[1]杨倩倩,古丽尼尕尔·阿布力孜,苗紫嫣,等.肩四针捣刺联合推拿治疗中风后肩痛临床研究[J].陕西中医,2024,(11):1553-1556.[doi:DOI:10.3969/j.issn.1000-7369.2024.11.025]
 YANG Qianqian,GULINIGAER Abulizi,MIAO Ziyan,et al.Clinical study on treatment of shoulder pain after apoplexy with four-needle ramming and massage[J].,2024,(11):1553-1556.[doi:DOI:10.3969/j.issn.1000-7369.2024.11.025]
点击复制

肩四针捣刺联合推拿治疗中风后肩痛临床研究
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年11期
页码:
1553-1556
栏目:
针灸经络
出版日期:
2024-11-05

文章信息/Info

Title:
Clinical study on treatment of shoulder pain after apoplexy with four-needle ramming and massage
作者:
杨倩倩古丽尼尕尔·阿布力孜苗紫嫣汪秀梅
(新疆医科大学第一附属医院中医诊疗中心针灸推拿科,新疆 乌鲁木齐 830000)
Author(s):
YANG QianqianGULINIGAER AbuliziMIAO ZiyanWANG Xiumei
(Department of Acupuncture and Massage,Center of TCM Diagnosis and Treatment,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)
关键词:
中风 肩痛 肩四针捣刺法 肩关节活动度 上肢运动功能 表面肌电图
Keywords:
Stroke Shoulder pain Shoulder four-needle ramming Shoulder range of motion Motor function of upper limb Surface electromyography
分类号:
R 255.2
DOI:
DOI:10.3969/j.issn.1000-7369.2024.11.025
文献标志码:
A
摘要:
目的:探讨肩四针捣刺法联合推拿治疗中风后肩痛效果及对患者肩部运动功能、表面肌电图(sEMG)的影响。方法:纳入220例中风后肩痛患者,按照随机数字表法分为对照组与观察组,各110例。对照组行推拿治疗,观察组行肩四针捣刺法联合推拿治疗。评价两组临床疗效,对比两组肩关节活动度、上肢功能[Fugl-Meyer运动功能评分法(FMA)]、日常生活能力[改良Barthel指数评分(MBI)]、sEMG[积分肌电值(IEMG)、平均肌电振幅值(AEMG)]。结果:观察组总治疗有效104例,总有效率94.55%,高于对照组的94例、85.45%,差异有统计学意义(P<0.05)。治疗后观察组肩关节屈曲、外旋、外展角度大于对照组,差异有统计学意义(均P<0.05)。治疗后观察组FMA、MBI评分高于对照组(P<0.05)。治疗后,两组患者IEMG、AEMG均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:中风后肩痛患者行肩四针捣刺法联合推拿治疗能有效改善患者肩关节活动度与肩部功能,改善肌力,提升肌肉收缩性,疗效较好。
Abstract:
Objective:To explore curative effect of shoulder four-needle ramming combined with massage on shoulder pain after stroke and its influences on shoulder motor function and surface electromyography(sEMG).Methods:220 patients with post-stroke shoulder pain were enrolled and divided into control group and observation group,110 cases in each group,by random number table method.The clinical curative effect in the two groups were evaluated.The shoulder range of motion,upper limb function [Fugl-Meyer assessment(FMA)],activities of daily living [modified barthel index(MBI)] and sEMG [integrated electromyography(IEMG),average electromyography amplitude(AEMG)] were compared between the two groups.Results:The total response rate of treatment 94.55%(104 cases)in the observation group was higher than that in the control group 85.45%(94 cases),difference statistically significant(P<0.05).After treatment,angles of shoulder flexion,external rotation and abduction in the observation group were greater than those in the control group,difference statistically significant(all P<0.05).After treatment,scores of FMA and MBI in the observation group were higher than those in the control group(P<0.05).After treatment,IEMG and AEMG were increased in both groups,which were higher in the observation group than those in the control group,difference statistically significant(P<0.05).Conclusion:Shoulder four-needle ramming combined with massage can effectively improve shoulder range of motion and shoulder function,improve muscle strength and muscle contraction in patients with shoulder pain after stroke,which has better curative effect.

