针刺联合功能训练对中风后肩痛患者上肢运动功能及血液流变学的影响

Effects of acupuncture combined with functional trainings on the upper limb motor functions and hemorheology in patients with post-stroke shoulder pain

目的 探讨针刺联合功能训练对中风后肩痛患者上肢运动功能及血液流变学的影响。方法 将86例中风后肩痛患者随机分为对照组与观察组,各43例。对照组在内科对症处理基础上给予康复功能训练干预,观察组在对照组基础上给予针刺治疗,2组均治疗4周。观察2组治疗前后视觉模拟量表(VAS)评分、简化Fugl-Meyer上肢运动功能评分(FMA)、改良Barthel指数评分(MBI)、肩关节活动度以及血液流变学变化,统计并比较2组临床总有效率。结果 观察组治疗后VAS评分,血浆黏度、全血高切黏度、纤维蛋白原及全血低切黏度水平均低于对照组(P<0.05),FMA 评分和MBI评分及肩关节前屈、后伸、外展、内旋、外旋均高于对照组(P<0.05);观察组总有效率(93.0%,40/43)高于对照组(76.7%,33/43)(P<0.05)。结论 针刺联合功能训练能够有效调节中风后肩痛患者血液流变学,缓解疼痛,提高关节活动度,对促进肢体运动功能康复有积极作用。

Objective To investigate the effects of acupuncture combined with functional trainings on the upper limb motor functions and hemorheology in patients with post-stroke shoulder pain.Methods A total of eighty-six patients with post-stroke shoulder pain were randomly divided into a control group and an observation group,with 43 cases in each group.The control group was given a rehabilitation function training intervention on the basis of internal medicine symptomatic treatments,while the observation group was given an acupuncture treatment on the basis of the control group,both treated for 4 weeks.The scores of the visual analog scale (VAS),scores of the simplified Fugl-Meyer assessment scale (FMA) for upper limb motor functions,scores of the modified Barthel index (MBI),changes in the shoulder mobility and hemorheology were observed in the two groups before and after treatment,and the total clinical effective rates of the two groups were statistically compared.Results After treatment,the VAS scores,levels of plasma viscosity,high shear whole blood viscosity,fibrinogen and low shear whole blood viscosity in the observation group were lower than those in the control group (P<0.05).The FMA score,MBI score,levels of the shoulder flexion,extension,abduction,internal rotation and external rotation in the observation group were higher than those in the control group (P< 0.05).The total effective rate of the observation group (93.0%,40 / 43) was higher than that of the control group (76.7%,33 / 43) (P<0.05).Conclusion Acupuncture combined with functional trainings can effectively regulate hemorheology in patients with post-stroke shoulder pain,relieve their pains,improve the joint mobility,having a positive effect on promoting the recovery of limb motor functions.