【目的】 观察揿针联合肌内效贴治疗卒中后肩-手综合征的临床疗效。【方法】 选取2022年7月至2024年7月北京大学 第三医院秦皇岛医院收治的182例明确诊断为卒中后肩-手综合征的患者为研究对象。采取随机数字表法将患者随机分为观 察组和对照组，每组 91例。对照组给予常规康复训练联合揿针治疗，观察组在对照组治疗的基础上，给予肌内效贴治疗。 共治疗4周。治疗4周后，评价2组临床疗效。观察2组患者治疗前后血清神经递质缓激肽、β-内啡肽、去甲肾上腺素（NE） 水平的变化情况，以及关节活动度评定量表（ROM）评分和Fugl-Meyer评估量表（FMA）评分的情况。比较2组患者治疗前后患 肢肿胀程度以及改良Barthel指数（MBI）的变化情况。【结果】（1）观察组总有效率为89.01%（81/91），对照组为76.92%（70/91）。 观察组疗效优于对照组，差异有统计学意义（P＜0.05）。（2）治疗后，2 组患者的血清 NE、缓激肽、β-内啡肽水平明显改善 （P＜0.05），且观察组在改善NE、缓激肽、β-内啡肽水平方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）治疗后， 2组患者的关节活动度ROM评分及上肢FMA评分明显改善（P＜0.05），且观察组在改善关节活动度ROM评分及上肢FMA评 分方面明显优于对照组，差异有统计学意义（P＜0.05）。（4）治疗后，2组患者的患肢肿胀程度及MBI评分明显改善（P＜0.05）， 且观察组在改善患肢肿胀程度及MBI评分方面明显优于对照组，差异有统计学意义（P＜0.05）。【结论】 揿针联合肌内效贴治 疗卒中后肩-手综合征，能显著改善患者血清神经递质水平和患肢的肿胀程度，提升患者关节活动度、上肢运动功能及日常生活活动能力，从而提高患者生活质量，疗效显著。

Objective To observe the clinical efficacy of thumb-tack needling combined with kinesio taping in the treatment of post-stroke shoulder-hand syndrome. Methods A total of 182 patients diagnosed with post-stroke shoulder-hand syndrome at Peking University Third Hospital Qinhuangdao Hospital from July 2022 to July 2024 were selected as study subjects. Patients were randomly divided into an observation group and a control group using a random number table， with 91 patients in each group. The control group received conventional rehabilitation training combined with thumb-tack needling therapy， while the observation group received additional kinesio taping therapy based on the control group’s treatment. The treatment course for both groups was 4 weeks. After 4-week treatment， clinical efficacy was evaluated in both groups. Changes in serum neurotransmitter levels （bradykinin，β-endorphin，and norepinephrine [NE]），Range of Motion （ROM） scale scores，and Fugl-Meyer Assessment （FMA） scale scores were observed before and after treatment in both groups. The degree of affected limb swelling and changes in the Modified Barthel Index （MBI） were compared between the two groups before and after treatment. Results （1） The total effective rate was 89.01% （81/91） in the observation group and 76.92%（70/91） in the control group. The efficacy in the observation group was superior to that in the control group， with a statistically significant difference （P＜0.05）. （2） After treatment， serum levels of NE， bradykinin， and β -endorphin were significantly improved in both groups （P＜0.05）， and the improvements in the observation group were significantly superior to those in the control group，with statistically significant differences （P＜0.05）. （3） After treatment，ROM scores and upper limb FMA scores were significantly improved in both groups （P＜ 0.05），and the improvements in the observation group were significantly superior to those in the control group， with statistically significant differences （P＜0.05）.（4） After treatment，the degree of affected limb swelling and MBI scores was significantly improved in both groups （P＜0.05），and the improvements in the observation group were significantly superior to those in the control group， with statistically significant differences （P＜0.05）. Conclusion Thumb-tack needling combined with kinesio taping significantly improves serum neurotransmitter levels and reduces swelling in the affected limb in patients with post-stroke shoulder-hand syndrome. It enhances joint mobility，upper limb motor function，and activities of daily living，thereby improving patients’ quality of life with notable therapeutic efficacy.

R246.9

秦皇岛市重点研发计划科技支撑项目（编号：202301A072）