参考文献/References:

[1] TOPPING M,KIM J,FLETCHER J.Association and pathways of birth in the stroke belt on old age dementia and stroke mortality[J].SSM Popul Health,2021,15:100841.
[2] 师媛,王晓娟.短暂性脑缺血发作患者颈动脉狭窄程度与颈动脉斑块易损性关系及对近期缺血性脑卒中的预测价值研究[J].陕西医学杂志,2022,51(4):454-457,496.
[3] 朱玉辉,翟丽杰,张双福,等.灯盏细辛注射液联合尤瑞克林治疗气虚血瘀型早期急性缺血性脑卒中临床研究[J].陕西中医,2020,41(5):609-611.
[4] 李民,曹杰,刘晓斌,等.老年高血压脑出血并发卒中相关性肺炎早期患者血清感染指标的检测及临床意义[J].陕西医学杂志,2023,52(10):1419-1422.
[5] VIRANI S S,ALONSO A,BENJAMIN E J,et al.Heart disease and stroke statistics-2020 update:A report from the American heart association[J].Circulation,2020,141(9):e139-e596.
[6] KUMAR P.Hemiplegic shoulder pain in people with stroke:Present and the future[J].Pain Manag,2019,9(2):107-110.
[7] 苏建康,汪杰,王丛笑,等.Mulligan动态关节松动术对脑卒中偏瘫肩痛的疗效观察[J].中国康复医学杂志,2020,35(11):1363-1365.
[8] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[9] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2014)[J].中华神经科杂志,2015,48(6):435-444.
[10] 李平,吴钟璇,张云如,等.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56.
[11] JOHANSSON G M,HAGER C K.A modified standardized nine hole peg test for valid and reliable kinematic assessment of dexterity post-stroke[J].J Neuroeng Rehabil,2019,16(1):8.
[12] 闵瑜,吴媛媛,黄臻,等.多所院校康复专业本科实习生应用改良Barthel指数的信度分析[J].中国康复医学杂志,2010,25(4):374-376.
[13] 陈立典.康复评定学[M].北京:华夏出版社,2004:129.
[14] 张红霞.经皮神经电刺激治疗卒中后偏瘫侧肩痛[J].中国疼痛医学杂志,2020,26(8):630-631,634.
[15] LI Z,LLU J,WANG X,et al.Bilateral vertebral artery dissection complicated by posterior circulation stroke in a young man:A case report[J].Medicine(Baltimore),2020,99(44):e22822.
[16] WANG T S,WANG S F,SONG W D,et al.Effectiveness of extracorporeal shock wave for post-stroke shoulder-hand syndrome:A protocol for systematic review and meta analysis[J].Medicine(Baltimore),2020,99(27):e20664.
[17] 朱韫钰,祁奇,蒋超,等.肌内效贴结合康复训练治疗脑卒中后肩手综合征的疗效观察[J].中华物理医学与康复杂志,2019,41(8):588-590.
[18] 常雪利.针灸治疗对脑卒中后偏瘫颈肩痛患者疼痛改善及预后的影响[J].陕西中医,2019,40(4):525-527.
[19] 曾晓霞,林荣,杨芳洁,等.温针灸治疗肩袖损伤的效果[J].中国康复理论与实践,2022,28(5):609-615.
[20] 于文颜,马良宵,田园,等.融合复杂网络与数据挖掘探析炎性痛的针灸处方特点[J].世界科学技术-中医药现代化,2022,24(11):4402-4410.
[21] 马小闵,尚国超,孙敦坡,等.毫针速刺法结合推拿对脑卒中软瘫期肩痛疗效及病灶超声检测指标的影响[J].中华中医药学刊,2022,40(4):139-142.
[22] 祁红艳,黄谦,张磊,等.毫针速刺法治疗第三腰椎横突综合征的疗效观察[J].中华中医药学刊,2019,37(12):2947-2950.
[23] 王漫,张智龙,王栩,等.“调神止痛针法”治疗中风后肩痛的临床研究[J].针刺研究,2019,44(8):605-609,619.
[24] CE E,LONGO S,LIMONTA E,et al.Peripheral fatigue:New mechanistic insights from recent technologies[J].Eur J Appl Physiol,2020,120(1):17-39.
[25] 孟泽祖,叶正旭,万博.关节腔内注射复方倍他米松注射液联合体外冲击波治疗疼痛性肩关节挛缩症临床疗效观察[J].陕西医学杂志,2021,50(6):682-686.
[26] ALI N,SYDNEY B,RACHEL L W,et al.Robust machine learning mapping of semg signals to future actuator commands in biomechatronic devices[J].Journal of Bionic Engineering,2024,21(1):270-287.
[27] 汪晓瑜,王小莉,喻磊,等.非肌电图引导Tenon氏囊下注射不同剂量A型肉毒毒素治疗先天性内斜视临床疗效观察[J].陕西医学杂志,2022,51(2):219-221,244.
[28] 徐文静,朱兴国,周停,等.血流限制联合低强度抗阻运动对脑卒中患者下肢功能及表面肌电的影响[J].中国康复医学杂志,2023,38(1):46-51.
[29] 闫雪,张为民,孙舒,等.中医综合康复方案治疗脑卒中后肢体痉挛的临床疗效[J].中国老年学杂志,2020,40(7):1372-1375.

