Evaluation Of The Therapeutic Effect Of Acupotomy And Acupuncture Combined With Rehabilitation Training On Patients With SHS Period ? After Stroke

Objective:To observe the clinical efficacy of acupotomy combined with rehabilitation training,acupuncture,acupuncture combined with rehabilitation training,acupotomy and acupuncture combined with rehabilitation training in the intervention of stage I shoulder-hand syndrome after stroke,and to explore the optimal optimized treatment plan for intervening stage I shoulder-hand syndrome after stroke,so as to guide clinical treatment.Methods:All patients were selected from three third-grade class-A hospitals in Zhejiang.A total of 75 patients were recruited according to the inclusion and exclusion criteria.Due to the loss of 7 patients,68 patients were randomly divided into group A,B and C according to different treatment plans.The group A(n=22)was treated with acupotomy combined with rehabilitation training,group B(n=23)with acupuncture combined with rehabilitation training,and group C(n=23)with acupotomy and acupuncture combined with rehabilitation training.All the three groups were treated for 4 courses,totaling 4 weeks,i.e.,28 days.The changes of shoulder pain,hand swelling and upper-extremity motor function in the three groups receiving different treatment plans were evaluated using VAS pain score,degree of hand swelling and upper-extremity Fugl-Meyer score before and 1,2,3 and 4 weeks after treatment.Results:1.The VAS pain score of the three groups was significantly improved after treatment compared with that before treatment.Significant improvement was found in both group A and B two weeks after treatment(P<0.05).The group C showed significant improvement one week after treatment(P<0.05).Comparison among the three groups demonstrated that 4 weeks after treatment,the pain of group C was significantly improved compared with group A and B(P<0.05).2.The degree of hand swelling in the three groups after treatment reduced significantly than that before treatment.After 2 weeks of treatment,the degree of hand swelling in group A and C was significantly improved(P<0.05).The degree of hand swelling in group B was significantly improved 3 weeks after treatment(P<0.05).Comparison among the three groups showed that 4 weeks after treatment,the degree of hand swelling in group C was significantly improved compared with group A and B(P<0.05).3.The upper-extremity Fugl-Meyer score of the three groups after treatment was significantly higher than that before treatment.Three weeks after treatment,the upper-limb motor function of the three groups was significantly improved(P<0.05).Comparison among the three groups revealed that 3 weeks after treatment,the upper-limb motor function of group C was significantly improved compared with group B(P<0.05).Four weeks after treatment,the upper-limb motor function of group C was significantly improved compared with group A and B(P<0.05).4.The total effective rate of group A was 90.91%,B was 82.61%,C was 95.65%.The curative effect of group C was higher than group A and B,with statistical differences(P<0.05).Conclusion:1.Acupotomy or acupuncture alone and acupotomy combined with acupuncture can significantly improve the shoulder pain,degree of hand swelling and upper-extremity motor function of patients with stage I shoulder-hand syndrome after stroke.2.Compared with acupotomy or acupuncture alone,acupotomy combined with acupuncture can significantly improve the motor function of the affected extremity,relieve shoulder pain and edema,delay muscle atrophy,and significantly accelerate rehabilitation training for extremity function after stroke.3.With the prolongation of the course of treatment,the efficacy of acupotomy combined with acupuncture becomes increasingly obvious.Moreover,it is safe,easy to operate and beneficial to social promotion.