Effectiveness of bee venom acupuncture in alleviating post-stroke shoulder pain: a systematic review and meta-analysis

BACKGROUND：Shoulder pain is a common complication of stroke.Bee venom acupuncture（BVA）is increasingly used in the treatment of post-stroke shoulder pain.OBJECTIVE：To summarize and evaluate evidence on the effectiveness of BVA in relieving shoulder pain after stroke.SEARCH STRATEGY：Nine databases,namely MEDLINE,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure（CNKI）,the Japan Science and Technology Information Aggregator,Electronic（J-STAGE）,and four Korean medical databases,namely,the National Assembly Library,the Research Information Service System,the National Discovery for Science Leaders,and OASIS,were searched from their inception through August 2014 without language restrictions.INCLUSION CRITERIA：Randomized controlled trials（RCTs）were included if BVA was used at acupoints as the sole treatment,or as an adjunct to other treatments,for shoulder pain after stroke.DATA EXTRACTION AND ANALYSIS：Two review authors independently selected trials for inclusion,assessed methodological quality and extracted data.RESULTS：A total of 138 potentially relevant articles were identifi ed,4 of which were RCTs that met our inclusion criteria.The quality of studies included was generally low,and a preponderance of positive results was demonstrated.All four trials reported favorable effects of BVA on shoulder pain after stroke.Two RCTs assessing the effects of BVA on post-stroke shoulder pain,as opposed to saline injections,were included in the meta-analysis.Pain was signifi cantly lower for BVA than for saline injections（standardized mean difference on 10-cm visual analog scale：1.46 cm,95%CI=0.30–2.62,P=0.02,n=86）CONCLUSION：This review provided evidence suggesting that BVA is effective in relieving shoulder pain after stroke.However,further studies are needed to confi rm the role of BVA in alleviating post-stroke shoulder pain.Future studies should be conducted with large samples and rigorous study designs.

Clinical Observation on the Post-stroke Shoulder Pain and Blood Viscosity Treated by Acupuncture-moxibustion Therapy

目的：探讨针灸治疗中风后偏瘫肩痛的临床疗效。方法：将90例中风后偏瘫肩痛患者按1：1：1随机分为3组。分别采用针灸、针灸加中药、中药进行治疗。结果：3组间疗效、全血黏度经统计学处理，针灸组、针灸加中药组与中药组相比具有显著性差异（P〈0．01）；而针灸组与针灸加中药组之间无显著性差异（P〉0．05）。结论：针灸治疗对中风后偏瘫肩痛具有良好疗效，对异常全血黏度有近期调节降低作用。

Central post-stroke pain due to injury of the spinothalamic tract in patients with cerebral infarction： a diffusion tensor tractography imaging study

Many studies using diffusion tensor tractography（DTT） have demonstrated that injury of the spinothalamic tract（STT） is the pathogenetic mechanism of central post-stroke pain（CPSP） in intracerebral hemorrhage; however, there is no DTT study reporting the pathogenetic mechanism of CPSP in cerebral infarction. In this study, we investigated injury of the STT in patients with CPSP following cerebral infarction, using DTT. Five patients with CPSP following cerebral infarction and eight age-and sex-matched healthy control subjects were recruited for this study. STT was examined using DTT. Among DTT parameters of the affected STT, fractional anisotropy and tract volume were decreased by more than two standard deviations in two patients（patients 1 and 2） and three patients（patients 3, 4, and 5）, respectively, compared with those of the control subjects, while mean diffusivity value was increased by more than two standard deviations in one patient（patient 2）. Regarding DTT configuration, all affected STTs passed through adjacent part of the infarct and three STTs showed narrowing. These findings suggest that injury of the STT might be a pathogenetic etiology of CPSP in patients with cerebral infarction.

