局部封闭注射联合塞来昔布胶囊治疗脑卒中后偏瘫侧肩关节疼痛的临床效果  

Clinical effect of local block injection combined with celecoxib capsules in the treatment of hemiplegic shoulder ioint pain after stroke

作　　者：张丹丹 赵嫦莹[1] 杨访 张意辉[1] 左彬 ZHANG Dandan;ZHAO Changying;YANG Fang;ZHANG Yihui;ZUO Bin(Guangdong Provincial Work Injury Rehabilitation Center,Guangzhou 510400,China)

机构地区：[1]广东省工伤康复中心,广州市510400

出　　处：《临床合理用药杂志》2023年第20期8-10,14,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察局部封闭注射联合塞来昔布胶囊治疗脑卒中后偏瘫侧肩关节疼痛的临床效果。方法选取2019年7月—2020年12月广东省工伤康复中心收治的脑卒中后偏瘫侧肩关节疼痛患者60例,依照随机数字表法分为观察组和对照组,每组30例。在常规康复训练基础上,对照组患者给予塞来昔布胶囊治疗,观察组患者在对照组基础上加用局部封闭注射治疗,2组均持续治疗4周。比较2组患者治疗效果,治疗前后视觉模拟评分法(VAS)评分、肩关节活动度(PROM)、上肢功能运动功能评定量表(FMA)评分、日常生活能力[改良Bathel指数(MBI)评分]及不良反应。结果观察组治疗总有效率为93.33%,高于对照组的73.33%(χ^(2)=4.320,P=0.038);治疗4周后,2组患者VAS评分较治疗前降低,PROM较治疗前增大,上肢FMA评分、MBI评分较治疗前升高,且观察组上述指标改善幅度大于对照组(P均<0.01);观察组与对照组不良反应总发生率比较差异无统计学意义(10.00%vs.6.67%,P>0.05)。结论局部封闭注射联合塞来昔布胶囊治疗脑卒中后偏瘫侧肩关节疼痛效果显著,可改善患者上肢功能,恢复患者部分日常生活能力,且安全可靠。Objective To observe the clinical effect of local block injection combined with celecoxib capsules in the treatment of hemiplegic shoulder ioint pain after stroke.Methods From July 2019 to December 2020,60 patients with hemiplegic shoulder ioint pain after stroke of Guangdong Provincial Work Injury Rehabilitation Center were selected,and randomly divided into an observation group and a control group by random number table method,with 30 patients in each group.On the basis of routine rehabilitation training,the control group patients were treated with celecoxib capsules,while the observation group patients were treated with local block injection on the basis of the control group,both groups continued to receive treatment for 4 weeks.The clinical efficacy,including visual analogue scale(VAS)score,shoulder range of motion(PROM),upper limb functional motor function assessment scale(FMA)score,daily living ability[Modified Bathel Index(MBI)score]before and after treatment and adverse reactions of the two groups were compared.Results The total effective rate in the observation group was 93.33%,higher than 73.33%in the control group(χ^(2)=4.320,P=0.038);After 4 weeks of treatment,the VAS score of both groups decreased compared to before treatment,PROM increased compared to before treatment,upper limb FMA score and MBI score increased compared to before treatment,and the improvement of the above indicators in the observation group was greater than that in the control group(all P<0.01);There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group(10.00%vs.6.67%,P>0.05).Conclusion Local block injection combined with celecoxib capsules is effective in the treatment of hemiplegic shoulder ioint pain after stroke.It can improve upper limb function and restore part of daily living ability of patients,which is safe and reliable.

关 键 词：脑卒中 偏瘫 肩关节疼痛 局部封闭注射 塞来昔布胶囊 上肢功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]