周康秋+吴世芳+谭碧海

【摘要】目的探讨中草药熏洗加马氏温灸对脑卒中后肩手综合征（SHSAS）的治疗效果。方法将100例SHSAS患者按随机数字表法分为对照组和观察组各50例，对照组给予神经内科基础治疗，观察组在对照组基础上给予中草药熏洗加马氏温灸，观察比较治疗前及治疗1个月后两组患者肩手综合征的临床积分状况。结果治疗后，两组患者临床症状积分各项评分均较治疗前得到较大改善，且观察组疼痛、水肿、关节活动度的评分均低于对照组，两组差异有统计学意义（P<0.01）。结论中草药熏洗加马氏温灸治疗脑卒中后肩手综合征有利于改善症状，促进患肢功能恢复，是行之有效的治疗手段。

【关键词】中草药熏洗；马氏温灸；脑卒中；肩手综合征

中图分类号：R743.3文献标识码：ADOI：10.3969/j.issn.10031383.2016.05.015

【Abstract】ObjectiveTo explore the therapeutic effect of Chinese herb fumigation and Mas warm moxibustion on shoulderhand syndrome after stroke（SHSAS）.Methods100 patients with SHSAS were divided into observation group and control group according to random number table method with 50 cases in each group.The control group were given neurology foundation treatment，and based on which the observation group were given Chinese herb fumigation and Mas warm moxibustion.And then，clinical integral scores before treatment and one month of treatment were compared between the two groups.ResultsAfter treatment，clinical integral scores significantly improved，but the scores of pain，edema and joint mobility in the observation group were lower than those of the control group，difference was statistically significant（P<0.01）.ConclusionChinese herb fumigation and Mas warm moxibustion can improve symptoms of SHSAS，promote limb functional recovery，it is an effective means of treatment.

【Key words】Chinese herb fumigation；Mas warm moxibustion；stroke；shoulderhand syndrome

脑卒中后肩手综合征（Shoulderhand Syndrome After Stroke，SHSAS）是指腦卒中后3个月内患侧肩部、腕关节、手指疼痛，活动受限以及血管运动功能障碍所致的手背部皮肤发红、发绀、皮温增高，严重者出现关节僵直、皮肤和肌肉萎缩等并发症，早期预防和治疗SHSAS具有重要意义[1，2]。2013年1月至2015年12月我院采用中草药熏洗加马氏温灸对SHSAS患者进行治疗，取得良好的效果，现总结报告如下。

1资料与方法1.1一般资料选取2013年1月至2015年12月在我院住院治疗的SHSAS患者100例作为研究对象，其中男56例，女44例；年龄55～81岁，平均（6572±10.35）岁；病程5～60 d，平均（25.41±1248）d；左侧偏瘫41例，右侧偏瘫59例。所有患者均符合西医《各类脑血管病诊断要点》[3]，符合中医《中风病诊断和疗效评定标准》[4]脑卒中的诊断标准及肩手综合征的诊断标准[5]。纳入标准：年龄40～80岁，神志清楚、生命体征稳定，病程<2个月，SHSAS分期为Ⅰ期，依从性好，患者知情同意、自愿参与并签知情同意书者。……