Spa therapy relieves knee and shoulder pain:a randomized controlled trial

Objective:To study the effect of spa therapy on relieving knee and shoulder pain.Methods:Participants were randomized to an intervention group(n=26)or a control group(n=23).The intervention group received the hot spring intervention program(1-2 times a day for two weeks),while the control group didn’t receive any intervention.Primary outcomes were assessed by the Western Ontario and McMaster University Osteoarthritis Index(WOMAC)and Shoulder Pain and Disability Index(SPADI).Secondary outcomes were assessed by general physical symptoms and Short Form-36(SF-36)health survey.Results:All parameters before intervention were homogenous between the groups.At baseline,there was no significant difference in WOMAC and SPADI index between the two groups,but there was a statistically significant difference in blurred vision,which was worse in the intervention group than in the control group(P<0.05).After intervention,general physical symptoms were relieved significantly in the intervention group compared with the control group(P<0.05).WOMAC index,SPADI index,social functioning,and general physical symptoms were relieved significantly after intervention in the intervention group(P<0.05).There is a significant difference in the blurred vision before and after the comparison of the control group(P<0.05).Conclusion:Spa therapy may relieve knee and shoulder pain and improve general physical symptoms and quality of life.

Repressing iron overload ameliorates central poststroke pain via the Hdac2-Kv1.2 axis in a rat model of hemorrhagic stroke

Thalamic hemorrhage can lead to the development of central post-stroke pain.Changes in histone acetylation levels,which are regulated by histone deacetylases,affect the excitability of neurons surrounding the hemorrhagic area.However,the regulato ry mechanism of histone deacetylases in central post-stroke pain remains unclea r.Here,we show that iron overload leads to an increase in histone deacetylase 2expression in damaged ventral posterolateral nucleus neurons.Inhibiting this increase restored histone H3 acetylation in the Kcna2 promoter region of the voltage-dependent potassium(Kv)channel subunit gene in a rat model of central post-stroke pain,thereby increasing Kcna2expression and relieving central pain.However,in the absence of nerve injury,increasing histone deacetylase 2 expression decreased Kcna2expression,decreased Kv current,increased the excitability of neurons in the ventral posterolateral nucleus area,and led to neuropathic pain symptoms.Moreover,treatment with the iron chelator deferiprone effectively reduced iron overload in the ventral posterolateral nucleus after intracerebral hemorrhage,reversed histone deacetylase 2 upregulation and Kv1.2 downregulation,and alleviated mechanical hypersensitivity in central post-stroke pain rats.These results suggest that histone deacetylase 2 upregulation and Kv1.2 downregulation,mediated by iron overload,are important factors in central post-stroke pain pathogenesis and co uld se rve as new to rgets for central poststroke pain treatment.

Pain management of hemiplegic shoulder pain post stroke in patients from Nanjing,China

We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accounted for 45.5% of the inpatients because of stroke. Results showed that the number of patients with hemiplegic shoulder pain post stroke increased yearly, attacking mainly males 50-69 years of age. Of 106 patients, there were 60 cases （56.6%） of adhesive capsulitis, 19 （17.9%） of shoulder subluxation, 14 （13.2%） of complex regional pain syndrome, and 13 （12.6%） of central pain. The main symptoms were shoulder pain （100%）, limit of shoulder mobility （98.1%）, and adhesion of the scapula （56.6%）. MRI of the shoulder showed tendon and ligament lesions （57.1%） and rotator cuff tear （38.1%）. 53.8% of central pain was related to the thalamus, in addition to the basal ganglia, brain stem, and cerebellopontine angle. Shoulder pain, upper limb motor function, and function independence were significantly improved after comprehensive rehabilitation. In par- ticular, electroacupuncture based on basic physical therapy exhibited efficacy on shoulder subluxa- tion and complex regional pain syndrome. Multiple linear regression results showed a negative re- lationship of efficacy of pain management with the attack period of shoulder pain, involvement of the posterior limb of the internal capsule, and duration between onset and rehabilitation treatment, but a positive correlation with pain-related education, pain regression period, and pain diagnosis.

