针灸对脑卒中后遗偏瘫侧颈肩痛患者疼痛程度及日常生活能力的影响

Effects of Acupuncture and Moxibustion on Pain Degree and Activities of Daily Living in Patients with Hemiplegic Neck and Shoulder Pain after Stroke

目的分析针灸对脑卒中后遗偏瘫侧颈肩痛患者疼痛程度及日常生活能力的影响。方法选取三明市大田县中医院2018年5月至2020年4月103例脑卒中后遗偏瘫侧颈肩痛患者,按随机数字表法分为两组,研究组51例,对照组52例。对照组使用常规治疗,在此基础上,研究组进行针灸干预,对比两组治疗效果、疼痛程度、日常生活能力、肢体功能与心理状态,分别采用视觉模拟评分法(VAS)、Barthel指数、Fugl-Meyer运动功能评估量表(FMA)、抑郁自评量表(SDS)及焦虑自评量表(SAS)进行评估。结果研究组总有效为92.16%,高于对照组的76.92%(P<0.05);治疗30 d后,两组患者VAS评分均较治疗前降低,Barthel指数均较治疗前提高,且研究组显著优于对照组(P<0.05);治疗30 d后,两组上肢部分、下肢部分评分及总分均较治疗前提高,SDS、SAS评分均治疗前降低,且研究组显著优于对照组(P<0.05)。结论针灸可有效提高脑卒中后遗偏瘫侧颈肩痛患者治疗效果,改善患者疼痛程度、肢体功能及日常生活能力,还可调节患者心理状态。

Objective To analyze the effect of acupuncture and moxibustion on pain degree and activities of daily living in patients with hemiplegic neck and shoulder pain after stroke.Methods The 103 patients with hemiplegic lateral neck and shoulder pain after stroke in Datian County Hospital of Traditional Chinese Medicine of Sanming city from May 2018 to April 2020 were randomly divided into two groups,51 cases in the study group and 52 cases in the control group.The control group received routine treatment.On this basis,the study group received acupuncture intervention.The treatment effect,pain degree,ability of daily living,limb function and psychological state were compared between the two groups.the Visual Analogue Scale(VAS),Barthel Index,Fugl-Meyer motor function assessment scale(FMA)score,Self-rating Depression Scale(SDS)and Self-rating Anxiety Scale(SAS)were used for evaluation.Results The total effective rate in the study group was 92.16%,which was higher than 76.92%in the control group(P<0.05).The VAS scores of the two groups of patients were lower than before treatment,and the Barthel index was higher than that before treatment,and the study group was significantly better than the control group(P<0.05).After 30 days of treatment,the scores and total scores of the upper and lower limbs of the two groups were improved compared with those before the treatment,and the SDS and SAS scores were all decreased before the treatment,and the study group was significantly better than the control group(P<0.05).Conclusion Acupuncture and moxibustion can effectively improve the treatment effect of patients with hemiplegic neck and shoulder pain after stroke,improve the degree of pain,limb function and daily living ability,and adjust the psychological state of patients.