针灸联合神经阻滞法对缺血性脑卒中后患者中枢性疼痛的临床研究

Clinical study on central pain in patients with ischemic stroke treated by acupuncture combined with nerve block

目的探讨针灸联合神经阻滞法对缺血性脑卒中后患者中枢性疼痛治疗作用。方法选取2015年1月至2018年1月诊治缺血性脑卒中后中枢性疼痛患者共70例,采用随机数字表法分为对照组和观察组,每组35例,对照组给予常规针灸治疗1疗程,观察组给予针灸联合神经阻滞法治疗1疗程,观察2组患者治疗前后VAS、PSQI、SF-MPQ、PAR评分变化。结果与治疗前比较,两组患者治疗后VAS及PSQI评分均降低,差异具有统计学意义(P <0. 05);与对照组治疗后比较,观察组患者治疗后VAS及PSQI评分均降低,差异具有统计学意义(P <0. 05)。观察组患者治疗后疼痛明显缓解人数及完全缓解人数明显高于对照组,观察组总有效率(93%)高于对照组总有效率(84%)。与治疗前比较,两组患者SF-MPQ评分均有不程度降低,差异具有统计学意义(P <0. 05);与对照组治疗后比较,观察组患者治疗后PRI感觉项、PRI情感项、及PRI总分均明显降低,差异具有统计学意义(P<0. 05)。结论针灸联合神经阻滞法能有效减轻缺血性脑卒中后中枢性疼痛水平,改善生活质量,可作为缺血性脑卒中后中枢性疼痛患者的药物治疗选择之一。

Objective ： To investigate the effect of acupuncture combined with nerve block on central pain after ischemic stroke. Methods ： From January 2015 to January 2018, 70 patients with central pain after ischemic stroke were divided into control group （u = 35） and observation group （u = 35）. The control group was treated with routine acupuncture and moxibustion for one course, and the observation group with acupuncture combined with nerve block for one course. Visual analogue scale （VASE）, short form of McGill Pain questionnaire （SF-MPQN）, pain anesis score （parr） were observed in both groups before and after treatment. The Pittsburgh Sleep quality Index （PQI） score was measured by Pittsburgh Sleep Quality Index （PSQI）. Results： Compared with before treatment, the VAS and PSQI scores of the two groups were decreased, the difference was statistically significant （P 〈 0. 05 ）. Compared with the control group, the VAS and PSQI scores of the observation group were lower after treatment. The difference was statistically significant. Significance （P 〈 0. 05 ）. The number of patients with significant pain relief and complete remission after treatment was significantly higher in the observation group than in the control group. The total effective rate of the observation group （93%） was higher than that of the control group （84%）. Compared with before treatment, the SF-MPQ scores of the two groups were not significantly decreased, and the difference was statistically significant （ P 〈 0. 05 ）. Compared with the control group, the PRI sensoryitems, PRI emotion items, and The total scores of PRI were significantly lower, and the difference was statistically significant （ P 〈 0. 05 ）. Conclusion ： Acupuncture combined with nerve block can effectively reduce the level of central pain after ischemic stroke and improve the quality of life. It can be used as one of the drug treatment options for patients with central pain after ischemic stroke.