Therapeutic efficacy of acupuncture combined with neuromuscular joint facilitation in treatment of hemiplegic shoulder pain

BACKGROUND Stroke is a type of cerebrovascular disease with high prevalence,mortality,and onset of disability.As a neurodevelopmental therapy,neuromuscular joint facilitation(NJF)is widely used in the treatment of orthopedic and neurological disorders in the clinical practice.It is mainly used for central nervous system diseases or orthopedic diseases,movement disorders,and pain rehabilitation.According to related studies,NJF can also be used as a rehabilitation treatment in patients with hemiplegic shoulder pain(HSP).AIM To investigate the clinical efficacy of acupuncture combined with NJF in patients with HSP.METHODS Forty patients with HSP were randomly divided into a treatment group and a control group.The treatment group was treated with acupuncture combined with NJF and the control group was treated with acupuncture alone.All patients were assessed by using the visual analogue scale(VAS),Fugl-Meyer assessment(FMA),Barthel index(BI),and passive range of motion(PROM)before and after the training.All the clinical data were analyzed using SPSS 20.0 statistical software.RESULTS There was no statistical difference in the general characteristics between the two groups.In the terms of duration of treatment,age,and pre-treatment indicators,the two groups were comparable(P>0.05).After the treatment,VAS,PROM,BI,and FMA scores were significantly improved in the two groups of patients(P<0.05).The VAS,PROM and FMA scores were significantly higher in the treatment group than in the control group(P<0.05).However,there was no significant difference in BI scores between the two groups(P>0.05).CONCLUSION Both acupuncture alone and acupuncture combined with NJF in the treatment of HSP are effective,and can improve the clinical symptoms of patients.Acupuncture combined with NJF can improve the upper limb motor function,relieve pain,and increase joint mobility in patients with HSP.The combination therapy is better than acupuncture alone.However,there is no significant difference in improving the score of patients’self-care ability.

The Relationship between Neck and Shoulder Pain and the Sagittal Alignment of the Spine in Standing in Younger Generation

Background: The relationship between chronic neck and shoulder pain and posture remains controversial. The purpose of this study was to investigate the relationship between chronic neck and shoulder pain and spinal sagittal alignment in standing posture in younger generation. Methods: Subjects included 57 females and 32 males (average age, 29.9 ± 5.7 years). All subjects were 20s or 30s. Spinal curvature was assessed using SpinalMouse. The subjects were also divided into a normal group (VAS zero group) and a pain group by VAS results. Statistical analysis was performed by Student’s t-test. Significance was defined as p < 0.05. Results: The normal group and pain group included 29 and 60 subjects, respectively. In terms of location of pain, thirty-one subjects felt neck pain, 50 felt pain above the scapula, and 17 felt pain between the thoracic spine and scapula. Thoracic kyphosis and lumbar lordosis in the pain group were significantly higher than those in the normal group (p = 0.013 and p = 0.020, respectively). Thoracic kyphosis in subjects with neck pain or pain above scapula was significantly higher than that in subjects without pain (p = 0.0075 and p = 0.025, respectively). Lumbar lordosis in subjects with pain above the scapula or interscapula was significantly higher than that in subjects without pain (p = 0.016).

The Effects of Interferential Stimulation on Pain and Motion after Shoulder Surgery: A Prospective Randomized Study

