针刀结合康复训练治疗中风后肩关节疼痛临床疗效观察

Curative Effect Observation of Acupotomy Combine with Rehabilitation Training in Treating Post-Stroke Shoulder Abnormalities

目的:观察小针刀治疗和康复训练对于治疗中风后偏瘫侧肩关节疼痛的临床效果。方法:将病人60例随机分为普通组和针刀组,每组30例。普通组采用普通针刺治疗,穴位处方:颈4~6夹脊、肩井、天宗、肩髃、肩髎、肩贞、臂臑、后溪、合谷;操作:针刺得气后,留针30min,4周为1个疗程。针刀组采用小针刀配合康复训练治疗,针刀每周治疗1次,康复训练每日1次,4周1个疗程。采用VAS视觉模拟疼痛评分及Melle评分观察2组患者治疗前与治疗后VAS疼痛度与关节活动度改善程度,评定2组综合疗效。结果:2组治疗方法治疗后VAS疼痛评分及关节活动度较治疗前明显改善(P<0.01);且针刀组较普通组在治疗后效果更佳(P<0.05);治疗后普通组治愈6例,显效7例,好转12例,无效5例;针刀组治愈13例,显效10例,好转7例,无效0例,针刀组疗效优于普通组(P<0.05)。结论:小针刀配合康复训练对于治疗中风后偏瘫侧肩关节疼痛是比普通针刺更加有效、可行的治疗方法。也证明了小针刀治疗和康复训练在中风病人后期康复中的重要作用。

Objective： To observe the clinical effect of acupotomy combine with rehabilitation training in treating post- stroke shoulder abnormalities Methods： 60 patients were randomly divided into normal group and acupotomy group, 30 cases in each group. The common group with conventional acupuncture and acupoint prescription： 4-6 Cervical Jiaji, Jianjing, Tianzong, Jianyu, Jianliao, Jianzhen, Binao, Houxi, Hegu; Operation： Acupuncture treat for 30min, four weeks for a course of treatment. Acupotomy group receive acupotomy combine with rehabilitation training treatment, acupunc- ture treatment once a week, rehabilitation training once a day, four weeks for a course of treatment. VAS visual analogue pain score and Melle score were used to observe the two groups of patients before treatment and after treatment VAS pain and joint activity degree of improvement, evaluation of two groups of comprehensive curative effect. Results： The treat- ment group after treatment for two VAS pain score and joint activity were significantly improved compared with before treatment（P〈0.01）; and the needle knife group than in the normal group after the treatment effect is better（P〈0.05）; 6 cases of normal group were cured after treatment,7 cases were markedly effective,12 cases improved, 5 cases ineffective; Acu- potomy 13 cases were cured,10 cases markedly effective, 7 cases improved,0 cases ineffective, Acupotomy group is better than the normal group（P〈0.05）. Conclusion： Acupotomy combined with rehabilitation training treatment is more effective and feasible than ordinary acupuncture for treatment of stroke hemiplegic shoulder pain. It proves the important role of small needle knife therapy and rehabilitation training in the rehabilitation of stroke patients.