偏瘫性肩痛的治疗研究进展  

Research progress in the treatment of hemiplegic shoulder pain

作　　者：岳雅蓉 项文平[2] 薛慧[2] 王雅明 牛翻燕 赵吉利 何飞[3] 满乾坤 田跃龙 刘忠 YUE Yarong;XIANG Wenping;XUE Hui;WANG Yaming;NIU Fanyan;ZHAO Jili;HE Fei;MAN Qiankun;TIAN Yuelong;LIU Zhong(Inner Mongolia University of Science and Technology,Baotou Medical College,Baotou 014040,Inner Mongolia Autonomous Region,China;Department of Neurology,Baotou Central Hospital,Baotou 014040,Inner Mongolia Autonomous Region,China;Department of Rehabilitation Medicine,Baotou Central Hospital,Baotou 014040,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古自治区包头014040 [2]包头市中心医院神经内科,内蒙古自治区包头014040 [3]包头市中心医院康复医学科,内蒙古自治区包头014040

出　　处：《神经病学与神经康复学杂志》2022年第3期131-143,共13页Journal of Neurology and Neurorehabilitation

摘　　要：偏瘫性肩痛(hemiplegic shoulder pain,HSP)又称卒中后肩痛,指在脑卒中后2~3个月发生的肩部疼痛症状,是脑卒中后的常见并发症。HSP病因复杂,治疗方法也要根据病因进行选择。药物治疗、神经电刺激、肩胛上神经阻滞、肉毒毒素注射和重复经颅磁刺激主要用于神经因素引起的疼痛;肌内效贴、矫形器和吊带主要用于机械因素引起的疼痛;针灸主要通过疏经活络、活血化瘀增加肌肉局部的血流量,从而改善疼痛症状。对于多病因造成的HSP,推荐联合治疗以达最佳效果。Hemiplegic shoulder pain(HSP),also known as post-stroke shoulder pain,refers to shoulder pain symptoms occurring within 2 to 3 months after a stroke.It is a common complication after stroke.The etiology of HSP is complex,and the treatment method should also be selected according to the etiology.Pharmacotherapy,nerve electrical stimulation,suprascapular nerve blocks,botulinum toxin A and repetitive transcranial magnetic stimulation(rTMS)are mainly used for pain caused by neurological factors.Kinesio taping,arm sling and shoulder orthosesare mainly used for pain caused by mechanical factors.Acupuncture mainly increases the local blood flow of muscles by activating collaterals and activating blood circulation,thus improving the pain symptoms.For HSP with multiple causes,combined treatments are recommended for optimal results.

关 键 词：偏瘫性肩痛 卒中后肩痛 中枢性卒中后疼痛 肩关节半脱位 治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]