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武汉市第三医院康复科武汉大学附属同仁医院
纸质出版日期:2019
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段轶轩, 张照庆, 骆小娟, 等. 内热针结合臭氧穴位注射治疗中风后肩痛的近期及远期疗效分析[J]. 针刺研究, 2019,44(1):51-56.
DUAN Yi-xuan, ZHANG Zhao-qing, LUO Xiao-juan, et al. Short-term and long-term therapeutic effects of internal heat-type acupuncture needle therapy combined with acupoint injection of O_3 for post-stroke shoulder pain[J]. Acupuncture research, 2019, 44(1): 51-56.
段轶轩, 张照庆, 骆小娟, 等. 内热针结合臭氧穴位注射治疗中风后肩痛的近期及远期疗效分析[J]. 针刺研究, 2019,44(1):51-56. DOI: 10.13702/j.1000-0607.170453.
DUAN Yi-xuan, ZHANG Zhao-qing, LUO Xiao-juan, et al. Short-term and long-term therapeutic effects of internal heat-type acupuncture needle therapy combined with acupoint injection of O_3 for post-stroke shoulder pain[J]. Acupuncture research, 2019, 44(1): 51-56. DOI: 10.13702/j.1000-0607.170453.
目的:运用不同量表观察并探讨内热针结合臭氧穴位注射治疗中风后肩痛的近期及远期疗效。方法:将中风后肩痛患者按照随机数字表法分为内热针结合臭氧穴位注射组29例、温针灸结合臭氧穴位注射组29例和臭氧穴位注射组30例。内热针结合臭氧穴位注射组予内热针42℃治疗
持续20min
1周1次
结合臭氧穴位注射3mL/穴
隔日1次;温针灸结合臭氧穴位注射组予温针灸及臭氧穴位注射
隔日1次;臭氧穴位注射组予臭氧穴位注射
隔日1次。3组均取患侧肩髃、肩髎、肩贞、臂臑、阿是穴
治疗4周。分别在治疗前、治疗2周末、4周末及6个月末检测3组患者视觉模拟量尺(VAS)评分、简易上肢关节FuglMeyer运动功能评分(FMA)及日常生活活动能力评价(ADL)评分。结果:在总有效率方面
内热针结合臭氧穴位注射组在治疗2周末达到79.31%(23/29)
在治疗4周末达到86.21%(25/29)
在治疗6个月末达到93.10%(27/29)
均明显高于温针灸结合臭氧穴位注射组和臭氧穴位注射组同时期的总有效率(P<0.05)。各组治疗前后VAS评分比较
治疗后较治疗前均降低(P<0.05
P<0.01)
治疗后FMA、ADL评分较同组治疗前提高(P<0.05
P<0.01)。治疗2周末、4周末及6个月末内热针结合臭氧穴位注射组VAS评分低于温针灸结合臭氧穴位注射组及臭氧穴位注射组(P<0.05)
FMA及ADL评分高于温针灸结合臭氧穴位注射组及臭氧穴位注射组(P<0.05)。结论:内热针结合臭氧穴位注射治疗中风后肩痛的近期及远期疗效明显。
Objective To observe the short-term and long-term therapeutic effects of internal heat-type acupuncture needle(IHTAN)therapy combined with acupoint injection of O_3 for 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_3 solution(3 mL
30μg/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 nd and 4 th week as well as the 6 th 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 2nd and 4th week as well as the 6th 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(P<0.05)
and the FMA and ADL scores were significantly higher in the IHTAN+acupoint injection group than in the other two groups(P<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(P>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 2nd week
3
2 and 12 cases at the 4th week
4
2 and 15 cases at the 6 th month were cured;15
14 and 16 cases at the 2nd week
17
17 and 13 cases at the 4th week
and 18
18 and 12 cases at the 6th month experienced marked improvement;13
16 and 6 cases at the 2nd week
9
11 and 4 cases at the 4th week
7
10 and 2 cases at the 6th month had no apparent changes in their shoulder pain severity
with the total effective rates at the 4th week and 6th 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_3 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.
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