Purpose: The purpose of this study is to determine the effects of interferential stimulation on pain and motion after shoulder surgery. Study Design: Randomized Controlled Trial. Methods: 102 patients undergoing arthroscopic rotator cuff repair or labral repair were prospectively randomized to receive either an interferential stimulation unit immediately after surgery (STIM) or not to receive the unit (NO-STIM). Each patient was measured for the range of motion (ROM) in forward flexion (FF), abduction (ABD), internal rotation (IR) and external rotation (ER). These measurements were taken prior to surgery and at the 6 weeks post-operative time point. Visual Analogue Scale (VAS) scores (0 - 10) and the amount of narcotic taken (standardized to 10 mg equivalents of hydrocodone) were measured and compared between the two groups at 2 days and 4 weeks post-operatively. 51 patients were excluded due to failure to document VAS scores and medication usage, lack of follow-up at the 6 weeks post-operative time point or hospitalization after surgery. This left 27 patients in the STIM group and 24 patients in the NO-STIM group. Results: No difference was found in the amount of narcotic taken after 2 days (STIM 14.37 ± 1.02, NO-STIM 15.88 ± 1.22, p = 0.34) or after 4 weeks (STIM 45.32 ± 4.36, NO-STIM 48.96 ± 5.50, p = 0.60). No difference in mean VAS scores were found at 2 days (STIM 5.56 ± 0.53, NO-STIM 4.63 ± 0.57, p = 0.24) or 4 weeks (STIM 1.68 ± 0.39, NO-STIM 1.38 ± 0.34, p = 0.57). At 6 weeks post-operatively, a difference was found in ER (STIM 62.5 ± 4.09, NO-STIM 50.4 ± 4.09, p = 0.04), and no differences found in FF (STIM 134.2 ± 5.29, NO-STIM 133.3 ± 4.85, p = 0.60), ABD (STIM 124.8 ± 6.22, NO-STIM 119.6 ± 5.42, p = 0.53) or IR (STIM 60.0 ± 3.69, NO-STIM 55.9 ± 3.03, p = 0.39). A post-hoc power analysis performed using an á = 0.05 revealed the study to be 90% powered to identify a difference of one narcotic equivalent between groups and 90% powered to identify a 0.3 difference in VAS scores. Conclusions: The use of an interferential stimulator in the immediate post-operative period had no effect on pain or narcotic usage following arthroscopic rotator cuff repair or labral repair. External rotation was significantly greater in the interferential stimulator group while no differences were found in other motion parameters.

DEVELOPMENT OF CLINICAL STUDIES ON ACUPUNCTURE TREATMENT OF SHOULDER PAIN IN PATIENTS WITH WIND STROKE

In the present paper, the authors review some new results of acupuncture treatment of shoulder pain in stroke patients from ① application of filiform needle with different needling manipulations, ② selection and combination of acupoints, and ③ some special needling methods including point-injection. Generally, if acupuncture therapy is used in combination with other rehabilitation methods, the therapeutic effect of shoulder-pain-relief will be much better. Regarding the acupoint selection, both local acupoints and those of the yang meridians are primarily used in clinical practice. Further studies on treating shoulder pain of hemiplegia based upon the basic theory of TCM are necessary.

Type A aortic dissection developed after type B dissection with the presentation of shoulder pain: A case report

BACKGROUND Aortic dissection(AD)is a life-threatening condition with a high mortality rate without immediate medical attention.Early diagnosis and appropriate treatment are critical in treating patients with AD.In the emergency department,patients with AD commonly present with classic symptoms of unanticipated severe chest or back pain.However,it is worth noting that atypical symptoms of AD are easily misdiagnosed.CASE SUMMARY A 51-year-old woman was first diagnosed with scapulohumeral periarthritis due to left shoulder pain.After careful examination of her previous medical history and contrast-enhanced computed tomography angiography,the patient was diagnosed with a new type A AD after chronic type B dissection in the ascending aorta.The patient was successfully treated with surgical replacement of the dissected aortic arch and remains in good health.CONCLUSION New retrograde type A AD after chronic type B dissection is relatively rare.It is worth noting that a physician who has a patient with suspected AD should be vigilant.Both patient medical history and imaging tests are crucial for a more precise diagnosis.

Neural Modulation of Hemiparetic Shoulder Pain by Repetitive Ultrasound-Guided Suprascapularis Nerve Block

