董氏奇穴结合中药蜡疗治疗血瘀型中风后肩痛的效果观察

Effect of Dong acupuncture combined with traditional Chinese medicine wax therapy on shoulder pain after blood stasis type stroke

目的研究血瘀型中风后肩痛患者接受董针和中药蜡疗联合治疗后的临床疗效。方法选取2019年1月至2021年1月于郑州市骨科医院就诊并确定为血瘀型中风后肩痛的208例患者为研究对象,采用随机数字表分为对照组(104例)和研究组(104例)。对照组患者接受董氏奇穴治疗,研究组患者在对照组的基础上接受中药蜡疗。分别于治疗前后对两组患者的疼痛强度、日常活动能力、肩关节活动度和上肢运动功能进行评分,检测血清β-内啡肽(β-EP)和脑啡肽(ENK)含量并观察两组的临床疗效。结果经过不同的方式治疗后,两组患者日常活动能力、肩关节活动度和上肢运动功能均显著优于治疗前(P<0.05),并且VAS也有不同程度的缓解(P<0.05)。与对照组相比,研究组患者的上述功能改善更明显,组间比较,差异有统计学意义(P<0.05)。经过治疗后两组患者血清β-EP和ENK含量均较治疗前有不同程度增加(P<0.05);与对照组相比,研究组患者的血清ENK含量明显偏高(P<0.05)。研究组患者治疗后的临床总有效率90.38%显著优于对照组79.81%,差异有统计学意义(P<0.05)。结论董氏奇穴联合中药蜡疗治疗能明显缓解血瘀型中风后患者的肩痛程度,其镇痛作用可能与其一定程度上增加β-EP和ENK含量有关。董氏奇穴联合中药蜡疗治疗还能显著改善患者的肩关节和日常活动功能,提高患者生活质量。

Objective To study the clinical effect of Dong acupuncture combined with traditional Chinese medicine wax therapy on patients with shoulder pain after blood stasis stroke.Methods A total of 208 patients with shoulder pain after apoplexy with blood stasis type were selected from Zhengzhou Orthopaedic Hospital from January 2019 to January 2021.They were divided into control group(104 cases)and study group(104 cases)by random number table.The control group received Dong special point acupuncture treatment,and the study group received traditional Chinese medicine wax therapy on the basis of the control group.The pain intensity,daily activity ability,shoulder range of motion and upper limb motor function of the two groups were scored before and after treatment,the serumβ-endorphin(β-EP)and enkephalin(ENK)contents were detected,and the clinical efficacy of the two groups was observed.Results After different treatment methods,the daily activity ability,shoulder range of motion and upper limb motor function of the two groups were significantly better than before treatment(P<0.05),and VAS was also relieved to different degrees(P<0.05).Compared with the control group,the above functional improvement was more obvious in the study group,and the difference was statistically significan(P<0.05).After treatment,serumβ-EP and ENK contents in 2 groups were increased to different degrees compared with before treatment(P<0.05).Compared with the control group,the serum ENK content in the study group was significantly higher(P<0.05).The total clinical effective rate of 90.38%in the study group was significantly better than 79.81%in the control group after treatment,and the difference was statistically significant(P<0.05).Conclusion Dong special point acupuncture combined with Chinese herbal wax therapy can significantly relieve the degree of shoulder pain in patients with blood-stasis type stroke,and its analgesic effect may be related to the increase ofβ-EP and ENK content to a certain extent.Dong special point acupuncture combined with traditional Chinese medicine wax therapy can also significantly improve the patient's shoulder joint and daily activity function,improve the patient's quality of life.