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目的:比较补元固肩针灸法与康复治疗偏瘫肩痛的疗效差异。方法:56例偏瘫肩痛患者随机分为针灸组(30例)、康复组(26例)。针灸组采用艾条温和灸关元、气海、足三里,针刺肩贞、臑俞、曲池等穴;康复组采用按摩局部组织、抗痉挛活动等常规康复治疗,均每天治疗1次,15次为一疗程,共治疗2个疗程。以疼痛视觉模拟评分(VAS)、Fugl-Meyer运动功能评定量表、临床神经功能缺损程度评分量表等为观察指标,在治疗前和治疗后30d分别进行评分,进行止痛效果和功能效果评价。结果:针灸组止痛总有效率为100.0%(30/30),康复组为96.2%(25/26),组间差异无统计学意义(P>0.05);治疗后两组VAS评分较治疗前均显著降低(均P<0.01),两组治疗前后差值比较,差异无统计学意义(P>0.05)。两组治疗后Fugl-Meyer运动功能评分、临床神经功能缺损程度评分均显著改善(均P<0.01),且针灸组改善程度优于康复组(均P<0.01)。结论:两种方法对偏瘫肩痛的治疗均有止痛效果,补元固肩针灸法对患侧上肢功能和神经功能缺损恢复要优于康复疗法。
OBJECTIVE: To compare the therapeutic effects of tonifying acupuncture with shoulder acupuncture and rehabilitation on hemiplegic shoulder pain. Methods: 56 patients with hemiplegia and shoulder pain were randomly divided into acupuncture group (30 cases) and rehabilitation group (26 cases). The acupuncture group adopted the mild moxibustion of Moxibustion, gas sea, Zusanli acupuncture, Zhenzhen, Qiyu, Quchi and other points. The rehabilitation group used local rehabilitation such as massage and antispasmodic activities and were treated once daily, 15 times for a course of treatment for a total of 2 courses. Pain visual analogue scale (VAS), Fugl-Meyer motor function assessment scale and clinical neurological deficit score scale were used as indexes to evaluate the analgesic effect and functional effect before and 30 days after treatment respectively. Results: The total effective rate of analgesia was 100.0% (30/30) in acupuncture group and 96.2% (25/26) in rehabilitation group, there was no significant difference between the two groups (P> 0.05) (P <0.01). There was no significant difference between the two groups before and after treatment (P> 0.05). The score of Fugl-Meyer motor function and the score of clinical neurological deficit in both groups were significantly improved after treatment (all P <0.01), and the acupuncture group was better than the rehabilitation group (all P <0.01). Conclusion: The two methods have analgesic effect on the treatment of hemiplegia and shoulder pain. Bu yuan on the shoulder acupuncture and moxibustion on the ipsilateral upper limb function and neurological deficit recovery is better than rehabilitation therapy.