Objective To observe the clinical therapeutic effect of"Tiaoshen Zhitong"(mental regulating and pain relieving)needling and its influence on serological indicators in the treatment of post-stroke shoulder pain

so as to provide new therapeutic thoughts and approach for post-stroke shoulder pain.Methods A total of 80 inpatients with post-stroke shoulder pain were randomly divided into a control group(routine needling

39 cases)and an observation group("Tiaoshen Zhitong"needling

41 cases)according to the random number table. Patients of the two groups accepted basic medication treatment including anticoagulants

hypotensive drugs

hypoglycermic drugs

lipid-lowering drugs

etc. In addition

patients of the control group were also treated by routine acupuncture stimulation(uniform reinforcing-reducing stimulation)of Jianyu(LI15)

Jianqian(EX-UE12)

Jianhou(Extra)

Jianliao(TE14)

Waiguan(TE5)and Hegu(LI4)on the affected side

and those of the observation group also treated by"Tiaoshen Zhitong"needling of Ear-Shenmen(MA-TF1)

bilateral Neiguan(PC6

lifting-thrusting-reducing method)

Shuigou(GV26

lifting-thrustingreducing method)

and Jianyu(LI15)

Jianliao(TE14)

Jianzhen(SI9)and Yanglingquan(GB34

the latter 4 points were stimulated with uniform reinforcing-reducing method)on the affected side. The treatment was given once every day

6 days a week for 4 weeks. The pain severity was assessed by using visual analogue scale(VAS)

the upper limb function evaluated by using Fugl-Meyer assessment(FMA)scale

the shoulder-joint function evaluated by using Constant-Murley score(CMS)questionnaire

and the daily living ability assessed by using Barthel index(BI)scale. The enzyme linked immunosorbent assay(ELISA)was used to determine the contents of serum beta-endorphin(β-EP)

enkephalin(ENK)and dynorphin(Dyn). The clinical therapeutic effect was evaluated by using Nimodipine scale method.Results Of the 39 and 41 cases in the control and observation groups

7(17. 95%)and 12(29. 27%)were basically cured

12(30. 77%)and 13(31. 71%)experienced marked improvement

8(20. 51%)and 11(26. 83%)were effective

12(30. 77%)and 5(12. 19%)failed

with the total effective rate being 69. 23% and 87. 80%

respectively. The effective rate of the observation group was significantly higher than that of the control group(P<0. 05). After the treatment

the VAS score was obviously reduced(P<0. 01)

and the scores of FMA scale

CMS questionnaire and BI scale

and contents of serum β-EP

ENK and Dyn were all increased obviously in the two groups compared with their own pre-treatment(P<0. 01). The therapeutic effect of"Tiaoshen Zhitong"needling was significantly superior to that of the routine needling in lowering VAS

and in raising scores of FMA scale

CMS questionnaire and BI scale and in up-regulating serum β-EP

ENK and Dyn levels(P<0. 01).Conclusion "Tiaoshen Zhitong"needling is effective in reducing post-stroke shoulder pain and improving the motor function of the upper limb and shoulder-joint as well as the quality of daily life in stroke patients with shoulder pain. Its analgesic effect is probably related to the increase of the levels of serum β-EP

ENK and Dyn.