重复经颅磁刺激联合电针与关节松动训练治疗卒中后肩痛的疗效观察

Observation of curative effect of repetitive transcranial magnetic stimulation combined with electroacupuncture and joint mobilization training in the treatment of poststroke shoulder pain

目的探究重复经颅磁刺激(rTMS)联合电针、关节松动训练治疗卒中后肩痛的疗效。方法选取2020年1月至2021年1月于本院卒中中心住院治疗的60例卒中后肩痛患者作为研究对象,随机分为rTMS组和药物组,每组30例。两组均给予电针、关节松动训练治疗,在此基础上rTMS组联合rTMS治疗,药物组联合药物关节腔注射治疗。比较两组视觉模拟评分(VAS)、Fugl-Meyer上肢运动功能评估量表(FMA)评分及改良Barthel指数(MBI)。结果治疗第2、4周,两组VAS评分均低于治疗前,差异有统计学意义(P<0.05);治疗第4周,rTMS组VAS评分低于药物组,差异有统计学意义(P<0.05)。治疗第2、4周,两组FMA-UE评分、MBI评分均高于治疗前,且rTMS组高于药物组,差异有统计学意义(P<0.05)。结论rTMS联合电针、关节松动训练治疗能有效缓解卒中后肩痛患者肩痛症状,恢复患侧上肢的运动功能,改善患者生活质量,值得临床推广应用。

Objective To explore the efficacy of repetitive transcranial magnetic stimulation(rTMS)combined with electroacupuncture and joint mobilization training in the treatment of post-stroke shoulder pain.Methods 60 patients with post-stroke shoulder pain who were hospitalized in the Stroke Center of our hospital from January 2020 to January 2021 were selected as the research subjects and they were randomly divided into the rTMS group and the drug group,with 30 cases in each group.Both groups were treated with electroacupuncture and joint mobilization training.On this basis,the rTMS group was combined with rTMS therapy,and the drug group was combined with drug intra-articular injection.The visual analogue scale(VAS),Fugl-Meyer motor function assessment(FMA)score and modified Barthel index(MBI)were compared between the two groups.Results In the 2nd and 4th weeks of treatment,the VAS scores of the two groups were lower than those before treatment,the difference was statistically significant(P<0.05).In the 2nd and 4th week of treatment,the FMA-UE score and MBI score of the two groups were higher than those before treatment,and the rTMS group was higher than the drug group,the difference was statistically significant(P<0.05).Conclusion rTMS combined with electroacupuncture and joint mobilization can effectively relieve the symptoms of shoulder pain in patients with post-stroke shoulder pain,restore the motor function of the affected upper limb,and improve the quality of life of patients.