运动针刺联合关节松动术治疗中风后肩痛的临床研究

Clinical effect of acupuncture-exercise therapy combined with joint mobilization on the post-stroke shoulder pain

目的探讨运动针刺联合关节松动术和远红外理疗贴治疗中风后肩痛的临床效果。方法 64例以肱二头肌长头肌腱病变为病理类型的中风肩痛患者分为治疗组和对照组,各32例。对照组给予关节松动术和远红外理疗贴进行治疗,治疗组在对照组的基础上增加运动针刺,治疗5次/周,4周为1个疗程。采用视觉模拟评分(VAS)和被动关节活动度(PROM)评定2组患者治疗前和治疗第1、2个疗程后肩痛情况。结果第1个疗程治疗后2组间及与治疗前的VAS评分比较,差异无统计学意义(P>0.05)。治疗2个疗程后,2组患者的VAS、PROM评分均较治疗前改善,且治疗组优于对照组(P<0.05)。治疗组治疗总有效率94.52%高于对照组82.76%(P<0.05)。结论运动针刺联合关节松动术和远红外理疗贴可有效缓解中风后肩痛,并改善肩关节前屈、外展和外旋等活动度。

Objective To discuss the clinical effect of acupuncture-exercise therapy combined with joint mobilization technique( JMT) and far-infrared physiotherapy paste( FIRPP) in treatment of post-stroke shoulder pain which pathological pattern was long head of biceps brachii( LHBB)lesion. Methods Totally 64 patients with the post-stroke shoulder pain were randomly divided into two groups. Thirty-two patients in the control group received JMT and FIRPP and another32 patients in the treatment group received extra acupuncture-exercise combined with JMT and FIRPP. All cases received treatment for 5 times per week,4 weeks for the 1 course. The shoulder pain was assessed by visual analogue scale( VAS) and passive range of motion( PROM) in the two groups before treatment and at the 4 th week and the eighth week of treatment.Result The score of VAS showed no significant difference between the two groups at the4 th week of treatment( P > 0. 05). But after the 2 course of treatment,the scores of VAS and PROM improved in both groups( P < 0. 05) and improved more in the treatment group than those in the control group( P < 0. 05). The total effective rate was significantly higher in the treatment group than in control group( 94. 52% vs. 82. 76%; P < 0. 05). Conclusion Acupuncture-exercise therapy combined with JMT and FIRPP could relieve shoulder pain,and improve shoulder range of motion in forward bend and abduction,and external rotation of humerus.