循经远取动法联合蜡疗对中风后肩痛患者疼痛、上肢运动功能、日常生活能力及血清白细胞介素6、肿瘤坏死因子α、一氧化氮水平的影响

Effect of needling distal point along meridian plus exercising combined with wax treatment on pain,upper extremity motor function,activities of daily living,serum interleukin-6,tumor necrosis factor-α,nitric oxide in patients with post-stroke shoulder pain

目的观察循经远取动法联合蜡疗对中风后肩痛症患者疼痛、上肢运动功能、日常生活能力及血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、一氧化氮(NO)水平的影响。方法将200例中风后肩痛患者按照随机数字表法分为2组,对照组100例予蜡疗治疗,治疗组100例予循经远取动法联合蜡疗治疗。2组均治疗14 d,比较2组治疗前后疼痛视觉模拟评分(VAS)、Fugl-Meyer运动功能评定量表(FMA)上肢部分评分、改良Barthel指数评分量表(MBI)评分变化情况及血清IL-6、TNF-α、NO水平变化情况。结果与本组治疗前比较,2组治疗后疼痛VAS均降低(P<0.05),FMA上肢部分评分及MBI评分均升高(P<0.05),且治疗组治疗后疼痛VAS低于对照组(P<0.05),FMA上肢部分评分及MBI评分均高于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清IL-6、TNF-α及NO水平均降低(P<0.05),且治疗组治疗后血清IL-6、TNF-α及NO水平均低于对照组(P<0.05)。结论循经远取动法联合蜡疗对中风后肩痛疗效确切,可有效缓解患者疼痛症状,改善上肢运动功能,提高日常生活能力,其作用机制可能与降低IL-6、TNF-α及NO水平,抑制炎症相关因子的释放和聚集,减轻肩部炎性反应有关。

Objective To observe the effect of needling distal point along meridian plus exercising combined with wax treatment on pain,upper extremity motor function(UE-MF),activities of daily living(ADL),serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),nitric oxide(NO)in patients with post-stroke shoulder pain(PSSP).Methods Totally 200 patients with PSSP were randomly divided into the treatment group and the control group,with 100 cases in each group;in addition to the wax treatment,and the treatment group additionally received needling distal point along meridian plus exercising.Treated for 14 days,aiming to compare visual analogue scale(VAS)for pain,Fugl-Meyer assessment(FMA)-of the upper extremity(FMA-UE),Modified Barthel Index(MBI),serum IL-6,TNF-α,NO.Results After treatment,the VAS for pain in groups was decreased compared with the treatment period(P<0.05),while the FMA-UE and MBI scores were increased(P<0.05);lower VAS for pain,and higher FMA-UE and MBI scores were detected in the treatment group than those in the control group(all P<0.05);the serum IL-6,TNF-α,NO in groups were decreased(P<0.05),the reduction in the treatment group was more prevalent(P<0.05).Conclusion For patients with PSSP,needling distal point along meridian plus exercising combined with wax treatment has a definite curative effect,which can effectively relieve the pain symptoms,improve the UE-MF,and ADL by reducing the levels of IL-6,TNF-α and NO,inhibiting the release and aggregation of inflammatory factors,and reducing the inflammatory response of the shoulder.