中醫(yī)定向透藥療法治療偏癱肩痛患者療效的臨床觀察
發(fā)布時(shí)間：2018-12-17 16:47
【摘要】：目的:本文旨在通過隨機(jī)對照性的臨床研究,比較中醫(yī)定向透藥療法和中頻脈沖電刺激治療偏癱肩痛的療效差異,為偏癱肩痛提供新的有效治療方法。方法:將經(jīng)過篩查的61例偏癱肩痛患者隨機(jī)分至治療組(31例)和對照組(30例),治療組給予中醫(yī)定向透藥療法,對照組給予中頻脈沖電刺激,兩組貼片均放置于岡上肌、三角肌中后束,治療時(shí)間為每次25min,每天1次,每周5次,連續(xù)治療4周,共20次,兩組同時(shí)給予常規(guī)康復(fù)治療。分別于入組后第0周(基線水平)、第2周、第4周、第8周進(jìn)行視覺模擬評分(VAS)、Fugl-Meyer運(yùn)動(dòng)功能評定量表(FMA)、肩關(guān)節(jié)被動(dòng)活動(dòng)度(PROM)、主動(dòng)活動(dòng)度(AROM)、Barthel指數(shù)量表(BI)、9條目患者健康問卷(PHQ-9)和健康狀況調(diào)查問卷(SF-36)相關(guān)量表評定,以第4周為主要評定時(shí)間,了解患者疼痛、上肢運(yùn)動(dòng)功能、肩關(guān)節(jié)活動(dòng)度、生活自理能力、抑郁狀態(tài)、生活健康狀況的改善情況。結(jié)果:1.共有60例患者完成本臨床研究,治療組30例,對照組30例,1例患者因個(gè)人原因出院而退出試驗(yàn),治療過程中未發(fā)生不良反應(yīng)。2.治療組和對照組第4周的VAS評分同基線水平相比分別降低1.74和0.95,組內(nèi)比較和組間比較均有顯著差異(P=0.000,P=0.000,P=0.000)。3.治療組和對照組第4周的FMA評分同基線水平相比均提高,組內(nèi)比較和組間比較均有顯著差異(P=0.000,P=0.000,P=0.017)。4.治療組和對照組第4周PROM前屈、外展、內(nèi)旋和外旋度數(shù)同基線水平相比均提高,組內(nèi)比較有顯著差異(治療組:P=0.000,P=0.000,P=0.000,P=0.005;對照組:P=0.000,P=0.000,P=0.000,P=0.000)。組間比較PROM前屈有顯著差異(P=0.031),PROM外展、內(nèi)旋、外旋無顯著差異(P=0.238,P=0.484,P=0.598)5.治療組和對照組第4周AROM前屈、外展、內(nèi)旋、外旋度數(shù)同基線水平相比均提高,除對照組AROM外旋數(shù)值無顯著差異(P=0.184)外,其余方向AROM數(shù)值有顯著差異(治療組:P=0.000,P=0.000,P=0.001,P=0.003;對照組:P=0.012,P=0.001,P=0.023)。組間比較AROM數(shù)值有顯著差異(P=0.045,P=0.045,P=0.028,P=0.035)。6.治療組和對照組第4周BI、PHQ-9和健康調(diào)查問卷分值與基線相比均提高,數(shù)值有顯著差異(治療組:P=0.000,P=0.000,P=0.000;對照組:P=0.001,P=0.000,P=0.003)。組間比較BI、PHQ-9和健康調(diào)查問卷有顯著差異(P=0.041,P=0.040,P=0.046)。結(jié)論:1.中醫(yī)定向透藥療法和中頻脈沖電刺均激能改善偏癱肩痛,且中醫(yī)定向透藥療法優(yōu)于中頻脈沖電刺激,其療效持久性更突出。2.中醫(yī)定向透藥療法和中頻脈沖電刺激還有助于改善肩關(guān)節(jié)主動(dòng)及被動(dòng)活動(dòng)度、上肢運(yùn)動(dòng)功能、生活自理能力、抑郁狀態(tài)和健康生活質(zhì)量,且前者優(yōu)于后者。
[Abstract]:Objective: to compare the curative effect of directional permeation therapy and middle frequency pulse electric stimulation in treating shoulder pain of hemiplegia by randomized controlled clinical study, and to provide a new effective treatment method for shoulder pain of hemiplegia. Methods: 61 patients with shoulder pain of hemiplegia were randomly divided into treatment group (31 cases) and control group (30 cases). The posterior bundle of deltoid muscle was treated for 25 minutes, once a day, 5 times a week for 4 weeks, 20 times. The two groups were given routine rehabilitation treatment at the same time. Visual analogue scale (VAS), Fugl-Meyer) was performed at week 0 (baseline level), week 2, week 4 and week 8 after admission to the group. (VAS), Fugl-Meyer motor function rating scale (FMA),) was used to assess passive motion of shoulder joint (PROM), active activity degree (AROM),). Barthel index scale (BI), 9 items of patient health questionnaire (PHQ-9) and health status questionnaire (SF-36) related to the evaluation of the fourth week as the main assessment time, to understand the pain, upper limb motor function, shoulder motion, shoulder motion. Self-care ability, depression, health improvement. Results: 1. A total of 60 patients completed the clinical study, the treatment group of 30 cases, the control group of 30 cases, one patient discharged from the test for personal reasons, no adverse reactions occurred in the course of treatment. 2. The VAS scores of the treatment group and the control group decreased by 1.74 and 0.95 respectively compared with the baseline level at the 4th week, and there were significant differences between the two groups. 3. The FMA scores in the treatment group and the control group at the 4th week were higher than those in the baseline level, and there were significant differences between the two groups (P < 0. 000P 0. 000 P 0. 017). 