基于肌骨超声技术中药熏蒸精准论治中风偏瘫恢复期肩痛疗效观察

Study on the Effect of Traditional Chinese Medicine Fumigation on Shoulder Pain During Convalescence of Stroke Hemiplegia based on Musculoskeletal Ultrasonic Technology

目的:探讨基于肌骨超声技术下中药熏蒸精准论治中风偏瘫恢复期肩痛的疗效。方法:选择2017年1月—2018年5月常州市德安医院康复中心收治的中风后偏瘫肩痛患者160例,按照随机数字表法分为对照组与研究组,每组各80例。两组均给予中药熏蒸治疗,对照组常规理学检查确定明显疼痛或病变部位为治疗靶点,研究组采用肌骨超声仪明确病变部位并将此作为治疗靶点,两组均每日治疗1次,每次30 min,每周治疗5次,治疗6周为1个疗程。观察两组患者治疗前及治疗1周、3周、6周时视觉模拟疼痛评分(VAS)、Fugl-Meyer上肢运动功能评分情况,比较治疗前与治疗6周时两组患者患侧肩关节被动活动度变化情况。结果:不同治疗时间在VAS评分、Fugl-Meyer上肢运动评分上存在显著主效应(P<0.01),不同治疗方法在VAS评分、Fugl-Meyer上肢运动评分上存在显著主效应(P<0.01),不同治疗时间和治疗方法间在VAS评分、Fugl-Meyer上肢运动评分中存在交互作用(P<0.01);治疗后研究组患者患侧肩关节前屈、后伸、内旋、外旋与外展的被动活动度均明显大于同期对照组,差异有统计学意义(P<0.05)。结论:在肌骨超声技术支持下开展中药熏蒸治疗中风偏瘫肩痛,可显著提高中药熏蒸治疗中风偏瘫肩痛的疗效,大大促进上肢功能的恢复。

Objective:To explore the effect of fumigation of traditional Chinese medicine on shoulder pain during convalescence of hemiplegia after stroke. Methods:A total of 160 cases of patients with poststroke hemiplegia shoulder pain in rehabilitation center of Changzhou Dean hospital from January 2017 to May 2018,who were according to random number table method were divided into control group and research group,80 cases in each group. In the two groups were given traditional Chinese medicine fumigation treatment,control group was given routine physical examination to determine the obvious pain or therapeutic targets for the lesion site,The study group was used musculoskeletal ultrasonic technology to identify the lesion site and use it as a therapeutic target,two groups of treatment 1 times a day,every time 30 min,five times a week treatment,treatment of 6 weeks for a course of treatment. To observe two groups of patients before treatment and treatment for 1 week,3 weeks,6 weeks visual analog pain score(VAS),Fugl-Meyer upper limb movement function grading,compare before and 6 weeks treatment in the two groups patients suffering from passive side shoulder joint activity changes. Results:Different treatment time in VAS score,Fugl-Meyer had significant main effect on upper limb movement score(P<0.01),different treatment methods in the VAS score,Fugl-Meyer significant main effect on upper limb movement score(P<0.01),between the different treatment time and treatment in VAS score,Fugl-Meyer interaction existed in the upper limb movement score(P<0.01);After treatment,the passive activity of the patients in the study group was significantly higher than that of the control group(P<0.05). Conclusion:Under the support of musculoskeletal ultrasonic technology,traditional Chinese medicine fumigation can improve the curative effect on shoulder pain of stroke hemiplegia,and promote the recovery of upper limb function.