雷火灸联合针刺治疗中风后肩痛的临床疗效观察

Observation on the clinical effect of thunder-fire moxibustion combined with acupuncture on shoulder pain after stroke

目的观察雷火灸对中风后肩痛患者的治疗效果,分析雷火灸在疾病治疗过程中的优势,为雷火灸治疗中风后肩痛的方案提供一定的临床依据。方法将60例中风后肩痛患者分为治疗组(雷火灸联合针刺组)、对照组(针刺组)。在3个疗程的康复治疗和基础治疗下,对照组30例采用常规针刺疗法,治疗组30例在对照组的基础上加用雷火灸治疗。治疗前后对2组患者的视觉模拟评分表(VAS评分)、简化Fugl-Meyer上肢功能评分表、肌骨超声各项测量值表进行评估并进行疗效分析。结果治疗后2组各项评分与治疗前比较差异均具有统计学意义(P<0.05),且治疗组的改善作用均优于对照组(P<0.05)。2组治疗后VAS评分均较治疗前降低,且治疗组低于对照组[(2.9±1.1)分与(3.5±0.9)分,P<0.05]。2组治疗后简化Fugl-Meyer上肢功能评分均较治疗前升高,且治疗组明显高于对照组[21(4)分与16(14)分,P<0.05]。2组治疗前后肌骨超声对肱二头肌长头肌腱腱鞘积液深度、肱二头肌长头肌腱厚度、肩胛下肌腱厚度、肩峰至大结节间距测量值均减低,且治疗组的改善效果优于对照组(1.50(0.60)mm与4.05(3.02)mm、2.50(0.23)mm与3.20(0.82)mm、4.15(0.60)mm与4.60(0.50)mm、23.65(8.98)mm与26.40(10.53)mm,均P<0.05)。结论雷火灸联合针刺治疗中风后肩痛疗效好,值得推广。

Objective To observe the therapeutic effect of thunder-fire moxibustion on patients with post-stroke shoulder pain,analyze the advantages of thunder-fire moxibustion in the course of disease treatment,and provide a certain clinical basis for thunder-fire moxibustion in the treatment of post-stroke shoulder pain.Methods Sixty patients with post-stroke shoulder pain were randomly divided into treatment group(lightning fire moxibustion combined with acupuncture group)and control group(acupuncture group).Under 3 courses of rehabilitation and basic treatment,30 cases in the control group were treated with conventional acupuncture therapy,and 30 cases in the treatment group were treated with thunder-fire moxibustion on the basis of the control group.Before and after treatment,the visual analog scale(VAS score)of the two groups of patients,the simplified Fugl-Meyer upper limb function score sheet,and the musculoskeletal ultra-sound measurement value table were evaluated and the therapeutic effect was analyzed.Results After treatment,the scores of the two groups were statistically significant compared with those before treatment(P<0.05),and the improvement effect of the treatment group was better than that of the control group(P<0.05).The VAS scores of both groups after treat-ment were lower than before treatment,and the treatment group was significantly lower than the control group[(2.9±1.1)points vs(3.5±0.9)points,P<0.05].The simplified Fugl-Meyer upper limb function scores of the two groups after treatment were higher than those before treatment,and the treatment group was significantly higher than the control group[21(4)points vs 16(14)points,P<0.05].Before and after treatment,the measured values of musculoskeletal ultrasound of the biceps long head tendon sheath effusion,biceps long head tendon thickness,subscapular tendon thickness,and the distance between the acromion and the greater tubercle were reduced,and the treatment group′s The improvement effecis better than that of the control group[1.50(0.60)mm vs 5(3.02)mm,2.50(0.23)mm vs 3.20(0.82)mm,4.15(0.60)mm vs 4.60(0.50)mm,23.65(8.98)mm vs 26.40(10.53)mm,all P<0.05]Conclusion Thun-der fire moxibustion combined with acupuncture has a good effect on shoulder pain after stroke,and it is worthy of pro-motion.