四黃水蜜外敷對腦卒中患者偏癱上肢腫脹的療效研究

肖彬新　　王玫　　謝曉華

[關鍵詞] 四黃水蜜;腦卒中;上肢;腫脹;肩手綜合征

[中圖分類號] R473.6? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）20-0158-04

Effect of external application of Sihuang Hydromel on treatment of upper limb swelling in stoke patients with hemiplegia

XIAO Binxin? ?WANG Mei? ?XIE? Xiaohua

Department of Brain Disease， People′s Hospital of Fujian University of Traditional Chinese Medicine， Fuzhou? ?350004，China

[Abstract] Objective To explore the effect of external application of Sihuang hydromel on the treatment of hemiplegic side upper limb swelling after stroke. Methods Sixty patients with hemiplegic side upper limb swelling after stroke treated in the People′s Hospital of Fujian University of Traditional Chinese Medicine from March 2018 to October 2019 were selected and randomly divided into the control group and the intervention group. The control group were treated with routine care， good limb position and limb function training. The intervention group were given Sihuang hydromel in addition to the treatment of the control group. The interventions were given for 1 week. The upper limb wrist joint circumference， swelling score， and motor function were compared between the two groups before and after treatment. Results After 7 days of intervention， the upper limb wrist joint circumferences in the intervention group and the control group were（15.64±1.02） cm and （16.36±1.28） cm， respectively. The swelling scores in the intervention group and the control group were （0.40±0.91） and （1.24±0.83） points， respectively. The FMA scores in the intervention group and the control group were（21.51±4.96） and（15.78±6.49） points， respectively. The differences between before and after treatment were statistically significant in both groups（P<0.05）. The upper limb wrist joint circumference， swelling score and motor function in the intervention group after treatment were improved compared with those in the control group， with statistically significant differences（P<0.05）. Conclusion External application of Sihuang hydromel combined with routine rehabilitation nursing can relieve upper limb swelling in stroke patients with hemiplegia and promote limb function recovery.

[Key words] Sihuang hydromel; Stroke; Upper limb; Swelling; Shoulder-hand syndrome

約85%腦卒中患者存在不同程度的肢體癱瘓[1]。偏癱肢體腫脹發生率為20%，多發生于急性期[2]。腦卒中后肢體腫脹原因尚未明確，臨床上認為卒中后神經受損，血管調節功能障礙，靜脈血液回流受阻;同時因偏癱側主動運動減少，肢體肌肉緊張度下降，肌肉泵的擠壓作用明顯減弱，導致血液回流不暢而瘀滯產生腫脹[3]。偏癱后機體營養代謝功能緩慢引起水、電解質紊亂，局部血管舒縮功能失調也是造成患肢水腫的高危因素[4-5]。若沒有重視，長期肢體制動和局部組織缺氧造成手部肌肉萎縮、掌指關節囊攣縮，腫脹滲出物纖維化引起的粘連和滑膜囊增厚，可導致肢體不可逆殘疾，影響患側上肢功能的康復[6]。肢體的腫脹程度可導致關節活動度下降、慢性疼痛，甚至炎癥和感染，影響肢體功能康復。同時加重患者心理負擔，易出現焦慮、抑郁等不良情緒。因此，及早消除患肢腫脹將會增加手功能康復幾率。中西結合是臨床治療發展的主要方向。本研究通過四黃水蜜外敷對卒中后偏癱上肢腫脹，臨床效果顯著，現報道如下。