【摘要】：目的:評(píng)價(jià)經(jīng)筋觸骨針?lè)▽?duì)腦卒中后肩痛患者的疼痛程度、上肢運(yùn)動(dòng)功能和生活質(zhì)量的改善情況。方法:將106例腦卒中后肩痛患者隨機(jī)分為觀察組和對(duì)照組,每組53例。觀察組采用經(jīng)筋觸骨針?lè)ńY(jié)合康復(fù)訓(xùn)練進(jìn)行治療,穴取患側(cè)"肩毭次""臂佈次""肩毼次""肩前次"、曲池、手三里、外關(guān),針體與皮膚呈45°角斜刺入腧穴"次",穿入筋結(jié)點(diǎn),針尖到達(dá)骨膜,手下有觸骨感覺(jué)后行針得氣,留針30 min;康復(fù)治療采用良肢位擺放、床上橋式運(yùn)動(dòng)、重心轉(zhuǎn)移及平衡訓(xùn)練、關(guān)節(jié)活動(dòng)度維持訓(xùn)練、肩關(guān)節(jié)被動(dòng)和主動(dòng)運(yùn)動(dòng)、日常生活活動(dòng)能力訓(xùn)練(ADL)、Bobath技術(shù)等康復(fù)訓(xùn)練。對(duì)照組采用常規(guī)針刺法結(jié)合康復(fù)訓(xùn)練進(jìn)行治療,穴取患側(cè)肩毭、臂佈、肩毼、肩前、曲池、手三里、外關(guān),康復(fù)訓(xùn)練同觀察組。兩組治療均每日1次,每周6次。完成20次治療后,采用疼痛視覺(jué)模擬量表(VAS)評(píng)分、上肢Fugl-Meyer(FMA)評(píng)分和Barthel(MBI)評(píng)分對(duì)兩組患者的疼痛程度、上肢運(yùn)動(dòng)功能和日常生活能力進(jìn)行評(píng)定,并評(píng)定兩組臨床療效。結(jié)果:兩組患者治療后VAS評(píng)分較治療前下降,FMA和MBI評(píng)分均較治療前升高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05,P0.01),且治療后觀察組均優(yōu)于對(duì)照組(均P0.05)。觀察組愈顯率為69.8%(37/53),優(yōu)于對(duì)照組的47.2%(25/53,P0.05)。結(jié)論:經(jīng)筋觸骨針?lè)苊黠@改善腦卒中肩痛患者的疼痛程度、上肢運(yùn)動(dòng)功能和日常生活能力,其療效優(yōu)于常規(guī)針刺。
[Abstract]:Objective: to evaluate the improvement of pain degree, upper limb motor function and quality of life in patients with shoulder pain after stroke. Methods: 106 patients with shoulder pain after stroke were randomly divided into observation group (n = 53) and control group (n = 53). The observation group was treated by meridian touching bone acupuncture method combined with rehabilitation training. Acupoints were taken from the affected side as "shoulder times", "arm cloth times", "shoulder front times", "bend pool", "hand three li", Waiguan, 45 擄angle between needle body and skin into the acupoint "times". Through the fascia node, the tip of the needle reaches the periosteum, the hand has the feeling of touching the bone to get qi through the needle, and keep the needle for 30 min; The rehabilitation training included good limb placement, bridge-type exercise on bed, center of gravity transfer and balance training, joint motion maintenance training, shoulder passive and active movement, daily life activity training, (ADL), Bobath technique and so on. The control group was treated with routine acupuncture combined with rehabilitation training. The points were taken from the affected side of the shoulder, arm cloth, shoulder, bended pool, hand Sanli, Waiguan, rehabilitation training with observation group. The two groups were treated once a day, 6 times a week. After 20 times of treatment, the pain degree, motor function and daily living ability of the two groups were evaluated by (VAS) score, Fugl-Meyer (FMA) score and Barthel (MBI) score. The clinical efficacy of the two groups was evaluated. Results: after treatment, the VAS score of the two groups was lower than that of the control group, and the FMA and MBI scores were higher than that of the control group (P 0.05, P 0.01), and the observation group was better than the control group after treatment (P0.05). The curative effect rate of the observation group was 69.8% (37 / 53), which was better than that of the control group (47.2%) (25 / 53). Conclusion: the acupuncture method of meridian touching bone can obviously improve the pain degree, upper limb motor function and daily living ability of stroke patients with shoulder pain, and its curative effect is superior to that of routine acupuncture.
【作者單位】： 南京中醫(yī)藥大學(xué);陜西中醫(yī)藥大學(xué)附屬醫(yī)院;
【基金】：陜西省科技廳惠民計(jì)劃項(xiàng)目:2015 HM-10 咸陽(yáng)市科學(xué)技術(shù)研究計(jì)劃項(xiàng)目:2015 K 04-24
【分類號(hào)】：R246.6

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