姜黄天灸膏穴位贴敷治疗脑卒中偏瘫肩痛临床疗效观察  

Clinical effect of acupoint application with turmeric blistering moxibustion plaster on post-stroke hemiplegic shoulder pain

作　　者：李壮苗[1] 燕文娟 刘芳[1] 李霞[1] 李秀霞 余梦婷 LI Zhuang-miao;YAN Wen-juan;LIU Fang;LI Xia;LI Xiu-xia;YU Meng-ting(School of Nursing,Fujian University of TCM,Fuzhou 350122,China;Women and Children's Hospital Affiliated to Xiamen University(Xiamen Municipal Maternal and Child Health Center);Affiliated Rehabilitation Hospital,Fujian University of TCM;West China Xiamen Hospital of Sichuan University)

机构地区：[1]福建中医药大学护理学院,福州350122 [2]厦门大学附属妇女儿童医院(厦门市妇幼保健院) [3]福建中医药大学附属康复医院 [4]四川大学华西厦门医院

出　　处：《中国针灸》2023年第12期1373-1378,共6页Chinese Acupuncture & Moxibustion

基　　金：2019年福建中医药大学校管课题护理学科开放课题项目:X2019042-学科。

摘　　要：目的:观察姜黄天灸膏穴位贴敷对脑卒中偏瘫肩痛患者疼痛、肩关节活动度和上肢运动功能的影响。方法:将82例卒中后偏瘫肩痛患者随机分为观察组(41例,剔除1例、脱落4例)及对照组(41例,剔除2例、脱落2例)。对照组予常规治疗、护理及康复训练。观察组在对照组基础上,于患侧阿是穴、肩髃、肩髎、臂臑、手三里、合谷行姜黄天灸膏穴位贴敷,每次6 h,每天1次,每周5次,2周为一疗程,共治疗2个疗程。分别于治疗前及治疗2、4周后观察两组患者视觉模拟量表(VAS)评分、肩关节活动度(ROM)及Fugl-Meyer运动功能评定量表上肢部分(U-FMA)评分。结果:两组患者治疗2、4周后VAS评分低于治疗前(P<0.05),肩关节屈曲、外展、内旋、外旋ROM大于治疗前(P<0.05),U-FMA评分高于治疗前(P<0.05);治疗4周后VAS评分低于治疗2周后(P<0.05),肩关节屈曲、外展、内旋、外旋ROM大于治疗2周后(P<0.05),U-FMA评分高于治疗2周后(P<0.05)。观察组患者治疗2、4周后VAS评分低于对照组(P<0.05);治疗2周后肩关节屈曲、外展ROM大于对照组(P<0.05);治疗4周后肩关节屈曲、外展、内旋、外旋ROM大于对照组(P<0.05),U-FMA评分高于对照组(P<0.05)。结论:姜黄天灸膏穴位贴敷可有效减轻脑卒中偏瘫肩痛患者肩痛程度,改善其肩关节活动度及提高上肢运动功能。Objective To observe the effects of acupoint application with turmeric blistering moxibustion plaster on pain,shoulder range of motion(ROM)and upper limb motor function in the patients with post-stroke hemiplegic shoulder pain(PSHSP).Methods Eighty-two patients with PSHSP were randomly divided into an observation group(41 cases,1 case was eliminated,4 cases dropped out)and a control group(41 cases,2 cases were eliminated and 2 cases dropped out).The routine treatment,nursing care and rehabilitation training were performed in the control group.On the basis of the intervention as the control group,in the observation group,the turmeric blistering moxibustion plaster was applied to bilateral ashi points,Jianyu(LI 15),Jianliao(TE 14),Binao(LI 14),Shousanli(LI 10)and Hegu(LI 4),once a day,remained for 6 hours each time.This moxibustion therapy was operated 5 times weekly,one course of treatment consisted of 2 weeks and 2 courses were required.Separately,before treatment and after 2 and 4 weeks of treatment,the score of visual analogue scale(VAS),shoulder ROM and the score of upper limbs in Fugl-Meyer assessment(U-FMA)were observed in the two groups.Results VAS scores were lower(P<0.05),ROM in shoulder flexion,abduction,internal rotation and external rotation was larger(P<0.05),and U-FMA scores were higher(P<0.05)after 2 and 4 weeks of treatment when compared with those before treatment in the two groups.After 4 weeks of treatment,VAS score decreased(P<0.05),and ROM in shoulder flexion,abduction,internal rotation,external rotation and U-FMA score increased(P<0.05)in comparison with those after 2 weeks of treatment in either group.In the observation group,VAS scores were dropped(P<0.05)after 2 and 4 weeks of treatment respectively,and ROM of shoulder flexion and abduction enlarged after 2 weeks of treatment(P<0.05)when compared with those in the control group.After 4 weeks of treatment,ROM in shoulder flexion,abduction,internal rotation and external rotation in the observation group was larger(P<0.05)and U-FMA score was

关 键 词：脑卒中 偏瘫肩痛 穴位贴敷 天灸 姜黄 疼痛程度 肩关节活动度 上肢运动功能 

分 类 号：R246.6[医药卫生—针灸推拿学]