每天治疗1次，每周5次，共治疗3周。分别于治疗前后观察两组患者视觉模拟量表（VAS）评分、手部肿胀程度、肩手综合征评估量表（SHSS）评分、Fugl-Meyer上肢运动功能评定（FMA-UE）评分、改良Barthel指数（MBI）评分，并评定两组临床疗效。结果：治疗后，两组患者VAS评分、手部肿胀程度、SHSS评分均较治疗前降低（P<0.05），FMA-UE、MBI评分均较治疗前提高（P<0.05）；腕踝针组VAS评分、手部肿胀程度、SHSS评分低于常规针刺组（P<0.05），FMA-UE、MBI评分高于常规针刺组（P<0.05）。腕踝针组总有效率为96.9%（31/32），高于常规针刺组的90.6%（29/32，P<0.05）。结论：腕踝针可有效减轻中风后肩手综合征Ⅰ期患者疼痛及手部肿胀程度，提高患者上肢运动功能及日常生活自理能力，疗效优于常规针刺。.
Keywords: self-care ability of daily life; acupuncture; clinical symptom; shoulder-hand syndrome phaseⅠafter stroke; wrist-ankle acupuncture.