正清风痛宁肩峰下间隙注射联合超声引导下放散式冲击波治疗脑卒中后偏瘫肩痛患者的短期疗效及安全性  

Short-term efficacy and safety of Zhengqing Fengtongning subacromial injection combined with radial extracorporeal shock wave therapy under ultrasound guidance in patients with hemiplegic shoulder pain after stroke

作　　者：童晓轩 王甦 吴何凤 贾献福 周艳 Tong Xiaoxuan;Wang Su;Wu Hefeng;Jia Xianfu;Zhou Yan(Department of Rehabilitation Medicine,The Sixth People's Hospital of Xiangtan,Xiangtan City,Hunan Province 411102,China;Tong Xiaoxuan works at the Department of Rehabilitation Medicine,The Third Hospital of Quzhou,Quzhou City,Zhejiang Province 324000,China)

机构地区：[1]湘潭市第六人民医院康复医学科,湘潭市411102 [2]衢州市第三医院康复医学科,衢州市324000

出　　处：《中华疼痛学杂志》2024年第6期886-890,共5页Chinese Journal Of Painology

摘　　要：目的探讨正清风痛宁肩峰下间隙注射联合超声引导下放散式冲击波治疗脑卒中后偏瘫肩痛患者的短期疗效及安全性。方法本研究为前瞻性随机对照试验。收集2022年1月1日至2023年7月31日,于湘潭市第六人民医院康复医学科住院的脑卒中后6个月内偏瘫肩痛患者150例,年龄36~67岁,性别不限,采用随机数字表法将其随机分为3组:常规组、冲击波组和联合组,每组50例。3组患者均给予肩关节位置管理、上肢被动运动、肩关节活动范围训练及物理因子治疗;冲击波组在上述治疗基础上增加冲击波治疗,冲击波频率10 Hz,压强1.6 bar,共治疗3次;联合组在冲击波组治疗基础上,在每次冲击波治疗前30 min,于肩峰下间隙注射正清风痛宁(2 ml∶50 mg)2 ml+利多卡因2 ml,每3日1次,共注射3次。治疗10 d后,比较3组患者的总体有效率、肩部疼痛视觉模拟评分(VAS)、肩关节被动活动度、抑郁自评量表评分(SDS)及不良反应发生率。正态分布的计量资料采用均数±标准差(±s)表示,3组间差异比较采用单因素方差分析,进一步采用LSD-t检验进行多重比较。结果联合组总有效率高于冲击波组和常规组(χ^(2)=3.49,P=0.016;98%比92%、84%,P均<0.05)。3组患者治疗后VAS、肩关节活动度及SDS均较治疗前明显改善(P均<0.05)。联合组VAS,前屈、外展、外旋活动度评分及SDS均优于其他两组(P均<0.05)。3组患者不良反应发生率差异无统计学意义(P>0.05)。结论正清风痛宁肩峰下间隙联合超声引导下冲击波治疗能明显改善脑卒中后偏瘫肩痛症状,促进肩关节功能恢复,提高康复治疗效果,且无不良反应增加。ObjectiveTo explore the short-term efficacy and safety of Zhengqing Fengtongning combined with radial extracorporeal shock wave therapy under ultrasound guidance in patients with hemiplegic shoulder pain after stroke.MethodsThis study was a prospective randomized controlled trial.From January 1,2022,to July 31,2023,150 patients with hemiplegic shoulder pain within 6 months after stroke,aged 36-67 years old and no gender limitation,admitted to the Department of Rehabilitation Medicine,Sixth People's Hospital of Xiangtan,were randomly divided into three groups by the random number table method:the conventional group,the shock wave group,and the combined group,with 50 cases in each group.All patients received shoulder joint position management,passive movement of the upper limb,range of motion training of the shoulder joint,and physical factor therapy.The patients in the shock wave group received shock wave therapy addition(10 Hz,1.6 bar),for 3 times,in the combined group,on the basis of the shock wave therapy,injected Zhengqing Fengtongning(2 ml:50 mg)2 ml+lidocaine 2 ml into the subacromial space,30 minutes before each shock wave treatment,once every 3 days,for a total of 3 injections.The total efficacy rate,visual analogue scale(VAS),passive range of motion of the shoulder joint,self depression scale(SDS),and adverse reaction incidence rate were compared among the 3 groups 10 days after the treatment.Measurement data with normal distribution were represented as Mean±SD,and comparison among multiple groups was analyzed by one-way analysis of variance,followed by LSD-t multiple comparisons test.ResultsThe total efficacy rate were higher in the combined group than that in the other groups(χ^(2)=3.49,P=0.016;98%vs.92%,84%,all P<0.05).VAS,shoulder joint mobility and SDS were significantly improved after the treatment than that pre-treatment in 3 groups(all P<0.05),and the combined group was better than the other groups in VAS,flexion,abduction,and external rotation mobility,and SDS(all P<0.05).The incidence of adver

关 键 词：高能冲击波 正清风痛宁 偏瘫肩痛 脑卒中 

分 类 号：R47[医药卫生—护理学]