温经通络散联合作业疗法治疗脑卒中后肩痛临床研究  

Clinical Study on Wenjing Tongluo Powder Combined with Occupational Therapy for Shoulder Pain After Stroke

作　　者：韩作献 HAN Zuoxian

机构地区：[1]浙江中医药大学附属金华中医院康复治疗部,浙江金华321000

出　　处：《新中医》2023年第12期30-34,共5页New Chinese Medicine

摘　　要：目的:观察温经通络散联合作业疗法治疗脑卒中后肩痛的临床疗效。方法:回顾性分析62例脑卒中后肩痛患者资料,根据不同治疗方式将其分为对照组与观察组各31例。对照组给予作业疗法干预,观察组在对照组基础上加用温经通络散治疗。比较2组临床疗效、不良反应发生率,以及治疗前后中医证候评分、疼痛视觉模拟评分法(VAS)评分、Fugl-Meyer运动功能评定量表(FMA)评分、改良Barthel指数(MBI)评分、肩关节活动度。结果:观察组总有效率为93.54%,对照组为80.64%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组肩痛、半身不遂、神识昏蒙、气短乏力、肢体瘫软、舌淡暗等中医证候评分均较治疗前降低(P<0.05),且观察组各项中医证候评分均低于对照组(P<0.05)。治疗后,2组疼痛VAS评分较治疗前降低,FMA、MBI评分均较治疗前升高(P<0.05),且观察组上述3项评分改善均优于对照组(P<0.05)。治疗后,2组肩关节前屈、后伸、外展、内旋、外旋活动度均较治疗前增大(P<0.05),且观察组上述各项肩关节活动度均大于对照组(P<0.05)。观察组不良反应发生率为6.45%,对照组为19.35%,2组比较,差异有统计学意义(P<0.05)。结论:温经通络散联合作业疗法治疗脑卒中后肩痛可提高疗效,有利于减轻疼痛,改善中医证候、上肢运动功能及肩关节功能,提高患者日常生活能力,减少不良反应。Objective:To observe the clinical effect of Wenjing Tongluo Powder combined with occupational therapy for shoulder pain after stroke.Methods:The data of 62 cases of patients with shoulder pain after stroke were given retrospective analysis and divided into the control group and the observation group according to different treatment methods,with 31 cases in each group.The control group was intervened with occupational therapy,and the observation group was additionally treated with Wenjing Tongluo Powder based on the treatment of the control group.The traditional Chinese medicine(TCM)syndrome scores,Visual Analogue Scale(VAS)scores,Fugl-Meyer Assessment(FMA)scores,Modified Barthel Index(MBI)and shoulder joint mobility before and after treatment,and the clinical effects and incidence of adverse reactions were compared between the two groups.Results:The total effective rate was 93.54%in the observation group and 80.64%in the control group,the difference being significant(P<0.05).After treatment,the TCM syndrome scores including shoulder pain,hemiplegia,mental confusion,short breath and fatigue,limb paralysis,and pale and dingy tongue in the two groups were decreased when compared with those before treatment(P<0.05),and the TCM syndrome scores in the observation group were lower than those in the control group(P<0.05).After treatment,VAS scores in the two groups were decreased when compared with those before treatment(P<0.05),the scores of FMA and MBI were increased when compared with those before treatment(P<0.05),and the improvement of the above three scores in the observation group were better than that in the control group(P<0.05).After treatment,the shoulder joint mobility including anteflexion,posterior extension,abduction,inward rotation,and outward rotation in the two groups was increased when compared with that before treatment(P<0.05),and the above shoulder joint mobility in the observation group was larger than that in the control group(P<0.05).The incidence of adverse reactions was 6.45%in the observation

关 键 词：脑卒中 肩痛 温经通络散 作业疗法 Fugl-Meyer运动功能评定量表 

分 类 号：R743.3[医药卫生—神经病学与精神病学]