摘要
目的:评价经筋触骨针法对脑卒中后肩痛患者的疼痛程度、上肢运动功能和生活质量的改善情况。方法:将106例脑卒中后肩痛患者随机分为观察组和对照组,每组53例。观察组采用经筋触骨针法结合康复训练进行治疗,穴取患侧"肩髃次""臂臑次""肩髎次""肩前次"、曲池、手三里、外关,针体与皮肤呈45°角斜刺入腧穴"次",穿入筋结点,针尖到达骨膜,手下有触骨感觉后行针得气,留针30 min;康复治疗采用良肢位摆放、床上桥式运动、重心转移及平衡训练、关节活动度维持训练、肩关节被动和主动运动、日常生活活动能力训练(ADL)、Bobath技术等康复训练。对照组采用常规针刺法结合康复训练进行治疗,穴取患侧肩髃、臂臑、肩髎、肩前、曲池、手三里、外关,康复训练同观察组。两组治疗均每日1次,每周6次。完成20次治疗后,采用疼痛视觉模拟量表(VAS)评分、上肢Fugl-Meyer(FMA)评分和Barthel(MBI)评分对两组患者的疼痛程度、上肢运动功能和日常生活能力进行评定,并评定两组临床疗效。结果:两组患者治疗后VAS评分较治疗前下降,FMA和MBI评分均较治疗前升高,差异均有统计学意义(P<0.05,P<0.01),且治疗后观察组均优于对照组(均P<0.05)。观察组愈显率为69.8%(37/53),优于对照组的47.2%(25/53,P<0.05)。结论:经筋触骨针法能明显改善脑卒中肩痛患者的疼痛程度、上肢运动功能和日常生活能力,其疗效优于常规针刺。
Objective To evaluate the pain severity,the motor function of the upper limb and the quality of life in the patients of post-stroke shoulder pain treated with the touching-periosteum needling technique of the meridian muscle region theory.Methods One hundred and six cases of post-stroke shoulder pain were randomized into an observation group and a control group,53 cases in each one.In the observation group,the touching-periosteum needle technique and the rehabilitation training were used on the bases of the theory of meridian muscle region.The points were Jianyuci,Binaoci,Jianliaoci,Jianqianci,Quchi（LI 11）,Shousanli（LI 10） and Waiguan（TE 5） on the affected side.The needles were inserted obliquely,at 45° degrees at those extra points to the tendon knots till the needle tips touching periosteum.The needles were manipulated to ensure the qi arrival and then retained for 30 min.The rehabilitation was applied,such as the anti-spasmodic posture,bridge-style movement on the bed,weight transition and balance training,joint activity maintenance training,passive and active movement of shoulder joint,the training for activities of daily living（ADL） and Bobath technique.In the control group,the routine acupuncture and the rehabilitation training were used.The acupints were Jianyu（LI 15）,Binao（LI 14）,Jianliao（TE 14）,Jianqian（Extra）,Quchi（LI 11）,Shousanli（LI 10） and Waiguan（TE 5）.The rehabilitation training was the same as the observation group.The treatment was given once every day,6 treatments a week.After 20 treatments,the visual analogue scale（VAS）,Fugl-Meyer（FMA） score and Barthel（MBI） score were adopted to evaluate the pain severity,the motor function of the upper limb and the ADL.The clinical therapeutic effects were evaluated in the two groups.Results The VAS scores were reduced after treatment as compared with those before treatment in the two groups,and FMA and MBI scores were all increased as compared with those before treatment,indicating the significant diff
作者
袁海光
刘智斌
冯卫星
YUAN Haiguang LIU Zhibin FENG Weixing(Nanjing University of CM, Nanjing 210000, Jiangsu Province, China Affiliated Hospital of Shaanxi University of CM, Xianyang 712000)
出处
《中国针灸》
CAS
CSCD
北大核心
2017年第10期1035-1039,共5页
Chinese Acupuncture & Moxibustion
基金
陕西省科技厅惠民计划项目:2015 HM-10
咸阳市科学技术研究计划项目:2015 K 04-24
关键词
脑卒中
肩痛
经筋
触骨针法
随机对照试验
stroke
shoulder pain
muscle region of meridian
touching-periosteum needling technique
randomized controlled trial（RCT）
