经筋结点恢刺法配合PNF技术改善偏瘫肩痛上肢运动功能及生活质量的临床观察  

Clinical Observation of Relaxing Needling at Meridian-muscle Nodes plus PNF Method in Improving Upper-limb Motor Function and Quality of Life in Hemiplegic Shoulder Pain

作　　者：韩振翔[1] 祁丽丽[2] 周一心[1] 张宏[2] 许文杰[1] 王宏林[1] 张贞[1] 王智博[1] HAN Zhen-xiang;QI Li-li;ZHOU Yi-xin;ZHANG Hong;XU Wen-jiel;WANG Hong-lin;ZHANG Zhen;WANG Zhi-bo(Shanghai Seventh People＇s Hospital, Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137 [2]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《上海针灸杂志》2017年第12期1420-1424,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市卫计委中发办项目(2014LQ030A);上海市中医药领军人才建设项目学术共同体(ZY3-RCPY-1-1001);上海市杏林新星(ZY3-RCPY-2-2077);上海市浦东新区卫计委项目(PW2014B-15);上海市浦东新区重点专科(中风专科)建设项目(PDZYXK-1-2014001)

摘　　要：目的观察经筋结点恢刺法配合康复技术对脑卒中偏瘫肩痛患者上肢运动功能及生活质量的影响。方法将90例脑卒中偏瘫肩痛患者随机分为康复组30例(采用PNF康复技术治疗)、恢刺组30例(采用经筋结点恢刺法治疗)、综合组30例(在经筋结点恢刺后采用PNF康复技术治疗),共治疗6星期,治疗前后评估AFS评分、FMA上肢功能活动评分、SS-QOL评分及统计肩手综合征的发生率。结果综合组在治疗1星期后AFS评分与康复组或恢刺组比较差异有统计学意义(P<0.05)。治疗6星期后,综合组治疗后FMA评分、SS-QOL评分与康复组或恢刺组比较差异有统计学意义(P<0.05)。治疗12星期后综合组肩手综合征发生率与康复组或恢刺组比较差异有统计学意义(P<0.05)。结论经筋结点恢刺法配合PNF康复技术可有效改善偏瘫肩痛的疗效,降低肩手综合征的发生率,提高患者的生活质量,是一种较为有效的治疗手段。Objective To observe the effect of relaxing needling at meridian-muscle nodes plus rehabilitation techniques on upper-limb motor function and quality of life （QOL） in hemiplegic shoulder pain after cerebral stroke. Method Ninety patients with hemiplegic shoulder pain after cerebral stroke were randomized into a rehabilitation group of 30 cases [intervened by proprioceptive neuromuscular facilitation （PNF） method], a relaxing needling group of 30 cases （intervened by relaxing needling at meridian-muscle nodes）, and a comprehensive group of 30 cases （intervened by relaxing needling at meridian-muscle nodes plus PNF method）, to receive 6-week treatment in total. Before and after the intervention, Assessment Face Scale （AFS）, Fugl-Meyer Assessment Scale （FMA） and Stroke Specific Quality of Life Scale （SS-QOL） were evaluated, and the occurrence rate of shoulder-hand syndrome was assessed. Result After 1-week treatment, the AFS score of the comprehensive group was significantly different from that in the rehabilitation group and relaxing needling group （P〈0.05）. After 6-week treatment, the FMA and SS-QOL scores in the comprehensive group were significantly different from those in both rehabilitation group and relaxing needling group （P〈0.05）. Twelve weeks later, the occurrence rate of shoulder-hand syndrome in the comprehensive group was significantly different from that in the other two groups （P〈0.05）. Conclusion Relaxing needling at meridian-muscle nodes plus PNF method can effectively improve the efficacy in the treatment of hemiplegic shoulder pain, reduce the occurrence of shoulder-hand syndrome, and enhance the QOL, thus is an effective approach.

关 键 词：针刺 经筋结点 恢刺 康复训练 中风并发症 偏瘫 肩痛 FMA SS-QOL AFS 

分 类 号：R246.6[医药卫生—针灸推拿学]