| Objective To explore the nursing intervention effect of Yiqi Tongluo Guasha on patients with shoulder and hand syndrome I and II after ischemic stroke,whether it can effectively improve the clinical symptoms of patients,reduce the TCM syndrome score,and improve the overall treatment efficiency.It provides ideas for treating shoulder and hand syndrome of Qi deficiency and blood stasis with external treatment of traditional Chinese medicine.Methods In this study,inpatients treated in the Department of Encephalopathy of Yunnan Hospital of Traditional Chinese Medicine from January 2022 to October 2022 were selected,and had passed the examination of the hospital ethics committee.The number was XW[2022] Lungreview word(002).Patients with shoulder-hand syndrome with Qi deficiency and blood stasis of ischemic stroke meeting the inclusion criteria were randomly divided into control group and intervention group by random number table method.The control group took the conventional treatment and nursing methods,the intervention group in the control group on the basis of the application of Yiqi Tongluo scraping method.The scraping program used in the intervention group was as follows: calculated from the day of admission,the patients completed one intervention in the first,fourth and seventh days in the hospital,each operation time was about 30 minutes.During hospitalization,a total of one course of treatment was completed,and three treatments were performed.Key scraping meridians for hand Yangming large intestine meridian,hand Taiyin lung meridian,hand Shaoyin heart meridian;Scraping treatment is performed on the basis of traditional treatment and nursing.Indicators were evaluated before intervention and the next day after one course of intervention(i.e.,the 8th day in hospital).Visual analogue scale(VAS)score,upper limb motor function(FMA)score and TCM syndrome score were used as evaluation indicators.The therapeutic effect was the evaluation index of efficacy,and the incidence of adverse reactions was the evaluation index of safety.VAS score,upper limb FMA(Fugl-Meyer)score and TCM symptom score before intervention(the 1st day of hospitalization)and after intervention(the 8th day of hospitalization)were compared to compare the therapeutic effect.Outcome A total of 74 samples were included in this study,including 37 in the control group and37 in the intervention group.In the process of sample collection,4 samples fell off in the control group and 3 samples fell off in the intervention group,with a total sample loss rate of 9.45%.There was no statistical significance in gender,age,length of stay,nationality,type of medical insurance,marital status and other baseline data between the two groups(P > 0.05),indicating comparability.Before intervention,there was no significant difference in FMA(Fugl-Meyer)score,VAS score and TCM symptom score between the control group and the intervention group(P > 0.05),indicating comparability.2.Efficacy evaluation(1)Upper extremity FMA score(1)Intra-group comparison: the FMA scores of the upper limbs of the two groups were compared before and after the intervention,and the FMA scores of the two groups were significantly improved after the intervention,with statistical significance(P < 0.01);(2)Inter-group comparison: The FMA scores of upper limbs of the two groups after intervention were compared,and there was a significant difference,with statistical significance(P < 0.01),and the improvement of FMA scores in the intervention group was better than that in the control group.(2)VAS score(1)Intra-group comparison: VAS scores of the two groups were compared before and after intervention,and VAS scores of the two groups were significantly decreased after intervention,with statistical significance(P < 0.01);(2)Comparison between groups: VAS scores of the two groups after intervention were compared,and there was a significant difference(P < 0.01),and the improvement of VAS scores in the intervention group was better than that in the control group.(3)TCM symptom points(1)Intra-group comparison: The scores of TCM syndrome in the two groups were compared before and after the intervention,and the scores of TCM syndrome in the two groups were significantly decreased after the intervention,with statistical significance(P < 0.01).(2)Inter-group comparison: the scores of single TCM symptoms between the two groups after intervention showed no difference except for spontaneous sweating and shortness of breath(P > 0.05),which was not statistically significant;There were significant differences in other symptoms,with statistical significance(P < 0.05).The total scores of TCM syndrome in the two groups after intervention were compared,and the difference was statistically significant(P < 0.01).The improvement of TCM syndrome scores in the intervention group was better than that in the control group.3.Evaluation of treatment effectivenessThe treatment effective rate of the two groups was compared: 33 cases in the control group,3 cases were cured(9%),6 cases were effective(18.18%),17 cases were effective(51.51%),7 cases were ineffective(21.21%),the total effective rate of the control group was 78.79%.Of the 34 cases in the intervention group,7 cases were cured(20.59%),11 cases were effective(32.35%),12 cases were effective(35.29%),4 cases were ineffective(11.76%),and the total effective rate of the intervention group was 88.24%.The total effective rate of the two groups was statistically significant(P < 0.05),and the curative effect of the intervention group was better than that of the control group.4.Safety evaluationDuring the intervention,no adverse reactions occurred in the control group and the intervention group.Conclusion 1.The treatment of phase I and II of SHS with Qi deficiency and blood stasis with the method of supplementing Qi and colluding Gua Sha can effectively improve the clinical symptoms of patients,reduce the scores of TCM symptoms of patients,and improve the overall treatment efficiency.2.The Qi Tongluo Gua Sha method is safe and effective,has no adverse reactions,and is suitable for clinical application. |
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