程序化手法联合常规疗法对偏瘫后上肢痛患者疼痛程度、上肢关节活动度的影响

Effect of Programmed Manipulation Combined with Conventional Therapy on Pain Degree and Joint Motion of Upper Limb in Patients with Hemiplegia

目的:探究程序化手法联合常规疗法在偏瘫后上肢痛患者治疗中的价值。方法:选取2019年1月—2023年1月河南省平煤神马医疗集团总医院收治的62例脑卒中偏瘫患者作为研究对象,采用电脑随机法将其分为研究组(n=31)和对照组(n=31)。对照组采用常规疗法,研究组在对照组基础上给予程序化手法。比较两组患者临床疗效、治疗前后视觉模拟量表(VAS)评分、Fugl-Meyer上肢功能量表(FMA)评分、肱动脉血流动力学[直径(D)、收缩期峰值血流速度(PSV)、阻力指数(RI)]、上肢关节活动度及不良反应情况。结果:研究组患者总有效率高于对照组,差异有统计学意义(χ^(2)=4.769,P<0.05)。治疗12周后,两组患者VAS评分较治疗前下降,且研究组低于对照组,两组患者FMA评分较治疗前升高,且研究组高于对照组,差异有统计学意义(t=5.478、2.587,P<0.05);两组患者D、PSV、RI均较治疗前改善,且研究组改善幅度大于对照组,差异有统计学意义(t=2.442、2.078、2.416,P<0.05);两组患者外旋范围、前屈范围均较治疗前增加,且研究组均高于对照组,差异有统计学意义(t=2.949、2.763,P<0.05)。治疗期间两组患者均未出现严重不良事件。结论:程序化手法疗效确切,可改善血流动力学指标,有效减轻疼痛,提高上肢运动功能,且具有较高安全性。

Objective:To explore the medical value of programmed manipulation combined with conventional therapy in the treatment of upper limb pain after hemiplegia.Methods:A total of 62 patients with upper limb pain after hemiplegia treated in the hospital from January 2019 to January 2023 were selected as the study objects,and they were randomly divided into 2 groups,with 31 cases in each group.The control group received conventional therapy,and the study group received programmed manipulation based on the control group.Clinical efficacy,visual analogue Scale(VAS)score before and after treatment,Fugl-Meyer Upper Limb Function Scale(FMA)score,brachial hemodynamics[diameter(D),peak systolic blood velocity(PSV),resistance index(RI)],upper limb joint range of motion and adverse reactions of two groups before and after treatment were compared.Results:The total effective rate of the study group was higher than that of the control group(χ^(2)=4.769,P<0.05).After 12 weeks of treatment,VAS of the study group was lower than that of the control group,FMA were higher than that of the control group(t=5.478,2.587;P<0.05).D,PSV and RI of the study group were higher than those of the control group(t=2.442,2.078,2.416;P<0.05).The range of external rotation and flexion in the study group was higher than that in the control group(t=2.949,2.763;P<0.05).There was no incidence of adverse reactions in the two groups.Conclusion:Programmed manipulation is effective.It can improve hemodynamic indexes,effectively reduce pain,and improve upper limb motor function.It has a high safety.