针刺结合肌内效贴治疗缺血性脑卒中后肩痛临床研究

Clinical Study on Acupuncture Combined with Kinesio Taping for Shoulder Pain after Ischemic Stroke

目的:观察在常规疗法基础上加用针刺结合肌内效贴治疗缺血性脑卒中后肩痛的临床疗效。方法:选取88例气虚血瘀型缺血性脑卒中后肩痛患者,按随机数字表法分为对照组和观察组各44例。2组均行神经内科常规治疗措施与针刺疗法,观察组加用肌内效贴治疗。2组均连续治疗4周。评定2组患者治疗前后的疼痛视觉模拟评分法(VAS)评分、上肢运动功能[傅格-梅尔氏(Fugl-Meyer)运动量表(FMMS)]、Barthel指数(BI)评分,检测肩关节活动度,统计临床疗效。结果:治疗后,总有效率观察组93.18%,对照组75.00%,2组比较,差异有统计学意义(P <0.05)。2组VAS评分均较治疗前减少,FMMS、BI评分均较治疗前升高,差异均有统计学意义(P <0.01);观察组VAS评分低于对照组,FMMS、BI评分均高于对照组,差异均有统计学意义(P <0.01)。2组肩关节前屈、后伸、外展、内旋、外旋的活动度均较治疗前增加(P <0.01),观察组肩关节活动度大于对照组(P <0.01)。结论:在常规神经内科疗法干预基础上以针刺结合肌内效贴治疗缺血性脑卒中后肩痛,可明显减轻肩关节的疼痛程度,改善患者的上肢运动功能、日常生活活动能力及肩关节活动度,提高临床疗效。

Objective:To observe the clinical effect of additional application of acupuncture combined with kinesio taping on the basis of routine therapy on shoulder pain after ischemic stroke.Methods:Selected 88 cases of patients with shoulder pain after ischemic stroke with qi deficiency and blood stasis syndrome and randomly divided them into the control group and the observation group according to the random number table.Both groups underwent routine neurological treatment and acupuncture,and the observation group was treated with kinesio taping.Both groups were treated continuously for 4 weeks.Evaluated visual analogue scale(VAS)scores,upper limb motor function[Fugl-Meyer exercise scale(FMMS)],Barthel index(BI)scores of patients in the two groups before and after treatment.Detected the range of motion of shoulder joints of patients,and recorded the clinical effect.Results:After treatment,the total effective rate was 93.18%in the observation group and 75.00%in the control group,compared the two groups,difference being significant(P<0.05).The VAS scores of the two groups were lower than those before treatment;the FMMS and BI scores were higher than those before treatment,differences being significant(P<0.01).The VAS scores of the observation group were lower than those of the control group,the FMMS and BI scores were higher than those in the control group,differences being significant(P<0.01).The motion degree of the anteflexion,posterior extension,abduction,internal rotation and external rotation of the shoulder joints in the two groups were increased when compared with those before treatment(P<0.01);the range of motion of shoulder joints in the observation group was greater than that in the control group(P<0.01).Conclusion:On the basis of routine neurology therapy intervention,the application of acupuncture combined with kinesio taping for shoulder pain after ischemic stroke can significantly reduce the degree of pain,improve upper limb motor function,daily living activity ability and range of motion of shoulder joints,and promote the clinical effect.