电针对偏瘫肩痛的治疗效应:单盲随机对照试验

Effects of Electroacupuncture on Hemiplegic Shoulder Pain: a Single-blind Randomized Controlled Trial

目的探讨电针对偏瘫肩痛的作用,以及对患者运动功能和日常生活能力的影响。方法将60例患者按随机数字表法分为两组,其中常规康复组30例,电针康复组30例。常规康复组给予偏瘫侧上肢良肢位摆放、使用肩托、关节活动范围训练、牵伸训练、超短波理疗及日常生活活动能力训练,电针康复组在此基础上取穴患侧肩髃、肩髎、臂臑、肩贞等,常规皮肤消毒后用指切进针法直刺1~1.5寸,行提插捻转手法,平补平泻,得气后连接电针治疗仪,选择疏密波,治疗20 min取针。两组患者各治疗4周,治疗前后分别评估患者偏瘫侧肩关节疼痛视觉模拟量表(VAS)评分、Fugl-Meyer上肢功能评分及改良Barthel评分。结果治疗4周后,两组患者VAS评分较治疗前均降低(P<0.05),Fugl-Meyer上肢功能评分及改良Barthel评分较治疗前升高(P<0.05)。电针康复组VAS评分降低程度及Fugl-Meyer上肢功能评分升高程度优于常规康复组(P<0.05)。结论电针结合常规康复治疗可缓解偏瘫后肩痛,改善上肢功能及日常生活活动能力。

Objective To observe the effects of electroacupuncture(EA)on hemiplegic shoulder pain(HSP),motor functions of upper limbs and activities of daily living.Methods Sixty HSP patients were assigned to the routine rehabilitation group and the EA rehabilitation group by random digit table,30 in each group.Patients in the routine rehabilitation group received positioning of the upper extremities on the affected side,use of shoulder hemislings,training for range of motion,stretch exercise,ultrashort-wave physiotherapy,and training of daily living activities.Those in the EA rehabilitation group were additionally needled at Jianyu(LI15),Jianliao(SJ14),Binao(LI14),Jianzhen(SI9),and so on.Direct needling at 1-1.5 cun after skin disinfection in the routine rehabilitation group,lifting and thrusting,twirling of needle,even reinforcing-reducing method,and connected to EA treatment device after de qi.Density wave was selected and connected after 20 min.All patients were treated for 4 successive weeks.Visual Analogue Scale(VAS)of the hemiplegic shoulder,Fugl-Meyer assessment(FMA)of the upper limbs,and Modified Barthel Index(MBI)were assessed before and after treatment.Results After 4 weeks of treatment,VAS scores decreased,FMA and MBI increased in the two groups(P<0.05).The improvements were better in the EA rehabilitation group than in the routine rehabilitation group(P<0.05).VAS decreased more and FMA increased more in the EA rehabilitation group than that in the routine rehabilitation group(P>0.05).Conclusion EA combined routine rehabilitation effectively relieved HSP,improved motor functions of upper extremities and activities of daily living in stroke survivors.