腕踝针配合康复疗法治疗脑卒中后肩痛的临床研究

Carpus-ankle Acupuncture Combined with Physical Therapy for Patients with Post-stroke Shoulder Pain:a Randomized Controlled Trial

目的:观察腕踝针配合康复疗法对脑卒中后肩痛的疗效,为临床治疗此病提供新证据和新手段。方法:本研究选取90例中风患者,采用计算机产生随机数字表,将病人随机分为腕踝针配合康复治疗组及康复治疗组。主要结局指标为视觉模拟评分(VAS),次要结局指标包括Fugl-Meyer关节活动及疼痛评分和ADL日常生活能力评分。两组均采取常规神经内科治疗,腕踝针配合康复治疗组在此基础上再行腕踝针刺。隔天治疗1次,10次1疗程,共治疗2疗程。治疗结束时及治疗后1月各评价1次。结果:治疗结束时,腕踝针结合康复治疗组VAS评分显著低于康复治疗组(P=0.02),而Fugl-Meyer运动功能评分和ADL评分均显著高于康复治疗组。治疗结束后1月时,腕踝针结合康复组的VAS评分、Fugl-Mey-er运动功能评分和ADL评分与与治疗结束时相近,而康复组的相关评分有向基线值靠拢的趋势。结论:腕踝针结合康复疗法对脑卒中后肩痛的即时镇痛效果和疗效维持时间均优于单独康复疗法。

Objectives：to clarify the efficacy of carpus-ankle acupuncture in the management of shoulder pain after stroke,in order to provide a new therapy.Methods：90 participants were included in this trial.They were randomly assigned to carpus-ankle acupuncture group and physical therapy group using computer generated random table.The main outcome measurement was VAS score.The secondary outcome measurements were Fugl-Meyer and ADL score.The treatment was given once every two days,10 times a course,20 times in total.Participants were assessed right after treatment and 1 month after treatment.Results：VAS score of two groups was decreased significantly after treatment（P0.05）.Carpus-ankle acupuncture group is superior to physical therapy group（P0.05）.Fugl-Meyer and ADL score were significant increase after treatment（P0.05）,and Carpus-ankle acupuncture group is superior to physical therapy group（P0.05）.Conclusion：Carpus-ankle acupuncture combined with physical therapy is better than physical therapy alone.