体外冲击波穴位冲击疗法治疗偏瘫肩痛的临床疗效

Effect of extracorporeal shock wave acupoint shock therapy on hemiplegic shoulder pain

目的:观察体外冲击波穴位冲击疗法治疗偏瘫肩痛(HSP)的临床疗效。方法:选取符合标准的54例HSP患者,随机分为3组,每组各18例。对照组采用常规康复治疗,观察A组在对照组的基础上加用体外冲击波痛点治疗,观察B组在观察A组基础上加用体外冲击波穴位治疗。比较3组治疗前、治疗后和随访时的疼痛视觉模拟评分(VAS),上肢Fugl-Meyer运动功能评分(U-FMA),肩关节屈曲、外展和外旋无痛被动关节活动度(PROM)。结果:治疗后和随访时,3组的VAS评分均较治疗前降低(P<0.05),U-FMA评分和屈曲、外展和外旋无痛PROM均较前治疗增高(P<0.05)。治疗后,观察A组和观察B组的VAS评分低于对照组(P<0.05),观察A组的屈曲无痛PROM和观察B组的屈曲、外展无痛PROM高于对照组(P<0.05)。随访时,观察A组和观察B组的VAS评分低于对照组(P<0.05),且观察B组的VAS评分低于观察A组(P<0.05);观察A组和观察B组的U-FMA评分高于对照组(P<0.05);观察A组和观察B组的屈曲、外展无痛PROM高于对照组(P<0.05),观察B组的屈曲、外展、外旋无痛PROM高于观察A组(P<0.05)。结论:传统的体外冲击波疗法和体外冲击波穴位冲击疗法都有利于HSP患者的疼痛程度、肩关节无痛PROM和上肢运动功能改善,体外冲击波穴位冲击疗法疗效更优。

Objective:To observe the effect of extracorporeal shock wave acupoint shock therapy on hemiplegic shoulder pain(HSP).Methods:A total of 54 HSP patients who met the standards were selected and randomly divided into 3 groups with 18 cases each.The control group was treated with routine rehabilitation therapy,the observation group A was treated with extracorporeal shock wave pain point therapy,and the observation group B was treated with extracorporeal shock wave acupoint shock therapy on the basis of the observation group A.The Visual Analog Scale(VAS),Upper Limb Fugl Meyer Motor Function Assessment(U-FMA)and pain-free Passive Joint Range of Motion(PROM)of shoulder flexion,abduction,and external rotation were compared among the three groups before treatment,after treatment,and during the follow-up period.Results:After treatment and during follow-up,the VAS scores in three groups were lower than those before treatment(P<0.05).U-FMA scores and pain-free PROM of flexion,abduction and external rotation were higher than those before treatment(P<0.05).After treatment,the VAS scores in the observation group A and observation group B were lower than those in the control group(P<0.05),the pain-free PROM of flexion in the observation group A and pain-free PROM of flexion and abduction in the observation group B were higher than those in the control group(P<0.05).During the follow-up period,the VAS scores in the observation group A and observation group B were lower than those in the control group(P<0.05),and those in the observation group B were lower than those in the observation group A(P<0.05).The U-FMA scores in the observation group A and observation group B were higher than those in the control group(P<0.05).The pain-free PROM of flexion and abduction in the observation group A and observation group B was higher than that in the control group(P<0.05),and that of flexion,abduction and external rotation in the observation group B was higher than in the observation group A(P<0.05).Conclusion:Both traditional extracorporeal shock wave therapy and extracorporeal shock wave acupoint therapy are beneficial to the improvement of pain degree,pain-free PROM of shoulder joint and motor function of upper limb in patients with HSP,and the effect of extracorporeal shock wave acupoint therapy is better.