Yuan Haiguang, Liu Zhibin, Feng Weixing
Nanjing University of CM, Nanjing 210000, Jiangsu Province, China; Affiliated Hospital of Shaanxi University of CM, Xianyang 712000.
Affiliated Hospital of Shaanxi University of CM, Xianyang 712000.
Zhongguo Zhen Jiu. 2017 Oct 12;37(10):1035-9. doi: 10.13703/j.0255-2930.2017.10.002.
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.
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 , , , , 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 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.
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 difference statistically (<0.05, <0.01). After treatment, the improvements in the observation group were better than those in the control group (all <0.05). The curative and remarkably effective rate was 69.8% (37/53) in the observation group, better than 47.2% (25/53) in the control group (<0.05).
The touching-periosteum needling technique of the meridian muscle region theory obviously improves the pain severity, the motor function of the upper limb and the quality of life in patients of post-stroke shoulder pain. The therapeutic effects are better than the routine acupuncture.
评价基于经筋理论的触骨针法治疗中风后肩痛患者的疼痛严重程度、上肢运动功能及生活质量。
将106例中风后肩痛患者随机分为观察组和对照组，每组53例。观察组在经筋理论基础上采用触骨针法结合康复训练。穴位选取患侧的 、 、 、 、曲池（LI 11）、手三里（LI 10）和外关（TE 5）。斜刺进针，在这些经外奇穴处与肌腱结节呈45°角进针，直至针尖触及骨膜。行针得气后留针30分钟。进行康复训练，如抗痉挛体位、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（ADL）训练及Bobath技术。对照组采用常规针刺结合康复训练。穴位选取肩髃（LI 15）、臂臑（LI 14）、肩髎（TE 14）、肩前（经外奇穴）、曲池（LI 11）、手三里（LI 10）和外关（TE 5）。康复训练同观察组。每天治疗1次，每周治疗6次。20次治疗后，采用视觉模拟评分法（VAS）、Fugl-Meyer（FMA）评分和Barthel（MBI）评分评估疼痛严重程度、上肢运动功能及ADL。评价两组的临床治疗效果。
两组治疗后VAS评分均较治疗前降低，FMA和MBI评分均较治疗前升高，差异有统计学意义（<0.05，<0.01）。治疗后，观察组改善情况优于对照组（均<0.05）。观察组痊愈显效率为69.8%（37/53），优于对照组的47.2%（25/53）（<0.05）。
基于经筋理论的触骨针法能明显改善中风后肩痛患者的疼痛严重程度、上肢运动功能及生活质量。治疗效果优于常规针刺。
