肩四针捣刺联合推拿治疗中风后肩痛临床研究

Clinical study on treatment of shoulder pain after apoplexy with four-needle ramming and massage

目的:探讨肩四针捣刺法联合推拿治疗中风后肩痛效果及对患者肩部运动功能、表面肌电图(sEMG)的影响。方法:纳入220例中风后肩痛患者,按照随机数字表法分为对照组与观察组,各110例。对照组行推拿治疗,观察组行肩四针捣刺法联合推拿治疗。评价两组临床疗效,对比两组肩关节活动度、上肢功能[Fugl-Meyer运动功能评分法(FMA)]、日常生活能力[改良Barthel指数评分(MBI)]、sEMG[积分肌电值(IEMG)、平均肌电振幅值(AEMG)]。结果:观察组总治疗有效104例,总有效率94.55%,高于对照组的94例、85.45%,差异有统计学意义(P<0.05)。治疗后观察组肩关节屈曲、外旋、外展角度大于对照组,差异有统计学意义(均P<0.05)。治疗后观察组FMA、MBI评分高于对照组(P<0.05)。治疗后,两组患者IEMG、AEMG均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:中风后肩痛患者行肩四针捣刺法联合推拿治疗能有效改善患者肩关节活动度与肩部功能,改善肌力,提升肌肉收缩性,疗效较好。

Objective:To explore curative effect of shoulder four-needle ramming combined with massage on shoulder pain after stroke and its influences on shoulder motor function and surface electromyography(sEMG).Methods:220 patients with post-stroke shoulder pain were enrolled and divided into control group and observation group,110 cases in each group,by random number table method.The clinical curative effect in the two groups were evaluated.The shoulder range of motion,upper limb function[Fugl-Meyer assessment(FMA)],activities of daily living[modified barthel index(MBI)]and sEMG[integrated electromyography(IEMG),average electromyography amplitude(AEMG)]were compared between the two groups.Results:The total response rate of treatment 94.55%(104 cases)in the observation group was higher than that in the control group 85.45%(94 cases),difference statistically significant(P<0.05).After treatment,angles of shoulder flexion,external rotation and abduction in the observation group were greater than those in the control group,difference statistically significant(all P<0.05).After treatment,scores of FMA and MBI in the observation group were higher than those in the control group(P<0.05).After treatment,IEMG and AEMG were increased in both groups,which were higher in the observation group than those in the control group,difference statistically significant(P<0.05).Conclusion:Shoulder four-needle ramming combined with massage can effectively improve shoulder range of motion and shoulder function,improve muscle strength and muscle contraction in patients with shoulder pain after stroke,which has better curative effect.