4. In the treatment group and the control group, the number of PROM flexion, abduction, internal rotation and external rotation increased significantly compared with the baseline level at the 4th week, and there was significant difference in the treatment group (treatment group: P0. 000P0. 000P0. 000P0. 005; In the control group, the control group (P = 0.000, P = 0.000). There was significant difference in PROM forward flexion between groups (P0. 031), PROM outreaching, internal rotation and extroversion (P0. 238, P0. 484, P0. 598). In the treatment group and the control group, the number of AROM flexion, abduction, internal rotation and degree of rotation increased compared with the baseline level at the 4th week. Except for the control group, there was no significant difference in the value of AROM external rotation (P0. 184), but there were significant differences in the other directions of AROM (treatment group: P0. 000, P < 0. 000). P0. 000, P0. 001, P0. 003; In the control group: P 0. 012, P = 0. 001, P = 0. 023). There was significant difference in AROM values among groups (P0. 045, P0. 028, P0. 035). The scores of BI,PHQ-9 and health questionnaire in the treatment group and the control group in the 4th week were significantly higher than those in the baseline (treatment group: P0. 000, P0. 000; control group, P0. 001, P0. 000, P0. 003). There was significant difference between BI,PHQ-9 and health questionnaire (P0. 041, P0. 040, P0. 046). Conclusion: 1. Both Chinese medicine directed permeation therapy and intermediate frequency pulse electroacupuncture can improve shoulder pain of hemiplegia, and traditional Chinese medicine directional permeation therapy is superior to intermediate frequency pulse electric stimulation, and its curative effect is more persistent. 2. Traditional Chinese medicine directional permeation therapy and middle frequency pulse electric stimulation can also improve the active and passive motion of shoulder, upper limb motor function, life self-care ability, depression state and healthy quality of life, and the former is superior to the latter.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.7
本文編號：2384470
[Abstract]:Objective: to compare the curative effect of directional permeation therapy and middle frequency pulse electric stimulation in treating shoulder pain of hemiplegia by randomized controlled clinical study, and to provide a new effective treatment method for shoulder pain of hemiplegia. Methods: 61 patients with shoulder pain of hemiplegia were randomly divided into treatment group (31 cases) and control group (30 cases). The posterior bundle of deltoid muscle was treated for 25 minutes, once a day, 5 times a week for 4 weeks, 20 times. The two groups were given routine rehabilitation treatment at the same time. Visual analogue scale (VAS), Fugl-Meyer) was performed at week 0 (baseline level), week 2, week 4 and week 8 after admission to the group. (VAS), Fugl-Meyer motor function rating scale (FMA),) was used to assess passive motion of shoulder joint (PROM), active activity degree (AROM),). Barthel index scale (BI), 9 items of patient health questionnaire (PHQ-9) and health status questionnaire (SF-36) related to the evaluation of the fourth week as the main assessment time, to understand the pain, upper limb motor function, shoulder motion, shoulder motion. Self-care ability, depression, health improvement. Results: 1. A total of 60 patients completed the clinical study, the treatment group of 30 cases, the control group of 30 cases, one patient discharged from the test for personal reasons, no adverse reactions occurred in the course of treatment. 