Clinical Efficacy of Jiwei Huangqi Guizhi Wuwutang Combined with Xingnao Kaiqiao Acupuncture on Shouder-hand Syndrome

Fu-ming WAN; Miao-yan ZHOU; Wei-zhen LI; Shu-qiang DING

doi:10.13422/j.cnki.syfjx.2020234

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Clinical Efficacy of Jiwei Huangqi Guizhi Wuwutang Combined with Xingnao Kaiqiao Acupuncture on Shouder-hand Syndrome

Clinic | 更新时间：2020-08-11

- Clinical Efficacy of Jiwei Huangqi Guizhi Wuwutang Combined with Xingnao Kaiqiao Acupuncture on Shouder-hand Syndrome
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 12, Pages: 133-138(2020)
- 作者机构：
  
  天津中医药大学第一附属医院，天津 300193
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.2020234
  CLC： R246;R49;R493
- Published Online：26 November 2019，
  
  Published：20 June 2020
- 稿件说明：
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万福铭,周淼焱,李唯溱等.加味黄芪桂枝五物汤联合醒脑开窍针刺法治疗脑卒中后肩手综合征的临床观察[J].中国实验方剂学杂志,2020,26(12):133-138.

WAN Fu-ming,ZHOU Miao-yan,LI Wei-zhen,et al.Clinical Efficacy of Jiwei Huangqi Guizhi Wuwutang Combined with Xingnao Kaiqiao Acupuncture on Shouder-hand Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(12):133-138.
万福铭,周淼焱,李唯溱等.加味黄芪桂枝五物汤联合醒脑开窍针刺法治疗脑卒中后肩手综合征的临床观察[J].中国实验方剂学杂志,2020,26(12):133-138. DOI： 10.13422/j.cnki.syfjx.2020234.

WAN Fu-ming,ZHOU Miao-yan,LI Wei-zhen,et al.Clinical Efficacy of Jiwei Huangqi Guizhi Wuwutang Combined with Xingnao Kaiqiao Acupuncture on Shouder-hand Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(12):133-138. DOI： 10.13422/j.cnki.syfjx.2020234.

摘要

目的

观察加味黄芪桂枝五物汤联合醒脑开窍针刺法治疗脑卒中后肩手综合征（SHS）的临床疗效及对神经源性炎症介质和血液流变学指标的影响。

方法

将148例患者随机按数字表法分为对照组和观察组各74例。两组口服双氯芬酸钠缓释片，75 min/次，1次/d，连续2～4周；肿胀明显，口服醋酸泼尼松片，10 min/次，1次/d，连续1～2周。并采用醒脑开窍针刺法，1次/d，6次/周；对照组口服脑心通胶囊

4粒/次

3次/d，观察组内服加味黄芪桂枝五物汤，1剂/d。两组疗程均为连续治疗4周。进行对治疗前后肩手综合征评估量表（SHSS）评分，记录疼痛、肿胀消失时间；进行治疗前后Fugl-Meyer功能量表上肢部分评分（U-FMA），日常生活活动能力（ADL）评分和气虚血瘀证评分；检测治疗前后降钙素基因相关肽（CGRP），P物质(SP)，缓激肽（BK）水平和血液流变学指标。

结果

观察组患者的临床疗效优于对照组（

＝2.106，

0.05）；观察组SHSS量表的感觉、自主神经、运动3个维度评分和SHSS总分均低于对照组（

0.01）；观察组疼痛、肿胀消失时间均短于对照组（

0.01）；观察组患者U-FMA，ADL评分均高于对照组（

0.01），气虚血瘀证评分低于对照组（

0.01）；观察组CGRP水平高于对照组（

0.01），SP和BK水平均低于对照组（

0.01）；观察组的全血黏度（高切、低切）、血浆黏度、纤维蛋白原和血小板聚集率等均低于对照组（

0.05）。

结论

在西医常规治疗的基础上，内服加味黄芪桂枝五物汤配合醒脑开窍针刺疗法可减轻SHS严重程度和中医临床证候，缩短病程，改善上肢运动功能，并可抑制神经源性炎症反应，改善血液流性，提高患者的日常生活活动能力和临床疗效。

Abstract

Objective

To observe the clinical efficacy of Jiwei Huangqi Guizhi Wuwutang combined with Xingnao Kaiqiao acupuncture on shouder-hand syndrome (SHS)

and its effect on neurogenic inflammatory factors and hemorheology.

Method

One hundred and forty-eight patients were randomly divided into control group and observation group (74 cases). Both groups' patients got rehabilitation measures

such as diclofenac sodium sustained release tablets for two to four weeks

75 min/time

1 time/day

and patients with apparent swelling got prednisone acetate tablets for one to two weeks

10 min/time

1 time/day. And patients in control group got Xingnao Kaiqiao acupuncture

1 time/day

6 times/week. Control grouporal Naoxintong capsule 4 tablets/time

3 times/day

patients in observation group were added with Jiwei Huangqi Guizhi Wuwutang

1 dose/day. The courses of treatment were 4 weeks. Before and after treatment

shoulder hand syndrome scale (SHSS)

the upperextremities of the Fugl-meyer movement assessment (U-FMA)

ability of daily life activities (ADL)

Qi deficiency and blood stasis syndrome and clinical efficacy were scored

disappearing time of pain and swelling were recorded

and levels of calcitonin gene related peptide (CGRP)

substance P (SP)

bradykinin (BK) and hemorheology were detected.

Result

The clinical efficacy in observation group was better than that in control group (

=2.106

0.05). And scores of sensory

autonomic

motion according to SHSS scale and the total scale of SHSS were all lower than those in control group (

0.01). Disappearing time of pain and swelling were shorten than those in control group (

0.01). After treatment

scores of U-FMA and ADL were higher than those in control group (

0.01)

while score of syndrome of Qi deficiency and blood stasis was lower than that in control group (

0.01). And level CGRP was higher than that in control group (

0.01)

and levels of SP and BK were lower than those in control group (

0.01). After treatment

whole blood viscosity (high cut

low cut)

plasma viscosity

fibrinogen and platelet aggregation rate were all lower than those in control group (

0.05).

Conclusion

In addition to the conventional western medicine therapy

Jiwei Huangqi Guizhi Wuwutang combined with Xingnao Kaiqiao acupuncture can reduce the severity of SHS and clinical syndromes of traditional Chinese medicine

shorten the course of disease

improve the motor function of upper limbs

inhibit the neurogenic inflammatory reaction

and improve the blood flow

the ability of daily life and the clinical efficacy of patients..

关键词

Keywords

references

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