针刺结合中药外敷治疗中风后肩痛对患者血清IL-1β的影响

Acupuncture Combined with External Application of Traditional Chinese Medicine in the Treatment of Post Apoplectic Shoulder Pain and its Effect on Serum IL-1 β

目的:探讨针刺结合中药外敷治疗中风后肩痛的临床疗效及对患者血清白介素-1β(IL-1β)水平的影响。方法:选取2019年1月—2019年10月本院中风后肩痛患者90例,随机分3组,各30例。3组均行基础康复治疗,针刺组选取患侧肩髃、肩髎、肩前、肩贞、阿是穴并配以循经远端取穴;中药外敷组将调好的药膏敷于患侧肩关节并配合TDP照射治疗;针药组予针刺(同针刺组)结合中药外敷疗法(同针药外敷组)。各组治疗均1次/d,每次30min,每周治疗6次,连续治疗4周。比较各组患者治疗前后的肩关节功能评分、Fugl-Meyer上肢运动功能评分,及患者血清IL-1β含量变化。结果:3组治疗后肩关节功能评分、Fugl-Meyer上肢运动功能评分均较治疗前显著显著增高(P<0.05),血清IL-1β含量较治疗前降低(P<0.05);且针药组治疗后肩关节功能评分、Fugl-Meyer上肢运动功能评分增高幅度大于针刺组及中药外敷组(P<0.01),血清IL-1β含量降低幅度大于针刺组及中药外敷组(P<0.01),针刺组及中药外敷组各指标改善幅度比较差异无统计学意义(P>0.05)。3组患者治疗期间均未产生全身性或局部不良反应。结论:与针刺及中药外敷疗法相比,针药联合疗法能显著改善中风后肩痛患者肩关节疼痛,改善患者活动能力,可降低患者血清IL-1β水平,值得在临床上推广。

Objective:To investigate the clinical efficacy of acupuncture combined with external application of traditional Chinese medicine in the treatment of post-stroke shoulder pain and its effect on the level of serum interleukin-1β (IL-1β).Methods:From January 2019 to October 2019,90 patients with shoulder pain after stroke in our hospital were selected and randomly divided into 3 groups with 30 cases in each group.All 3 groups received basic rehabilitation treatment.The acupuncture group selected the affected scapula,scapula,Jianqian,Jianzhen,and Ashi points and selected points along the distal end of the meridian;the traditional Chinese medicine external application group applied the adjusted ointment to the affected side Side shoulder joints were treated with TDP irradiation;the acupuncture group was given acupuncture (same as acupuncture group) combined with external application of traditional Chinese medicine (same acupuncture group).Each group was treated once a day,30 minutes each time,6 times a week for 4 consecutive weeks.The shoulder joint function scores,Fugl-Meyer upper limb motor function scores,and the changes in serum IL-1β levels of patients in each group were compared before and after treatment.Results:After treatment,the shoulder joint function scores and Fugl-Meyer upper limb motor function scores of the three groups were significantly higher than before treatment (P<0.05),and the serum IL-1β content was lower than before treatment (P<0.05);and the acupuncture group After treatment,shoulder function score and Fugl-Meyer upper limb motor function score increased more than the acupuncture group and traditional Chinese medicine external application group (P<0.01),and the serum IL-1β content decreased more than the acupuncture group and traditional Chinese medicine external application group (P<0.01),There was no statistically significant difference in the improvement range of each index between the acupuncture group and the Chinese medicine external application group (P>0.05).No systemic or local adverse reactions occurred in the three groups of patients during treatment.Conclusion:Compared with acupuncture and external application of traditional Chinese medicine,acupuncture and medicine combination therapy can significantly improve shoulder joint pain in patients with post-stroke shoulder pain,improve patient mobility,and reduce serum IL-1β levels in patients,which is worthy of clinical promotion.