2. The VAS scores of the treatment group and the control group decreased by 1.74 and 0.95 respectively compared with the baseline level at the 4th week, and there were significant differences between the two groups. 3. The FMA scores in the treatment group and the control group at the 4th week were higher than those in the baseline level, and there were significant differences between the two groups (P < 0. 000P 0. 000 P 0. 017). 4. In the treatment group and the control group, the number of PROM flexion, abduction, internal rotation and external rotation increased significantly compared with the baseline level at the 4th week, and there was significant difference in the treatment group (treatment group: P0. 000P0. 000P0. 000P0. 005; In the control group, the control group (P = 0.000, P = 0.000). There was significant difference in PROM forward flexion between groups (P0. 031), PROM outreaching, internal rotation and extroversion (P0. 238, P0. 484, P0. 598). In the treatment group and the control group, the number of AROM flexion, abduction, internal rotation and degree of rotation increased compared with the baseline level at the 4th week. Except for the control group, there was no significant difference in the value of AROM external rotation (P0. 184), but there were significant differences in the other directions of AROM (treatment group: P0. 000, P < 0. 000). P0. 000, P0. 001, P0. 003; In the control group: P 0. 012, P = 0. 001, P = 0. 023). There was significant difference in AROM values among groups (P0. 045, P0. 028, P0. 035). The scores of BI,PHQ-9 and health questionnaire in the treatment group and the control group in the 4th week were significantly higher than those in the baseline (treatment group: P0. 000, P0. 000; control group, P0. 001, P0. 000, P0. 003). There was significant difference between BI,PHQ-9 and health questionnaire (P0. 041, P0. 040, P0. 046). Conclusion: 1. Both Chinese medicine directed permeation therapy and intermediate frequency pulse electroacupuncture can improve shoulder pain of hemiplegia, and traditional Chinese medicine directional permeation therapy is superior to intermediate frequency pulse electric stimulation, and its curative effect is more persistent. 2. Traditional Chinese medicine directional permeation therapy and middle frequency pulse electric stimulation can also improve the active and passive motion of shoulder, upper limb motor function, life self-care ability, depression state and healthy quality of life, and the former is superior to the latter.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.7
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 龐艷萍;洪香君;;中醫(yī)定向透藥療法聯(lián)合患肢手法按摩在膝關(guān)節(jié)骨性關(guān)節(jié)炎中的應(yīng)用[J];檢驗(yàn)醫(yī)學(xué)與臨床;2016年11期
2 周媚媚;路微波;李放;沈夏鋒;徐友康;;腦卒中后早期偏癱肩痛與肩關(guān)節(jié)被動(dòng)活動(dòng)度相關(guān)性分析[J];中國運(yùn)動(dòng)醫(yī)學(xué)雜志;2015年08期
3 宋小慧;謝青;崔立軍;鮑勇;縱亞;張偉明;;肌電反饋功能性電刺激治療急性期腦梗死手功能障礙的臨床研究[J];中國康復(fù)醫(yī)學(xué)雜志;2015年06期
4 彭繼海;范小平;張雷;白文方;杜健茹;張鳴生;;二腹肌低頻調(diào)制中頻電針刺激對腦卒中后吞咽障礙舌骨位移的影響[J];中國康復(fù)醫(yī)學(xué)雜志;2015年06期
5 欽曉英;葛秋華;葉祥明;;中藥熏洗結(jié)合中頻電療治療偏癱后肩痛的療效觀察[J];護(hù)理與康復(fù);2015年05期
6 王軍;王艷君;王占江;;低中頻電療肩痛穴治療肩周炎30例療效觀察[J];臨床合理用藥雜志;2014年07期
7 范文祥;倪朝民;陳進(jìn);張金龍;穆景頌;許鳳娟;;肌電生物反饋對于腦卒中患者肢體功能及日常生活活動(dòng)能力的影響[J];中國臨床保健雜志;2014年01期
8 楊信才;劉涓;崔彩虹;王燕;胡衛(wèi)華;侯彥雪;劉瑾;;常規(guī)康復(fù)治療配合正弦調(diào)制中頻電療對腦卒中偏癱患者平衡及運(yùn)動(dòng)功能的影響[J];醫(yī)學(xué)研究與教育;2013年06期
9 張晟豪;李源莉;王俊;劉朝暉;;中醫(yī)定向透藥療法聯(lián)合針刺治療偏癱后肩手綜合征的療效觀察[J];中國實(shí)用醫(yī)藥;2013年30期
10 張曉玲;官俏兵;顧旭東;王琰萍;胡樂明;;經(jīng)皮電神經(jīng)刺激對腦卒中后肩手綜合征患者交感神經(jīng)皮膚反應(yīng)的影響[J];中華物理醫(yī)學(xué)與康復(fù)雜志;2012年12期
相關(guān)碩士學(xué)位論文 前1條
1 付明超;功能性電刺激治療早期腦卒中患者肩痛的療效觀察[D];成都中醫(yī)藥大學(xué);2013年
，本文編號：2384470
本文鏈接：http://sikaile.net/zhongyixuelunwen/2384470.html
最近更新
教材專著
