揿针联合站立数字作业治疗对卒中后肩痛的临床研究  

Clinical study on thumbtack needle embedding combined with standing digital ot training in treating hemiplegic shoulder pain

作　　者：麦韵怡 范颖洁 梁高哲 陈柯竹 王俊华[3,4] Mai Yunyi;Fan Yingjie;Liang Gaozhe(The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学第五临床医学院,广州510405 [2]广东医科大学附属第二医院康复医学科,湛江524000 [3]广东省第二中医院针灸康复科,广州510095 [4]广东省中医药工程技术研究院,广州510095

出　　处：《中国康复》2024年第1期8-11,共4页Chinese Journal of Rehabilitation

基　　金：广东省科技计划项目(2017B020210009);湛江市科技计划项目(2021A05110)。

摘　　要：目的:观察揿针联合站立数字作业治疗(OT)对卒中后肩痛的疗效。方法:将64例卒中后肩痛患者随机分为对照组和观察组各32例,均进行为期4周、每周5d的常规治疗;对照组在常规治疗基础上进行揿针治疗,主穴取患侧肩贞、臑俞、天宗、秉风、曲垣、肩外俞、肩中俞,配穴取合谷、中渚、后溪,留针4h后取下,1次/d;观察组在对照组的基础上增加站立数字OT训练,20 min/次,1次/d。在治疗前、治疗4周后均采用视觉模拟量表(VAS)评分、简化Fugl-Meyer运动功能评定表上肢部分(FMA-UE)及改良Barthel指数(MBI)分别评定肩痛程度、上肢运动功能及日常生活能力。结果:与治疗前相比,治疗4周后2组的VAS评分均显著降低、FMA-UE和MBI评分均显著提高(均P<0.05);与对照组相比,观察组治疗4周后的VAS评分显著降低、FMA-UE和MBI评分均显著提高(均P<0.05)。结论:揿针联合站立数字OT训练可有效减轻卒中后肩痛患者的肩部疼痛、改善上肢运动功能并提高日常生活能力。Objective:To observe the effectiveness of thumbtack needle embedding combined with standing digital OT training for hemiplegic shoulder pain.Methods:A total of 64 qualified patients with hemiplegic shoulder pain were included and randomly divided into a control group and an observation group,with 32 patients in each group.Patients in both groups received routine treatments for 4 weeks,5 days a week.Patients in control group additionally received thumbtack needle embedding therapy on the main acupoints,including Jianzhen,Naoshu,Tianzong,Bingfeng,Quyuan,Jianwaishu and Jianzhongshu,and associated acupoints including Hegu,Zhongzhu and Houxi on the affected limb.The needles were embedded for 4 h,once a day.Patients in the observation group also received 20 min of standing digital OT training based on the treatment of the control group once a day.The measurements were as follows:Visual Analogue Scale(VAS)for the level of shoulder pain;Fugl-Meyer assessment-upper limb(FMA-UE)for the motor function of upper limb;Modified Barthel Index(MBI)for the ability of daily activities.Results:As compared with the scores before treatment,the VAS scores in two groups were significantly decreased,and the FMA-UE score and MBI score were significantly increased after 4 weeks(P<0.05).As compared with the control group,after a 4-week treatment,the VAS score in the observation group was significantly decreased,and the FMA-UE score and MBI score were significantly increased(P<0.05).Conclusion:Thumbtack needle embedding combined with standing digital OT training can effectively relieve shoulder pain,and improve the motor function of upper limb and the ability of daily activities in patients with hemiplegic shoulder pain.

关 键 词：卒中后肩痛 揿针 站立数字OT 视觉模拟量表 上肢运动功能 日常生活活动能力 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]