针刺肌筋膜触发点联合深层肌肉刺激治疗老年卒中后肩痛的临床研究

Clinical Study of Acupuncture Myofascial Trigger Points Combined with Deep Muscle Stimulator in the Treatment of Senile Poststroke Shoulder Pain

目的探讨针刺肌筋膜触发点联合深层肌肉刺激治疗老年卒中后肩痛的临床效果.方法选取本院2020年1月—2022年6月收治的76例老年卒中后偏瘫伴肩痛患者为研究对象,采用随机数字表法分为两组.对照组(n=38)采用常规综合康复治疗,观察组(n=38)在此基础上采用针刺肌筋膜触发点联合深层肌肉刺激治疗.比较两组患者治疗前后的疼痛视觉模拟(VAS)评分、肩关节被动活动度及Fugl-Meyer上肢运动功能评定量表(FMA-UE)评分.结果首次治疗当日、治疗1周后、治疗4周后,观察组的VAS评分均低于治疗前,且低于同时段对照组,组间差异有统计学意义(P<0.05).治疗4周后,两组的FMA-UE评分均高于治疗前,且观察组的FMA-UE评分为(17.9±4.7)分,高于对照组的(15.7±4.5)分,组间差异有统计学意义(P<0.05).治疗4周后,观察组的肩关节前屈、外展活动度均大于治疗前,且大于对照组,组间差异有统计学意义(P<0.05);首次治疗当日、治疗1周后、治疗4周后,观察组的肩关节外旋活动度均大于治疗前,且大于对照组,组间差异有统计学意义(P<0.05).结论采用针刺肌筋膜触发点联合深层肌肉刺激治疗老年卒中后肩痛患者,可有效缓解疼痛,增加其肩关节被动活动范围,改善患侧上肢功能,值得临床推广使用.

Objective To investigate the clinical effect of acupuncture myofascial trigger point combined with deep muscle stimulation in the treatment of senile poststroke shoulder pain.Methods A total of 76 elderly patients with poststroke hemiplegia and shoulder pain admitted to the hospital from January 2020 to June 2022 were selected as the research objects,and were divided into two groups by random number table method.The control group(n=38)received conventional comprehensive rehabilitation treatment,and the observation group(n=38)received acupuncture myofascial trigger point combined with deep muscle stimulation on this basis.The pain visual analogue scale(VAS)score,passive motion of shoulder joint and Fugl-Meyer assessment upper extremity scale(FMA-UE)score were compared between the two groups before and after treatment.Results On the day of the first treatment,1 week after treatment and 4 weeks after treatment,the VAS scores of the observation group were lower than before treatment,and were lower than those of the control group at the same time,the differences between the groups were statistically significant(P<0.05).After 4 weeks of treatment,the FMA-UE scores of both groups were higher than those before treatment,and the FMA-UE score of the observation group was(17.9±4.7)points,higher than(15.7±4.5)points of the control group,the difference between the groups was statistically significant(P<0.05).After 4 weeks of treatment,the anterior flexion and abductor motion of shoulder joint in the observation group were greater than before treatment,and were greater than those in the control group,the differences between the groups were statistically significant(P<0.05);on the day of the first treatment,1 week after treatment and 4 weeks after treatment,the external rotational motion of shoulder joint in the observation group was greater than before treatment,and was greater than that in the control group,and the difference between the groups was statistically significant(P<0.05).Conclusion Acupuncture myofascial trigger point combined with deep muscle stimulation in the treatment of senile poststroke shoulder pain can effectively relieve pain,increase the passive range of motion of shoulder joint,improve the function of the affected side of the upper limb,and is worthy of clinical promotion.