防痉挛针刺法联合肩胛带控制训练治疗脑卒中偏瘫肩痛临床观察

Clinical Observation of Antispasmodic Acupuncture Combined with Scapular Strap Control Training in the Treatment of Hemiplegic Shoulder Pain After Stroke

目的:观察防痉挛针刺法联合肩胛带控制训练治疗脑卒中偏瘫肩痛的临床疗效。方法:选择2020年10月至2021年10月成都市中西医结合医院住院治疗的脑卒中患者80例,伴有偏瘫肩痛、运动受限,所有受试者均为右利手,按照随机数字表法分为对照组和治疗组,每组40例。对照组给予肩胛带控制训练治疗,治疗组给予防痉挛针刺法联合肩胛带控制训练治疗。观察两组疼痛视觉模拟评分(visual analogue scale,VAS)、改良Ashworth评分、被动关节活动度(passive range of motion,PROM)、简化Fugl-Meye运动功能量表上肢部分(Fugl-Meyer motor function assessment upper limb,FMA-UE)和改良Barthel指数(modified barthel index,MBI)变化情况。结果:治疗组治疗后VAS评分、Ashworth评分低于对照组,PROM、FMA-UE评分及MBI评分高于对照组,差异有统计学意义(P<0.05)。结论:防痉挛针刺法联合肩胛带控制训练治疗脑卒中偏瘫肩痛,能明显减轻患者偏瘫肩痛,平衡肌张力,改善患肩关节活动度、提高上肢运动功能。

Objective:To observe the clinical efficacy of antispasmodic acupuncture combined with shoulder strap control training on hemiplegic shoulder pain(HSP) after stroke.Methods:A total of 80 stroke patients with HSP and limited movement were selected from October 2020 to October 2021 in Chengdu Integrated TCM & Western Medicine Hospital.All subjects were right-handed and divided into the control group and the treatment group according to the random number table method,with 40 cases in each group.The control group was given shoulder strap control training,while the treatment group was given antispasmodic acupuncture combined with shoulder strap control training.Then the changes in visual analogue scale(VAS),modified Ashworth score,passive range of motion(PROM),simplified Fugl-Meyer motor function assessment upper limb(FMA-UE) and modified Barthel index( MBI) were observed in the two groups.Results:After treatment,VAS score and Ashworth score in the treatment group were lower than those in the control group,while PROM,FMA-UE scores and MBI scores were higher than those in the control group,and all the differences were statistically significant(P<0.05).Conclusion:Antispasmodic acupuncture combined with scapular strap control training can significantly reduce HSP,balance muscle tension,improve shoulder motion and enhance upper limb motor function in patients after stroke.