[Short-term and long-term therapeutic effects of internal heat-type acupuncture needle therapy combined with acupoint injection of O for post-stroke shoulder pain].

OBJECTIVE

To observe the short-term and long-term therapeutic effects of internal heat-type acupuncture needle (IHTAN) therapy combined with acupoint injection of Ofor post-stroke shoulder pain in apopletic patients.

METHODS

Patients with post-stroke shoulder pain were divided into warm needle moxibustion ＋ acupoint injection group (29 cases), acupoint injection group (30 cases) and IHTAN＋acupoint injection group (29 cases) according to the random number table. For acupoint injection, O solution (3 mL, 30 µg/mL) was injected into Jianyu (LI15), Jianliao (SJ14), Jianzhen (LI9), Binao (LI14) and Ashi points (4-6 acupoints every time) on the affected side, once every other day for 4 weeks. For warm needle moxibustion, the above mentioned acupoints were stimulated with filiform needles attached with an ignited moxa-stick, once every other day for 4 weeks. For IHTAN, the internal warmth controllable acupuncture needles were inserted into the above mentioned acupoints on the affected side, and then connected to an internal heat acupuncture apparatus for stimulating the acupoints at 42 ℃， 20 min every time, once a week, for 4 weeks. The severity of shoulder pain was assessed by using visual analogue scale (VAS, 0-10 points), the upper limb joint motion function evaluated using Fugl-Meyer assessment scale (FMA, 0－66 points), and the ability of daily living activities (ADL) evaluated using Barthel index (0－100 points) at the ends of the 2 and 4 week as well as the 6 month after the treatment. If the shoulder pain disappeared or basically disappeared, it was considered to be healed. If the pain was relieved, it was considered to be effective. Otherwise, it was considered to be ineffective.

RESULTS

At the ends of the 2 and 4 week as well as the 6 month after the treatment, the VAS scores of the IHTAN＋acupoint injection group were significantly lower than those of the warm needle moxibustion＋acupoint injection and acupoint injection groups (<0.05), and the FMA and ADL scores were significantly higher in the IHTAN＋acupoint injection group than in the other two groups (<0.05). No significant differences were found between the warm needle moxibustion＋acupoint injection and the acupoint injection groups in the scores of VAS, FMA and ADL (>0.05). Of the 29, 30 and 29 cases in the warm needle moxibustion＋acupoint injection, acupoint injection and IHTNA＋acupoint injection groups, 1, 0 and 7 cases at the 2 week, 3, 2 and 12 cases at the 4 week, 4, 2 and 15 cases at the 6 month were cured; 15, 14 and 16 cases at the 2 week, 17, 17 and 13 cases at the 4 week, and 18, 18 and 12 cases at the 6 month experienced marked improvement; 13, 16 and 6 cases at the 2 week, 9, 11 and 4 cases at the 4 week, 7, 10 and 2 cases at the 6 month had no apparent changes in their shoulder pain severity, with the total effective rates at the 4 week and 6 month being 68.97% and 75.86%, 63.33% and 66.60%, and 86.21% and 93.10%, respectively.

CONCLUSION

The internal heat-type acupuncture needle therapy combined with O acupoint injection has obvious short-term and long-term therapeutic effects for post-stroke shoulder pain and is obviously superior to warm needle moxibustion＋ acupoint injection and simple acupoint injection in relieving shoulder pain and improving upper limb motion function.