眼针熥疗止痛技术治疗中风后肩手综合征的随机对照临床试验

Random Clinical Trail on Efficacy of Post-Stroke Shoulder-Hand Syndrome Treated by Eye-Acupuncture Therapy with Warm External Application of Chinese Herbs

目的观察眼针熥疗止痛技术治疗中风后肩手综合征1期的临床疗效。方法将356例中风后肩手综合征Ⅰ期患者采用分层区组随机化方法分为试验1组120例,试验2组122例,对照组114例。对照组采用常规康复训练,试验1组在康复训练基础上采用熥疗治疗,试验2组在康复训练基础上采用眼针结合熥疗进行治疗。比较3组中风后肩手综合征患者在治疗前后疼痛视觉模拟法(VAS)评分、GEPI评分、疼痛评分与GEPI相关性评价、首次疼痛起效时间。结果治疗前,3组之间VAS的评分比较,P>0.05,差异无统计学意义;治疗后,试验2组与对照组VAS评分均显著低于治疗前,且试验2组显著低于对照组(P<0.001);3组治疗前后比较都有差异(P<0.001);试验1组与对照组VAS评分均显著低于治疗前,且试验1组显著低于对照组(P<0.001);试验2组与试验1组比较,VAS评分显著低于治疗前,且试验2组显著低于试验1组(P<0.001)。3组治疗前后比较都存在差异(P<0.001);3组肩关节活动度变化,比较治疗前(访视1)和治疗第2周后(访视2),3组之间比较无显著性差异(P>0.05);治疗第4周后(访视3)及治疗第6周随访(访视4),共评分4次,3组之间有显著性差异(P<0.01);3组首次止痛起效时间比较无显著差异(P>0.05)。结论眼针熥疗止痛技术治疗中风后肩手综合征1期止痛效果明显、改善肩关节活动度效果显著,随着疼痛消失肩关节活动度范围增加,止痛疗效眼针结合熥疗方法明显优于单纯康复训练治疗。

Objective To observe the effect of eye-acupuncture therapy with warm external application of Chinese herbs on pain relief in patients with post-stroke shoulder-hand syndrome(SHS)at stageⅠ.Methods A total of 356 participants with the criteria of SHS at stage I were assigned randomly to clinical trial groupⅠ(n=120),clinical trial groupⅡ(n=122)and control group(n=114).The control group used conventional rehabilitation training.The clinical trial groupⅠon the basis of rehabilitation training used warm external application of Chinese herbs and the clinical trial groupⅡon the basis of rehabilitation training used eye-acupuncture therapy with warm external application of Chinese herbs.We compared VAS score,GEPI score,pain score and GEPI correlation evaluation and time of onset of first pain of the three groups before and after treatment.Results Before treatment,VAS scores of the three groups had no significant difference(P>0.05).After treatment,VAS scores in the clinical trial groupⅡwere significantly lower than those before treatment.The VAS scores of the clinical trial groupⅡwas significantly lower than that of the control group(P<0.001).All three groups had differences before and after treatment(P<0.001).VAS scores in the clinical trial group I and control group were significantly lower than those before treatment.The VAS score of the clinical trial group I was significantly lower than that of the control group(P<0.001).VAS score of the clinical trial groupⅡwas significantly lower than that of the clinical trial group I before treatment.The VAS score of the clinical trial groupⅡwas significantly lower than that of the clinical trial group I(P<0.001).All three groups had differences before and after treatment(P<0.001).The range of motion of shoulder joint in the three groups was compared before treatment(visit 1)and after treatment(visit 2).There was no significant difference among the three groups(P>0.05).After the fourth week of treatment(visit 3)and the sixth week of treatment(visit 4),the scores were scored for 4 times,and there were significant differences among the three groups(P<0.01).There was no significant difference in the time of initial analgesic effect among the three groups(P>0.05).Conclusion Eye-acupuncture combined with warm external application of Chinese herbs can obtain a marked efficacy on pain relief in patients with post-stroke SHS at stage I.The shoulder joint activity improvement effect is remarkable,with the increase of shoulder joint activity scope.The analgesic effect of eye-acupuncture combined with warm external application of Chinese herbs is better than simple rehabilitation treatment.