超声介导药物靶向递送技术联合肌电生物反馈治疗卒中后肩痛的临床观察

Clinical Observation of Ultrasound Mediated Drug Targeting Delivery Technique combined with Electromyographic Biofeedback Therapy for Shoulder Pain Following Stroke

目的:观察超声介导药物靶向递送技术联合肌电生物反馈治疗卒中后肩痛的效果。方法:将90例卒中后肩痛患者按随机数字表法分为对照组、肌电生物反馈组(肌电组)、超声介导药物联合肌电生物反馈组(联合组),每组各30例。对照组患者予基础康复治疗,肌电组患者在对照组基础上予肌电生物反馈治疗,联合组患者在对照组基础上予超声介导药物(祛湿止痛液)联合肌电生物反馈治疗,共治疗8周。于治疗前、治疗后采用视觉模拟评分(VAS)、简化上肢Fugl-Meyer量表(FMA)、量角器分别评价其肩痛、上肢运动功能及肩关节被动活动度。结果:治疗8周后,3组患者VAS评分均较治疗前降低,FMA评分、肩关节活动度均较治疗前增加,差异均有统计学意义(P<0.05);治疗8周后,联合组患者VAS评分低于对照组及肌电组(P<0.05),肌电组患者VAS评分低于对照组(P<0.05);联合组患者FMA评分及肩关节被动活动度均高于对照组及肌电组(P<0.05);肌电组患者FMA评分及肩关节被动活动度均高于对照组(P<0.05)。对照组、肌电组、联合组愈显率分别39.29%、65.52%、89.29%。联合组愈显率高于对照组及肌电组,差异均有统计学意义(P<0.05);肌电组愈显率高于对照组,差异有统计学意义(P<0.05)。结论:超声介导药物靶向递送技术联合肌电生物反馈疗法可明显减轻卒中后肩痛,改善肩关节运动功能。

Objective: To observe the effect of ultrasound-mediated drug delivery combined with electromyographic(EMG) biofeedback in the treatment of post-stroke shoulder pain. Methods: 90 patients with post-stroke shoulder pain were randomly divided into control group, EMG biofeedback group(EMG group) and ultrasound-mediated drug combined with EMG biofeedback group(combined group), 30 cases in each group. The control group received basic rehabilitation treatment, the EMG group received EMG biofeedback treatment on the basis of the control group, and the combined group received ultrasound-mediated drug therapy combined with EMG biofeedback treatment on the basis of the control group for 8 weeks. Visual analogue scale(VAS),simplified upper limb Fugl-Meyer scale and protractor were used to evaluate shoulder pain, upper limb motor function and shoulder passive motion before and after treatment. Results: After 8 weeks of treatment, visual analogue score(VAS), simplified upper limb Fugl-Meyer scale, shoulder joint activity of the 3 groups before treatment were improved varying degrees, the difference was statistically significant(P <0.05);after 8 weeks of treatment, the VAS score of the combined group was lower than that of the control group and EMG group, the difference was statistically significant(P<0.05), and the VAS score of the EMG group was lower than that of the EMG group(P<0.05). FMA score and shoulder passive activity in the combined group were higher than those in the control group and EMG group, and the difference was statistically significant(P <0.05);FMA score and shoulder passive activity in the EMG group were higher than those in the control group, and the difference was statistically significant(P <0.05). The cure rate of the control group, EMG group and combined group were39.29%, 65.52% and 89.29% respectively. The combined group was higher than the control group and EMG group, the difference was statistically significant(P<0.05);the EMG group was higher than the control group, the difference was statistically significant(P <0.05). Conclusion: Ultrasound-mediated drug delivery combined with EMG biofeedback therapy can significantly relieve post-stroke shoulder pain and improve shoulder joint motor function.