浮刺合康复训练治疗脑卒中后肩手综合征肩部疼痛疗效观察  

Observation on the clinical efficacy of shoulder pain in post-stroke shoulder-hand syndrome treated with floating acupuncture and rehabilitation training

作　　者：汪军 崔晓 倪欢欢 黄春水 周翠侠 吴佶 史骏超 吴毅[2] 

机构地区：[1]上海市长宁区天山中医医院康复科,上海200051 [2]复旦大学附属华山医院康复医学科

出　　处：《中国针灸》2013年第4期294-298,共5页Chinese Acupuncture & Moxibustion

基　　金：国家中医药管理局十二五重点学科建设项目;上海市长宁区卫生局科研基金项目:20114ZY 04001

摘　　要：目的:比较浮刺、西药口服及中药局部熏蒸治疗脑卒中后肩手综合征肩部疼痛的疗效差异。方法:将90例脑卒中后肩手综合征(第Ⅰ期)患者随机分为浮刺组、西药组、中药局部熏蒸组,每组30例。浮刺组寻找患者患肩明显压痛点2个,在每一个压痛点的下方80～100mm处作为浮刺进针部位;西药组口服莫比可7.5mg;中药局部熏蒸组采用活血舒筋中药局部熏蒸。3组患者均接受康复训练,浮刺治疗、西药口服、中药局部熏蒸、康复训练分别每日1次,共治疗观察1个月。采用视觉模拟评分法、高岸肩关节功能评定量表疼痛评定部分对3组患者肩部疼痛治疗前后动态改变情况进行测评;应用改良Barthel指数对3组患者治疗前后日常生活自理能力动态改变进行评价。结果:浮刺治疗对脑卒中后肩手综合征患者肩部疼痛、日常生活自理能力的改善优于西药口服及中药局部熏蒸治疗(均P<0.01);中药局部熏蒸对脑卒中后肩手综合征患者肩部疼痛改善优于西药口服(均P<0.01);中药局部熏蒸与西药口服对脑卒中后肩手综合征患者日常生活自理能力改善无统计学差异(P>0.05),二者疗效相当。结论:浮刺治疗可以及时、有效缓解脑卒中后肩手综合征患者肩部疼痛,对脑卒中后肩手综合征患者肩部疼痛、日常生活自理能力的改善优于西药口服及中药局部熏蒸治疗。Objective To compare the efficacy difference in the treatment of shoulder pain in post-stroke shoulder-hand syndrome among floating acupuncture, oral administration of western medicine and local fumigation of Chinese herbs. Methods Ninety cases of post-stroke shoulder-hand syndrome （stage I ） were randomized into a floating acupuncture group, a western medicine group and a local Chinese herbs fumigation group, 30 cases in each one. In the floating acupuncture group, two obvious tender points were detected on the shoulder and the site 80-100 mm inferior to each tender point was taken as the inserting point and stimulated with floating needling technique. In the western medicine group, mobic 7.5 mg was prescribed for oral administration. In the local Chinese herbs fumigation group, the formula for activating blood circulation and relaxing tendon was used for local fumiga- tion. All the patients in three groups received rehabilitation training. The floating acupuncture, oral administration of western medicine, local Chinese herbs fumigation and rehabilitation training were given once a day respectively in corresponding group and the cases were observed for 1 month. The visual analogue scale （VAS） and Takagishi shoulder joint function assessment were adopted to evaluate the dynamic change of the patients with shoulder pain before and after treatment in three groups. The modified Barthel index was used to evaluate the dynamic change of daily life activity of the patients in three groups. Results With floating acupuncture, shoulder pain was relieved and the daily life activity was improved in the patients with post-stroke shoulder-hand syndrome, which was supe- rior to the oral administration of western medicine and local Chinese herbs fumigation （P〈0.01）. With local Chinese herbs fumigation, the improvement of shoulder pain was superior to the oral administration of western medicine. The difference in the improvement of daily life activity was not significant statistically between the local Chineseherbs

关 键 词：脑卒中后遗症 肩手综合征 肩部疼痛 浮刺 莫比可 熏蒸 

分 类 号：R246.6[医药卫生—针灸推拿学]