Background: Neural blockade is widely used in clinical practice to alleviate acute or chronic pain, including pain during rehabilitation. To date there is little controlled evidence to confirm the efficacy of nerve blocks in hemiparetic shoulder pain after stroke. Design: This study is a prospective, open label, cohort trial reporting result from a cohort of stroke patients affected by shoulder pain. Aim: As a cohort study report, in which it is often firstly reported the possibility of an association between an observed effect and a specific environmental based on detailed clinical evaluations and histories, we aim to firstly provide clues in identifying Suprascapularis Nerve blockade as further valuable approach for shoulder pain after stroke. Population: We studied a cohort of patients affected by hemiparetic shoulder pain after Stroke. Methods: Our protocol foresees nerve blocks to be performed each 3 out of 4 days (treatment lasting 30 days) in conjunction with a rehabilitation program with the first aim to provide the window of opportunity to proceed with effective rehabilitation. 47 potential study subjects fulfilled the study criteria and were enrolled. Twenty-four subjects were randomised to the study Group to receive SSNB for the pain of their hemiparetic shoulder while 23 subjects randomized to the control Group whose member did not receive SSNB. They received serial blocks each 3 out of 4 days during rehabilitation.Results: Both treatment reported a reduction in the intensity of their shoulder pain, according to data collected from day 1 through day 42 (6 weeks). Study Group patients, receiving SSNBs, reported significant improvement from entry through the whole follow-up period. The efficiency data were higher for SSNB Group after 2 weeks and again for SSNb group at the end of treatment. Conclusion: Excellent pain relief was achieved in SSNB without clinically relevant complications, these patients having a better improvement on pain during rehabilitation, than the control subjects. Great efficacy has been achieved by combining a nerve block and rehabilitation. About Clinical Rehabilitation Impact, we believe that Suprascapularis nerve blocks can help the stroke survivors maintain an ambulatory or outpatient treatment status, maintain participation in a physical therapy or rehabilitation program, decrease the need for analgesics and in some cases lead to a complete pain relief.

Influence of enhancing dynamic scapular recognition on shoulder disability,and pain in diabetics with frozen shoulder:A case report

BACKGROUND Frozen shoulder(FS)is a familiar disorder.Diabetics with FS have more severe symptoms and a worse prognosis.Thus,this study investigated the influence of enhancing dynamic scapular recognition on shoulder disability and pain in diabetics with FS.CASE SUMMARY A Forty-five years-old male person with diabetes mellitus and a unilateral FS(stage II)for at least 3 mo with shoulder pain and limitation in both passive and active ranges of motion(ROMs)of the glenohumeral joint of≥25%in 2 directions participated in this study.This person received dynamic scapular recognition exercise was applied to a diabetic person with a unilateral FS(stage II).The main outcome measures were upward rotation of the scapula,shoulder pain and disability index,and shoulder range of motion of flexion,abduction,and external rotation.The dynamic scapular exercise was performed for 15 min/session and 3 sessions/wk lasted for 4 wk.After 4 wk of intervention,there were improvements between pre-treatment and post-treatment in shoulder pain,shoulder pain and disability index,shoulder ROM,and upward rotation of the scapula.CONCLUSION This case report suggested that enhancing dynamic scapular recognition may improve shoulder pain and disability;upward rotation of the scapula;and shoulder ROM of shoulder abduction,flexion,and external rotation after 4 wk.

Shoulder adhesive capsulitis in cancer patients undergoing positron emission tomography-computed tomography and the association with shoulder pain

