Symathetic nerver function after the thermotherapy near the stellate ganglion

肩手综合征是脑卒中患者的严重并发症之一，常影响患者的生活质量和康复治疗。近年来，光（LASRE或红外线）照射对星状神经节的影响被报道，其机制中也有热能或光电能阻断交感神经节的作用。本研究通过对脑卒中患者颈部热敷的生理反应，探讨单纯热疗对交感神经功能的影响。<Methods>对33例斯托克脑卒中肩手综合征患者，在双手食指和足趾上放置热敏电阻，分析其瘫痪侧颈部热敷1.5分钟的热反应，并对热反应与临床参数的相关性进行统计学分析。<Results>麻痹手指和手的温度明显高于其他两侧的温度。热敷治疗后，瘫痪手指的温度明显升高，但正常（非患病）侧的温度没有变化。热疗后，瘫痪手的温度明显高于其他手的温度。热疗后双手温度差值与临床参数（功能独立性测量中的上臂功能和肩关节活动度）有统计学相关性，认为热疗对颈部的局部效应可能与交感星状神经节阻滞效应相同。

Shoulder hand syndrome is one of the severe complications in stroke patients and the disorders often disturbed the QOL and the rehabilitation therapy. Recently,the effects of the light (LASRE or infrared) irradiation to the stellate ganglion were reported as well as the sympathetic ganglion block by thermological or photo-electrical energy in the mechanism. In this study,to access the effects of the sympathetic nerve function of simple thermotherapy,we studied the physiological responses by hot packs on the neck in stroke patients.<Methods>In 33 stoke patients suffering from shoulder hand syndrome,we set the thermister on both index fingers on hands and toes and analyzed the thermal responses to the hot packs on paralytic side of the neck for I S minutes.We studied the statistical correlation between the thermo-reaction and the clinical parameters.<Results>The temperature of the paralytic fingers and hands was significantly higher than the temperature of the other sides. After the hot packs therapy,the temperature of paralytic fingers became significantly higher but the temperature of the normal (non-affected)sides did not changed. And after the thermal therapy,the temperature of the paralytic hands became significantly higher than the temperature of the other hands. There was statistical correlation between the difference of both hands temperature after thermotherapy and clinical parameter (upper arm function in functional independence measure and the range of shoulder motion).It was considered that the local effects of the thermotherapy to the neck might be same effects as the sympathetic stellate ganglion block.