理筋正骨手法结合本体感觉训练治疗脑卒中后偏瘫肩痛疗效观察  

Clinical Effect of Tendon-regulation and Bone-setting Manipulation Combined with Proprioception Training in Treatment of Hemiplegic Shoulder Pain after Stroke

作　　者：李冬静 肖洪波[1] 蔡润[1] 陈瑞全 陈朝晖[2] 金祥雨 程露露[2] LI Dongjing;XIAO Hongbo;CAI Run;CHEN Ruiquan;CHEN Zhaohui;JIN Xiangyu;CHENG Lulu(The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China;College of Acupuncture and Moxibustion,Anhui University of Chinese Medicine,Anhui Hefei 230012,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031 [2]安徽中医药大学针灸推拿学院,安徽合肥230012

出　　处：《安徽中医药大学学报》2025年第1期27-31,共5页Journal of Anhui University of Chinese Medicine

基　　金：安徽高校自然科学研究重大项目(KJ2021ZD0062);安徽省中央财政中医药事业传承与发展专项资金项目(皖卫中医药发〔2020〕5号)。

摘　　要：目的观察理筋正骨手法结合本体感觉训练治疗脑卒中后偏瘫肩痛(hemiplegic shoulder pain,HSP)的疗效。方法将60例HSP患者随机分为神经肌肉本体感觉促进(proprioceptive neuromuscular facilitation,PNF)组(对照组)和理筋正骨手法结合PNF组(观察组),每组30例。比较两组患者治疗前后视觉模拟量表(visual analogue scale,VAS)评分、压痛程度评分、Fugl-Meyer评估表上肢板块(Fugl-Meyer assessment upper extremity,FMA-UE)评分、肩关节被动活动度及本体感觉。结果治疗后两组患者肩关节疼痛VAS评分、压痛程度、FMA-UE评分、肩关节被动活动度、本体感觉均较治疗前显著改善(P<0.05),且观察组上述各项指标改善程度均显著优于对照组(P<0.05)。结论理筋正骨手法联合本体感觉训练可有效缓解HSP患者肩关节疼痛,改善患者肩关节运动功能及被动关节活动度,提高本体感觉,其疗效优于本体感觉训练。Objective To investigate the clinical effect of tendon-regulation and bone-setting manipulation combined with proprioception training in the treatment of hemiplegic shoulder pain(HSP)after stroke.Methods A total of 60 patients with HSP were randomly divided into proprioceptive neuromuscular facilitation(control)group and tendon-regulation and bone-setting manipulation+PNF group(observation group),with 30 patients in each group.The two groups were observed and compared in terms of Visual Analogue Scale(VAS)score,tenderness score,Fugl-Meyer Assessment-Upper Extremity(FMA-UE)score,passive range of motion of shoulder joint,and proprioception before and after treatment.Results After treatment,both groups had significant improvements in VAS score,tenderness score,FMA-UE score,passive range of motion of shoulder joint,and proprioception(P<0.05),and the observation group had significantly better improvements in the above indicators than the control group(P<0.05).Conclusion For patients with HSP,tendon-regulation and bone-setting manipulation combined with proprioception training can effectively alleviate shoulder joint pain,improve the motor function and range of motion of shoulder joint,and enhance proprioception,with a better therapeutic effect than proprioception training alone.

关 键 词：脑卒中后肩痛 理筋正骨手法 本体感觉 神经肌肉本体感觉促进技术 

分 类 号：R743[医药卫生—神经病学与精神病学]