不同针刺选穴治疗缺血性脑卒中后偏瘫肩痛的临床观察  

Clinical effect of acupuncture at different points for post-stroke patients with hemiplegic shoulder pain

作　　者：刘爽[1] 刘钧天[1] 李然[1] LIU Shuang;LIU Juntian;LI Ran(Department of Acupuncture and Moxibustion,Huguosi Hospital of Traditional Chinese Medicine,Affiliated to Beijing University of Chinese Medicine,Beijing 100035)

机构地区：[1]北京中医药大学附属护国寺中医医院针灸科,北京100035

出　　处：《河北中医》2022年第10期1712-1715,共4页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察不同针刺选穴治疗缺血性脑卒中后偏瘫肩痛患者的临床疗效。方法将80例缺血性脑卒中后偏瘫肩痛患者按照随机数字法分为2组,对照组40例予常规针刺取穴治疗,治疗组40例采用髓海组穴和三肩组穴针刺治疗。2组均治疗28 d后统计疗效,比较2组治疗前后疼痛视觉模拟评分(VAS)、Fugl-Meyer评定量表(FMA)评分及改良Barthel指数(MBI)评分变化情况,比较2组治疗前后肩关节外旋、内旋、外展、后伸及前屈活动角度变化情况。结果治疗组总有效率92.5%(37/40),对照组总有效率72.5%(29/40),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后疼痛VAS均降低(P<0.05),FMA评分及MBI评分均升高(P<0.05),且治疗组治疗后疼痛VAS低于对照组(P<0.05),FMA评分及MBI评分高于对照组(P<0.05)。与本组治疗前比较,2组治疗后肩关节外旋、内旋、外展、后伸及前屈活动角度均增大(P<0.05),且治疗组治疗后肩关节外旋、内旋、外展、后伸及前屈活动角度均大于对照组(P<0.05)。结论采用髓海组穴和三肩组穴针刺治疗缺血性脑卒中后偏瘫肩痛的临床疗效较常规针刺取穴治疗更佳,可有效缓解患者疼痛症状,促进肢体功能恢复,提高日常生活能力,改善肩关节活动度,标本兼治,从而能够有效提高治疗效果。Objective To observe the clinical effect of acupuncture at different points for post-stroke patients with hemiplegic shoulder pain(HSP).Methods Totally 80 post-stroke patients with HSP were randomly assigned to receive conventional acupuncture(n=40,control group)or acupuncture at SuiHai and Sanjian points(n=40,treatment group).A 28-day treatment was performed to compare visual analogue scale(VAS)for pain,Fugl-Meyer Assessment(FMA),Modified Barthel Index(MBI),shoulder mobility(external rotation,internal rotation,abduction,posterior extension and anteflexion);the curative effect was assessed.Results The overall effective rate in the treatment group was significantly higher than that in the control group(92.5%[37/40]vs 72.5%[29/40];P<0.05,respectively).Compared with before treatment,the both groups had significant decreased VAS score(P<0.05),and significant increased FMA score and MBI score after treatment(P<0.05).The treatment group was superior to the control group for the scores of VAS,FMA,MBI(all P<0.05).Compared with before treatment,the both groups had significant increased shoulder mobility after treatment(P<0.05);and the treatment group was superior to the control group for shoulder mobility(P<0.05).Conclusion For post-stroke patients with HSP,acupuncture at SuiHai and Sanjian points is superior to receive conventional acupuncture,which can effectively relieve pain symptoms,promote limb function recovery,improve activity of daily living and shoulder mobility,thereby effectively improving the treatment effect.

关 键 词：缺血性脑卒中 偏瘫 肩痛 针灸疗法 

分 类 号：R255.2[医药卫生—中医内科学] R743.3[医药卫生—中医学]