补元通络法治疗中风后肩痛的临床研究

Clinical Study of Post-Stroke Shoulder Pain with Tonifying Promordial Qi and Dredging Collaterals Method

目的:观察补元通络针灸法对中风患者肩痛的治疗作用,比较补元通络针灸法、肩胛部局部针刺法及康复疗法的疗效差异。方法:108例中风后肩痛患者随机分配到A组补元通络针灸组、B组肩胛部局部取穴针刺组、C组康复组,每组36例,实际过程中脱落17例,最终共收集91例偏瘫肩痛患者。A组30例,B组35例,C组26例,3组均采用基础治疗,分别进行补元通络针灸法治疗,肩胛部局部针刺治疗及康复治疗,治疗前后进行疼痛视觉模拟评分(VAS)、Fugl-Meyer运动功能评定量表、临床神经功能缺损程度评分量表评价,比较3组疗效。结果:补元通络针灸组(A组)、肩胛部局部取穴针刺组(B组)和康复组(C组)的肩痛强度、上肢运动功能、神经功能在治疗后均有改善,3组止痛效果比较(VAS分值),A组有效率100%,B组有效率94%,C组有效率96%,3组VAS分值的止痛效果组间无显著性差异(P>0.05)。3组治疗前后VAS分值、F-M分值、神经功能缺损分值比较,3组治疗前分值均无显著性差异(P>0.05),具有可比性。3组治疗后30天分值均减少,与治疗前比较均有非常显著性差异(P<0.05),说明3组均有良好的治疗效果。3组治疗前后VAS分值、F-M分值、神经功能缺损分值比较,组间比较有显著性差异(P<0.05):A组与B组具有显著性差异;A组与C组具有显著性差异;B组与C组不具有显著性差异。结论:补元通络针灸法、肩胛部局部取穴针刺和康复训练都可以改善脑中风患者肩痛强度及关节运动、神经功能,3种疗法止痛效果上无明显差异。3组治疗前后VAS分值、F-M分值、神经功能缺损分值比较,均优于治疗前(P<0.05),组间比较补元通络针灸组优于其它两组(P<0.05),提示补元通络针灸法疗效更佳。

Objective ： To observe the clinical efficacy in treatment of post - stroke shoulder pain with Tonifying Promor- dial Qi and Dredging Collaterals Method. Methods ：91 cases of post -stroke shoulder pain were randomized into Tonifying Promordial Qi and Dredging Collaterals group （A group）, shoulder acupuncture group （B group） and rehabilitation （C group）. The Visual Analogue Scale, Fugl -Meyer motor function scale, Neurological function deficit scale （simplified form） were evaluated before and after treatment. Result： The Visual Analogue Scale, Fugl -Meyer motor function scale, Neurological function deficit scale（ simplified form） were improved significantly after treatment in the three groups （all P 〈 0.05 ）. A group was better than the other two groups （ P 〈 0.05 ）. B group and C group had no difference （ P 〉 0.05 ）. Conclusion ： Tonifying Promordial Qi and Dredging Collaterals Method has better efficacy in treating post - stroke shoulder pain.