BACKGROUND Adhesive capsulitis is a relatively common condition that can develop in cancer patients during treatment.Positron emission tomography-computed tomography(PET-CT)is routinely performed as a follow-up study in cancer patients after therapy.Being aware of PET-CT findings to suggest shoulder adhesive capsulitis may help to alert clinicians for the diagnosis of unsuspected shoulder capsulitis.AIM To assess the association of shoulder adhesive capsulitis with cancer/therapy type and symptoms in cancer patients undergoing PET-CT.METHODS Our prospective study received Institutional Review Board approval.Written informed consent was obtained from all patients,who answered a questionnaire regarding shoulder pain/stiffness at the time of PET-CT study,between March 2015 and April 2019.Patients with advanced glenohumeral arthrosis,metastatic disease or other mass in the shoulder,or shoulder arthroplasty were excluded.Patterns of shoulder capsule 18F-fluorodeoxyglucose(FDG)uptake were noted.Standard Uptake Value(SUV)max and SUVmean values were measured at rotator interval(RI)and deltoid muscle in bilateral shoulders.Normalized SUV(SUV of RI/SUV of deltoid muscle)was also calculated.We assessed if SUV values are different between symptomatic and asymptomatic patients in both shoulders.Covariates were age,gender,and therapy type(surgery,chemotherapy,radiation).Wilcoxon rank sum tests were used to compare unadjusted marginal differences for age,SUV measurements between symptomatic and asymptomatic patients.Multiple linear regression models were used to examine the relationship between right or left shoulder SUV measurements and symptom status,after adjusting for covariates.Statistical significance level was set at P<0.05.RESULTS Of 252 patients initially enrolled for the study(mean age 66 years,67 symptomatic),shoulder PET-CT data were obtained in 200 patients(52 were excluded due to exclusion criteria above).The most common cancer types were lymphoma(n=61),lung(n=54)and breast(n=53).No significant difference was noted between symptomatic and asymptomatic patients in terms of age,gender,proportion of patients who had surgical therapy and radiation therapy.A proportion of patients who received chemotherapy was higher in patients who were asymptomatic in the right shoulder compared to those symptomatic in the right shoulder(65%vs 48%,P=0.012).No such difference was seen for the left shoulder.In both shoulders,SUVmax and SUVmean were higher in symptomatic shoulders than asymptomatic shoulders(Left SUVmax 2.0 vs 1.6,SUVmean 1.6 vs 1.3,both P<0.002;Right SUVmax 2.2 vs 1.8,SUVmean 1.8 vs 1.5,both P<0.01).For lung cancer patients,bilateral RI SUVmax and SUVmean values were higher in symptomatic shoulders than asymptomatic shoulders.For other cancer patients,symptomatic patients had higher left RI SUVmax/mean than asymptomatic patients after adjustment.CONCLUSION In symptomatic patients metabolic activities in RI were higher than asymptomatic patients.Adhesive capsulitis should be considered in cancer patients with shoulder symptoms and positive FDG uptake in RI.

Effect of kinesio taping on shoulder pain after stroke

Objective:To discuss the clinical effect of kinesio taping on shoulder pain after stroke. Methods: A total of 60 patients with shoulder pain after stroke in our hospital between July 2016 and March 2018 were divided into the treatment group and the control group according to the SPSS random method, 30 in each group. The treatment group was treated with kinesio taping and combined comprehensive rehabilitation therapy, while the control group received simple comprehensive rehabilitation therapy for 4 weeks. The visual analogue scale (VAS), simplified Fugl-Meyer motor function score (FMA) and range of motion (ROM) were used to evaluate the pain degree, upper limb function and shoulder joint activity of the patients before and 2 and 4 weeks after treatment.Results: There was no difference in VAS score between the two groups before treatment (P>0.05),and the VAS score of the treatment group were significantly lower than those of the control group after 2 weeks and 4 weeks (P<0.05).There was no difference in FMA score between the two groups before treatment (P>0.05), and the FMA scores of the treatment group were significantly higher than that of the control group after 2 weeks and 4 weeks (P<0.05).There was no difference in the shoulder flexion, extension, abduction, internal rotation and external rotation of the two groups before treatment (P>0.05), and the shoulder flexion, extension, abduction, internal rotation and external rotation of the patients in the treatment group were significantly greater than those in the control group after 2 and 4 weeks of treatment (P<0.05).Conclusion:Kinesio taping combined with rehabilitation therapy can alleviate the pain and improve the upper limb function and shoulder motion function after stoke. It worth of clinical use.

Immediate analgesia effect of contralateral needling at Tiaokou (ST38) in patients with chronic shoulder pain: A randomized controlled exploratory trial

Objective:To compare the immediate effect of acupuncture at the contralateral versus ipsilateral Tiaokou (ST38) in patients with Chronic shoulder pain (CSP).Method:Altogether,38 patients with unilateral CSP were randomly assigned to a contralateral ST38 group (Contra group) or ipsilateral ST38 group (Ipsi group).Each underwent 20 min of manual acupuncture:Contra group at the contralateral ST38,Ipsi group at the ipsilateral ST38.Primary outcome measure was the visual analog scale (VAS) score.Secondary outcome measure for assessing shoulder mobility was the Constant-Murley (CM) score,which included pain level,activities of daily living (ADL),and shoulder range of motion (RONM).These factors were assessed before and immediately after acupuncture.A value of P <.05 indicated significance.Results:VAS scores decreased immediately after treatment in both groups,but the effect was significantly greater in the Contra group (P =.043).CM scores also improved in both groups,but the Contra group improved significantly more (P =.002).The CM's pain and ADL scores were similar in the two groups (P =.055 and P =.193,respectively),but ROM and strength scores were better in the Contra group than in the Ipsi group (P =.003 and P =.037,respectively).No adverse effects were reported.Conclusion:The immediate effect of acupuncture at the contralateral ST38 may be superior to that at the ipsilateral ST38 in CSP patients.

