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[摘要]
目的 探讨伸筋丹胶囊联合巴氯芬治疗肩手综合征的临床效果。方法 选取2016年11月-2018年11月上海市宝山区张庙街道泗塘社区卫生服务中心收治的82例肩手综合征患者,随机分为对照组和治疗组,每组各41例。对照组口服巴氯芬片,初始剂量5 mg/次,3次/d;而后每隔3 d增加5 mg/次,直至维持剂量20 mg/次,3次/d。治疗组在对照组基础上口服伸筋丹胶囊,5粒/次,3次/d。两组均连续治疗4周。观察两组的临床疗效,比较两组治疗前后患手肿胀程度、手背侧皮肤温差、上肢疼痛视觉模拟评分法(VAS)评分、Fugl-Meyer上肢运动功能评定量表(U-FMA)评分、改良Ashworth痉挛量表(MAS)评分、改良Barthel指数(MBI)评分及世界卫生组织生存质量测定简式量表(WHOQOL-BREF)评分的变化情况。结果 治疗后,对照组和治疗组的总有效率分别是75.6%、92.7%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患手肿胀程度和手背侧皮肤温差较治疗前均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组患手肿胀程度和手背侧皮肤温差显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组上肢疼痛VAS评分、MAS评分均较治疗前显著下降,而U-FMA评分、MBI评分均显著上升,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组VAS评分、MAS评分显著低于对照组,而U-FMA评分、MBI评分高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组WHOQOL-BREF中各领域评分及总体生存质量、总体健康状况评分均显著升高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组这些评分显著高于对照组,两组比较差异具有统计学意义(P<0.05)。结论 伸筋丹胶囊联合巴氯芬治疗肩手综合征具有较好的临床疗效,可明显缓解患者症状,减轻肢体疼痛,促进上肢运动功能的恢复,提高日常生活能力,改善生活质量,具有一定的临床推广应用价值。
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[Abstract]
Objective To investigate the clinical effect of Shenjindan Capsules combined with baclofen in treatment of shoulder-hand syndrome. Methods Patients (82 cases) with shoulder-hand syndrome in Sitang Community Health Service Center of Zhangmiao Street in Baoshan District from November 2016 to November 2018 were randomly divided into control (41 cases) and treatment (41 cases) groups. Patients in the control group were po administered with Baclofen Tablets, the initial dosage was 5 mg/time, three times daily. Then the dosage was increased by 5 mg/time until the maintenance dosage was 20 mg/time, three times daily. Patients in the treatment group were po administered with Shenjindan Capsules, 5 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the changes of affected hand swelling degree, skin temperature difference on the back of hand, VAS score, U-FMA score, MAS score, MBI score, and WHOQOL-BREF score in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 75.6% and 92.7%, respectively, and there were differences between two groups (P<0.05). After treatment, affected hand swelling degree and skin temperature difference on the back of hand in two groups were significantly decreased, and there were differences in the same group (P<0.05). After treatment, affected hand swelling degree and skin temperature difference on the back of hand in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, VAS score and MAS score in two groups were significantly decreased, but U-FMA score and MBI score were significantly increased, and there were differences in the same group (P<0.05). After treatment, VAS score and MAS score in the treatment group were lower than those in the control group, but U-FMA score and MBI score were higher than those in the control group, and there were differences between two groups (P<0.05). After treatment, WHOQOL-BREF score in all fields, overall life quality score and overall health status score were significantly increased in both groups, and there were differences in the same group (P<0.05). After treatment, these scores in the treatment group were higher than those in the control group, and there were differences between two groups (P<0.05). Conclusion Shenjindan Capsules combined with baclofen has significant effect in treatment of shoulder-hand syndrome, and can obviously relieve symptoms of patients, and reduce limb pain, and also can promote the recovery of upper limb motor function, and improve daily living ability and the life quality, which has a certain clinical application value.
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