相似文献/References:

[1]倪建俐,黄 姝,袁 晴△.中医特色疗法治疗中风后肢体功能障碍研究进展*[J].陕西中医,2020,(9):1339.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.045]
[2]张晓霞,杨 峥△,赵 亭.风三针治疗中风后吞咽障碍临床研究*[J].陕西中医,2020,(10):1504.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.046]
 ZHANG Xiaoxia,YANG Zheng,ZHAO Ting..The clinical effect of “three wind needles” in patients with dysphagia after stroke[J].,2020,(11):1504.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.046]
[3]郭 爽,于存娟,陈婷婷.星蒌承气汤治疗中风病痰热腑实证疗效及对患者生物学指标和血浆内毒素脂多糖的影响[J].陕西中医,2022,(5):592.[doi:DOI:10.3969/j.issn.1000-7369.2022.05.011]
 GUO Shuang,YU Cunjuan,CHEN Tingting.Effect of Xinglou Chengqi decoction on biological indexes and plasma LPS of patients with stroke disease[J].,2022,(11):592.[doi:DOI:10.3969/j.issn.1000-7369.2022.05.011]
[4]兰 谢,余帅江.温针灸对中风后遗症患者血清炎症因子的影响[J].陕西中医,2022,(7):954.[doi:DOI:10.3969/j.issn.1000-7369.2022.07.035]
 LAN Xie,YU Shuaijiang.Effects of warm acupuncture and moxibustion on serum inflammatory factor in patients with stroke sequelae[J].,2022,(11):954.[doi:DOI:10.3969/j.issn.1000-7369.2022.07.035]
[5]赵康如,柳 雪,范兆鹏,等.针灸联合门德尔松手法对中风后吞咽困难患者吞咽功能的影响[J].陕西中医,2022,(7):958.[doi:DOI:10.3969/j.issn.1000-7369.2022.07.036]
 ZHAO Kangru,LIU Xue,FAN Zhaopeng,et al.Effect of acupuncture and Mendelssohn's manipulation on the improvement of swallowing function in patients with dysphagia after stroke[J].,2022,(11):958.[doi:DOI:10.3969/j.issn.1000-7369.2022.07.036]
[6]张 敏,王 渊,王 强,等.针刺疗法治疗肱二头肌长头肌腱鞘炎研究进展[J].陕西中医,2023,(1):124.[doi:DOI:10.3969/j.issn.1000-7369.2023.01.030]
[7]王友刚,高大红,柳 刚,等.压灸足运感区联合盆底肌肉训练对中风后尿失禁患者临床症状、膀胱残余尿量及生活质量的影响[J].陕西中医,2023,(5):663.[doi:DOI:10.3969/j.issn.1000-7369.2023.05.030]
 WANG Yougang,GAO Dahong,LIU Gang,et al.Effects of foot massage and pelvic floor muscle training on clinical symptoms,residual urine volume of bladder and quality of life of patients with urinary incontinence after stroke[J].,2023,(11):663.[doi:DOI:10.3969/j.issn.1000-7369.2023.05.030]
[8]陈雨菲,李小黎,张 婧,等.温针灸治疗气虚血瘀型中风后遗症研究进展[J].陕西中医,2023,(8):1150.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.036]
[9]梁艳桂,吴海科,黄耀渠,等.针灸不同穴位组治疗中风后假性球麻痹吞咽功能障碍疗效研究[J].陕西中医,2024,(3):411.[doi:DOI:10.3969/j.issn.1000-7369.2024.03.029]
 LIANG Yangui,WU Haike,HUANG Yaoqu,et al.Curative effect study on different acupuncture point on swallowing dysfunction caused by pseudobulbar palsy after stroke[J].,2024,(11):411.[doi:DOI:10.3969/j.issn.1000-7369.2024.03.029]
[10]张 敌,王彦华,陈昺伃.脑卒中半身不遂中医病机探析[J].陕西中医,2024,(7):947.[doi:DOI:10.3969/j.issn.1000-7369.2024.07.019]
 ZHANG Di,WANG Yanhua,CHEN Bingyu.Traditional Chinese medicine pathogenesis of stroke hemiplegia[J].,2024,(11):947.[doi:DOI:10.3969/j.issn.1000-7369.2024.07.019]

备注/Memo

备注/Memo:
基金项目:新疆维吾尔自治区区域协同创新专项(上海合同组织科技伙伴计划及国际科技合作计划)课题(2022E01008)
更新日期/Last Update: 2024-11-11