肩部控制训练联合神经松动术对脑卒中偏瘫患者肩痛及上肢功能的效果

目的观察肩部控制训练基础上联合神经松动术治疗脑卒中偏瘫患者肩痛的效果。方法2020年1月至2021年11月,南通市第二人民医院脑卒中偏瘫患者43例,随机分为对照组(n=21)和治疗组(n=22)。对照组采用肩部控制训练,治疗组加用神经松动术。治疗前、治疗4周后,采用疼痛数字表法(NRS)和Fugl-Meyer评定量表上肢部分(FMA-UE)进行评定。结果对照组脱落1例,治疗组脱落2例。两组治疗后NRS和FMA-UE评分显著改善(|t|>7.898,P<0.001),且治疗组优于对照组(|t|>2.337,P<0.05)。结论肩部控制训练联合神经松动术能显著缓解脑卒中偏瘫患者的肩痛,改善其上肢运动功能。

静脉注射联合关节腔灌注氨甲环酸对肩关节镜肩袖修补术后患者的作用效果

目的 探究静脉注射联合关节腔灌注氨甲环酸对肩关节镜肩袖修补术后患者的影响。方法 收集医院2020年2月至2022年11月收治的84例接受肩关节镜肩袖修补术患者的临床资料。依照术中止血干预方式分为观察组(56例,静脉注射联合关节腔灌注氨甲环酸)和对照组(28例,氨甲环酸静脉注射)。比较两组血红蛋白、手术出血量、手术时间、肩关节肿胀情况、疼痛程度、肩关节功能、并发症、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-3(MMP-3)水平。结果 术后1 d两组血红蛋白下降,观察组高于对照组(P<0.001)。两组手术出血量、手术时间相比,差异有统计学意义(P<0.001)。两组肩关节周径组间、时间、交互效应有统计学意义(P<0.05)。术后1、2 d,两组疼痛评分差异有统计学意义,且观察组低于对照组(P<0.05);两组术后2 d的疼痛评分均低于术后1 d(P<0.001)。术后1个月两组肩关节功能评分均高于术前,观察组高于对照组(P<0.001)。两组术后IL-1β、TNF-α、MMP-3均降低,且观察组低于对照组(P<0.001)。结论 静脉注射联合关节腔灌注氨甲环酸应用于肩关节镜肩袖修补手术中能够有效发挥止血作用,减轻炎症反应,缓解患者疼痛,改善肩关节功能,相对安全。

银质针疗法联合中药熏蒸对颈肩腰腿痛患者疼痛程度、运动功能及血流动力学的影响

目的探讨颈银质针疗法联合中药熏蒸对颈肩腰腿痛患者疼痛程度、运动功能及血流动力学的影响。方法选取医院2019年10月至2021年1月收治的颈肩腰腿痛患者120例,按入院时段分为对照组和观察组,各60例。对照组患者予常规西医方案治疗,观察组患者予银质针联合中药熏蒸方案治疗。结果观察组总有效率为88.33%,显著高于对照组的73.33%(P<0.05);观察组患者的Fugl-Meyer评估量表(FMA)、疼痛数字评定量表(NRS)评分均显著低于对照组(P<0.05);观察组患者的血流动力学指标血浆黏度、红细胞沉降率、红细胞电泳时间均显著低于对照组(P<0.05)。结论银质针疗法联合中药熏蒸治疗颈肩腰腿痛的临床疗效良好,可改善患者的疼痛程度、运动功能及血流动力学指标。