Duan Yi-Xuan, Zhang Zhao-Qing, Luo Xiao-Juan, Yin Jing, Xia Yang
Rehabilitation Department, Tongren Hospital of Wuhan University, Wuhan Third Hospital, Wuhan 430060, China.
Zhen Ci Yan Jiu. 2019 Mar 25;44(3):205-10. doi: 10.13702/j.1000-0607.170743.
To evaluate the effectiveness and safety of internal heat-type acupuncture needle (IHTAN) the-rapy in the treatment of post-stroke shoulder pain in apopletic patients.
According to the random number table, 96 patients with post-stroke shoulder pain were divided into IHTAN group and warm needle moxibustion group (＝48 in each one). Jianyu (LI15), Jianliao (TE14), Jianzhen (SI9), Binao (LI14) and Ashi points (Extra) on the affected side were selected in the two groups. For patients of the IHTAN group, internal warmth controllable acupuncture needles were inserted into the above-mentioned acupoints, 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. For patients of the warm needle moxibustion group, the above mentioned acupoints were stimulated with filiform needles attached with an ignited moxa-stick, once every other day, for 4 weeks. 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, ot-herwise, it was considered to be ineffective. The incidence of local skin injury including burn, empyrosis, silt blue, hematoma and infection, the heart rate, respiration, blood pressure, oxyhemoglobin saturation, blood routine (hemoglobin level, white blood cell [WBC] count, platelet count), creatase and dipolymer levels were recorded or detected. Additionally, the patients' satisfaction rate about the treatment environment was recorded.
Following the treatment, of the 45 and 47 cases in the warm needle moxibustion and IHTAN groups, 5 (11.11%) and 20 (42.55%) were cured, 26(57.78%) and 21(44.68%) experienced marked improvement, and 14 (31.11%) and 6 (12.77%) had no apparent changes in their shoulder pain severity, with the total effective rates being 68.89% and 87.23%, respectively. The curative rate and total effective rate of the IHTAN group were significantly higher than those of the warm needle moxibustion group (<0.01，<0.05). The incidence of skin injury of the IHTAN group was evidently lower than that of the warm needle moxibustion group (<0.01), and the patients' therapeutic environment satisfaction rate was remarkably higher in the IHTNA group than in the warm needle moxibustion group (<0.05). No significant differences were found between the two groups and between pre- and post-treatment in each group in the heart rate, respiration frequency, systolic and diastolic pressures, oxyhemoglobin saturation, hemoglobin content, WBC count, platelet count, and plasma dipolymer, creatine kinase, lactic dehydrogenase, and beta-hydroxybutyrate dehydrogenase levels (>0.05).
The IHTAN therapy is effective, safe and reliable in the treatment of post-stroke shoulder pain. In terms of the incidence of skin injury and the satisfaction degree of therapeutic environment, the internal heat-type acupuncture needle therapy is obviously superior to the warm needle moxibustion therapy.
评价内热式针灸针疗法治疗中风后肩痛的有效性和安全性。
将96例中风后肩痛患者按随机数字表法分为内热式针灸针组和温针组，每组48例。两组均选取患侧肩髃（LI15）、肩髎（TE14）、肩贞（SI9）、臂臑（LI14）及阿是穴（奇穴）。内热式针灸针组患者将内热可控针灸针针刺上述穴位，然后连接内热针灸仪，于42℃刺激穴位，每次20分钟，每周1次，共4周。温针组患者用点燃的艾条温针灸上述穴位，隔日1次，共4周。若肩痛消失或基本消失为治愈，疼痛减轻为有效，否则为无效。记录或检测局部皮肤损伤（包括烫伤、化脓、瘀青、血肿及感染）的发生率、心率、呼吸、血压、氧合血红蛋白饱和度、血常规（血红蛋白水平、白细胞计数、血小板计数）、肌酸激酶及D - 二聚体水平。此外，记录患者对治疗环境的满意率。
治疗后，温针组45例、内热式针灸针组47例中，治愈分别为5例（11.11%）、20例（42.55%），显效分别为26例（57.78%）、21例（44.68%），肩痛程度无明显变化分别为14例（31.11%）、6例（12.77%），总有效率分别为68.89%、87.23%。内热式针灸针组治愈率和总有效率均显著高于温针组（P<0.01，P<0.05）。内热式针灸针组皮肤损伤发生率明显低于温针组（P<0.01），内热式针灸针组患者对治疗环境的满意率显著高于温针组（P<0.05）。两组间及每组治疗前后心率、呼吸频率、收缩压、舒张压、氧合血红蛋白饱和度、血红蛋白含量、白细胞计数、血小板计数及血浆D - 二聚体、肌酸激酶、乳酸脱氢酶、β - 羟丁酸脱氢酶水平比较，差异均无统计学意义（P>0.05）。
内热式针灸针疗法治疗中风后肩痛有效、安全可靠。在内热式针灸针疗法治疗中风后肩痛的皮肤损伤发生率及治疗环境满意率方面，明显优于温针疗法。
