中药熏蒸联合冲击波康复治疗脑卒中后肩痛的效果  

CLINICAL EFFECT OF TRADITIONAL CHINESE MEDICINE FUMIGATION COMBINED WITH SHOCKWAVE REHABILITATION IN TREATMENT OF SHOULDER PAIN AFTER STROKE

作　　者：谈雪梅[1] 何俊[1] 焦素芹[1] 马静[1] 彭冬祥 吴冲 TAN Xuemei, HE Jun, JIAO Suqin, MA J ing, PENG Dongxiang, WUChong(Rehabilitation Centre, Changzhou Dean Hospital, Changzhou 213000, Chin)

机构地区：[1]常州市德安医院康复中心,江苏常州213000

出　　处：《精准医学杂志》2017年第6期692-696,共5页Journal of Precision Medicine

基　　金：常州市2016年第41批科技计划项目(2016373)

摘　　要：目的探讨中药熏蒸仪联合冲击波康复治疗脑卒中后肩痛的效果。方法选取我院收治的脑卒中后肩痛病人90例,按数字表法随机分为中药熏蒸组、冲击波组以及中药熏蒸与冲击波联合治疗组,每组30例病人。3组病人均给予常规内科治疗与常规康复训练,在此基础上,中药熏蒸组以自拟组方并运用国产智能熏蒸仪进行中药熏蒸治疗,冲击波组运用放散式体外冲击波治疗仪治疗,联合治疗组采取中药熏蒸与冲击波联合治疗。3组均以20d为1个疗程,治疗1个疗程后评估3组病人的疼痛治疗有效率、肩关节活动度以及日常生活能力的改善情况。结果疗程结束时,联合治疗组的肩痛治疗总有效率为96.7%,明显高于中药熏蒸组的73.3%与冲击波组的86.7%,差异有统计学意义(Z=4.628、2.967,P<0.05);疗程结束时3组病人的肩关节主动活动度(前屈、后伸、外展、外旋、内旋)以及日常生活能力比较,差异有统计学意义(F=3.062~3.819,P<0.05)。结论对于脑卒中后肩痛病人,在常规康复训练基础上,采取中药熏蒸与冲击波联合治疗方案能有效减轻疼痛,改善肩关节活动度,提高病人的日常生活活动能力。Objective To investigate the clinical effect of traditional Chinese medicine （TCM） fumigation combined with shockwave rehabilitation in the treatment of shoulder pain after stroke. Methods A total of 90 patients with shoulder pain after stroke who were admitted to our hospital were enrolled and randomly divided into TCM fumigation group, shockwave group, and TCM fumigation＋shockwave group, with 30 patients in each group. All patients were given conventional medical treatment and conventional rehabilitation training; in addition, the patients in the TCM fumigation group were given TCM fumigation with a self made prescription and a domestic intelligent device for TCM fumigation, those in the shockwave group were given treatment with an extracorporeal shockwave therapeutic apparatus, and those in the TCM fumigation2-shockwave group were given TCM fumiga- tion combined with shockwave therapy. The course of treatment was 20 days for all groups, and after one course of treatment, the patients were evaluated in terms of response rate of pain and improvements in range of motion of the shoulder joint and activities of daily living. Results At the end of the course of treatment, the TCM fumigation＋shockwave group had a significantly higher response rate of pain than the TCM fumigation group and the shockwave group （96.7 % vs 73.3 %86.7 %, Z= 4. 628 and 2. 967, P〈0.06）; there were also significant differences between the three groups in active range of motion of the shoulder joint （flexion, extension, abduction, extorsion, and intorsion） and activities of daily living （F=3.062 3.819,P〈0.05）. Conclusion As for patients with shoulder pain after stroke, TCM fumigation combined with shockwave, in addition to conventional rehabilitation training, can effectively reduce pain and improve the range of motion of the shoulder joint and patients＇ activities of daily living.

关 键 词：中药疗法 高能量冲击波 卒中 肩痛 治疗结果 

分 类 号：R743[医药卫生—神经病学与精神病学] R312[医药卫生—临床医学]