电针联合康复治疗中风后肩关节半脱位的疗效观察

发布时间：2018-07-21 15:08

【摘要】：目的:观察电针联合康复治疗对中风后肩关节半脱位的临床疗效,为临床寻找一种操作简便、安全有效的治疗中风后肩关节半脱位的方法。方法:将60例中风后符合本研究纳入标准的肩关节半脱位患者随机分为奇穴组、常规针刺组、康复对照组,每组各20例,以上三组患者均采取相同的基础治疗,而奇穴组和常规针刺组都运用电针刺激联合康复治疗,奇穴组针刺选取冈上肌和三角肌上的穴位,常规针刺组选取三角肌上的穴位;康复对照组运用纯康复疗法,三组疗程均为4周。治疗前及疗程结束后均对比三组患者患侧肩部疼痛评分(VAS)、肩峰下缘与肱骨头间的最小距离(AHI)、上肢运动功能(FMA)的变化情况,并进行综合统计分析。结果:1.治疗后三组患者在肩痛方面均有不同程度的缓解,治疗前后差异有显著统计学意义(P0.01),其中肩痛缓解的程度奇穴组比康复对照组明显,差异显著(P0.01),而奇穴组与常规针刺组比较、常规针刺组与康复对照组比较疼痛均有缓解,差异均有统计学意义(P0.05)。2.治疗后三组患者肩关节半脱位的距离均有不同程度的缩小,治疗前后差异有显著统计学意义(P0.01),其中距离缩小的程度奇穴组较康复对照组明显,差异显著(P0.01),而奇穴组与常规针刺组比较、常规针刺组与康复对照组比较半脱位距离均有缩小,差异均有统计学意义(P0.05)。3.疗程结束后三组患者在上肢运动功能方面的改善评分均有明显提高,治疗前后差异有显著统计学意义(P0.01),其中功能改善奇穴组较康复对照组明显,差异显著(P0.01),而奇穴组与常规针刺组比较、常规针刺组与康复对照组比较功能改善均较明显,差异均有统计学意义(P0.05)。4.疗程结束后经Ridit分析三组患者的综合疗效,R奇穴R常规针剌R康复,即综合疗效奇穴组优于常规针刺组,而常规针刺组优于康复对照组。结论:1.电针联合康复治疗与单纯康复治疗对中风后肩关节半脱位症状均有改善作用,但电针联合康复治疗优于单纯康复治疗。2.电针刺激冈上肌和三角肌上的穴位,在很大程度上缓解了患侧肩部疼痛、减小半脱位距离、促进患侧上肢运动功能的恢复,其治疗效果比单纯电针刺激三角肌上的穴位更优。
[Abstract]:Objective: to observe the clinical effect of electroacupuncture combined rehabilitation therapy on shoulder subluxation after stroke and to find a safe and effective method for treating shoulder subluxation after stroke. Methods: sixty patients with subluxation of shoulder joint were randomly divided into three groups: Qi-point group, routine acupuncture group and rehabilitation control group, 20 cases in each group. The patients in the above three groups were treated with the same basic therapy. The Qi-point group and the conventional acupuncture group were treated with electroacupuncture combined rehabilitation therapy. The Qi-point group selected the points on the supraspinatus muscle and the deltoid muscle, the conventional acupuncture group selected the points on the deltoid muscle, and the rehabilitation control group used pure rehabilitation therapy. All the three groups were treated for 4 weeks. The changes of shoulder pain score (VAS), the minimum distance between the lower margin of acromion and humerus head (AHI) and the motor function of upper limb (FMA) were compared before and after treatment. The result is 1: 1. After treatment, the three groups had different degree of relief in shoulder pain, and the difference was statistically significant before and after treatment (P0.01). The degree of relief of shoulder pain in Qipoint group was significantly higher than that in rehabilitation control group (P0.01), and the Qi-point group was significantly different from that of routine acupuncture group (P0.01). Routine acupuncture group and rehabilitation control group compared with the pain relief, the differences were statistically significant (P0.05). 2. After treatment, the distance of shoulder subluxation in the three groups was reduced to different degrees, and the difference before and after treatment was statistically significant (P0.01). The difference was significant (P0.01). Compared with the routine acupuncture group, the distance of subluxation between the routine acupuncture group and the rehabilitation control group was reduced, and the difference was statistically significant (P0.05). 3. At the end of the treatment, the improvement scores of upper limb motor function in the three groups were obviously improved, and the difference before and after treatment was statistically significant (P0.01), among which the improvement of function at Qi-point group was more obvious than that in the rehabilitation control group. The difference was significant (P0.01), and Qi-point group and routine acupuncture group, routine acupuncture group and rehabilitation control group compared with the functional improvement was more significant (P0.05). 4. After the course of treatment, Ridit was used to analyze the comprehensive curative effect of the three groups, namely, the comprehensive curative effect was superior to the routine acupuncture group, and the routine acupuncture group was superior to the rehabilitation control group. Conclusion 1. Both electroacupuncture combined rehabilitation therapy and simple rehabilitation therapy can improve the symptoms of shoulder subluxation after stroke, but electroacupuncture combined rehabilitation therapy is better than simple rehabilitation treatment. Electroacupuncture stimulation of supraspinatus muscle and deltoid point greatly alleviated shoulder pain, reduced the distance of subluxation, and promoted the recovery of motor function of the affected upper limb. The therapeutic effect was better than that of electroacupuncture alone in stimulating acupoints on deltoid muscle.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

【相似文献】