基于穴位敏化理论探讨力敏针刺治疗脑卒中后肩痛的临床疗效OA
The Clinical Efficacy of Force-sensitive Acupuncture Based on the Acupoint Sensitization Theory in the Treatment of Post-stroke Shoulder Pain
目的:基于穴位敏化理论观察力敏针刺治疗脑卒中后肩痛(PSSP)的临床疗效,并探讨其对患者肩关节运动功能、疼痛程度及日常生活活动能力的影响.方法:将120例PSSP患者采用随机数字表法分为力敏针刺组、常规针刺组和本体感觉神经肌肉促进(PNF)组各40例.三组均接受脑血管病基础治疗,在此基础上,力敏针刺组施以力敏针刺(辨敏取穴,探及肩髃次等筋结病灶点进行针刺),常规针刺组施以常规固定穴位针刺,PNF组施以PNF技术治疗.三组均治疗4周,于治疗前后采用视觉模拟评分法(VAS)、简化Fugl-Meyer运动功能量表上肢部分(FMA-UE)、肩关节被动活动度(PROM)及改良Barthel指数(MBI)进行评估,并比较三组临床疗效.结果:常规针刺组1例因晕针脱落,其余119例完成研究.治疗后,三组VAS评分均较治疗前降低,FMA-UE、PROM及MBI评分均较治疗前升高(P<0.05).力敏针刺组VAS评分、FMA-UE评分、MBI评分、屈曲及外展PROM均显著优于常规针刺组和PNF组(P<0.05).力敏针刺组总有效率为87.50%,显著高于常规针刺组的71.79%和PNF组的75.00%(P<0.05).结论:基于穴位敏化理论的力敏针刺能有效缓解PSSP患者疼痛,改善上肢运动功能及关节活动度,提高日常生活能力,疗效优于常规针刺及PNF技术,值得临床推广应用.
Objective:To observe the clinical efficacy of force-sensitized acupuncture in treating post-stroke shoulder pain(PSSP)based on the theory of acupoint sensitization,and to explore its effects on patients'shoulder joint motor function,pain severity,and activities of daily living.Methods:A total of 120 PSSP patients were randomly divided into a force-sensitive acupuncture group,a conventional acupuncture group,and a proprioceptive neuromuscular facilitation(PNF)group,with 40 cases in each group.All three groups received standard basic treatment for cerebrovascular diseases.Additionally,the force-sensitive acupuncture group received force-sensitive acupuncture(acupoints were selected based on sensitization detection,targeting myofascial trigger points such as Jianyuci);the conventional acupuncture group received routine acupuncture at fixed acupoints;and the PNF group received PNF therapy.All treatments lasted for 4 weeks.Evaluations were conducted before and after treatment using the Visual Analogue Scale(VAS),the Fugl-Meyer Assessment Upper Extremity(FMA-UE),passive range of motion(PROM)of the shoulder joint,and the Modified Barthel Index(MBI).Results:One patient in the conventional acupuncture group withdrew due to fainting during acupuncture,and the remaining 119 patients completed the study.After treatment,the VAS scores of all three groups decreased compared with before treatment,while the FMA-UE,PROM,and MBI scores increased compared with before treatment(P<0.05).The VAS score,FMA-UE score,MBI score,and flexion and abduction PROM of the force-sensitive acupuncture group were significantly superior to those of the conventional acupuncture group and the PNF group(P<0.05).The total effective rate of the force-sensitive acupuncture group was 87.50%,significantly higher than the 71.79%of the conventional acupuncture group and the 75.00%of the PNF group(P<0.05).Conclusion:Force-sensitive acupuncture guided by the acupoint sensitization theory effectively alleviates pain,improves upper limb motor function and joint mobility,and enhances the quality of daily living in PSSP patients.Its efficacy is superior to that of conventional acupuncture and PNF techniques,indicating its potential value for broader clinical application.
彭天忠;朱满华;袁娟;周峰;占琦楠;叶飞;余庆英
江西中医药大学附属洪都中医院,江西 南昌 330008江西中医药大学附属洪都中医院,江西 南昌 330008江西中医药大学附属洪都中医院,江西 南昌 330008江西中医药大学附属洪都中医院,江西 南昌 330008江西中医药大学附属洪都中医院,江西 南昌 330008江西中医药大学附属洪都中医院,江西 南昌 330008江西中医药大学附属洪都中医院,江西 南昌 330008
医药卫生
脑卒中后肩痛力敏针刺穴位敏化本体感觉神经肌肉促进技术
post-stroke shoulder painforce-sensitive acupunctureacupoint sensitizationproprioceptive neuromuscular facilitation
《中医康复》 2026 (9)
39-44,6
江西省中医药科技计划项目(2023B0419)江西省中医药中青年骨干人才培养项目(赣中医药科教字[2020]5号)国家中医优势专科(康复科)(国中医药医政函[2024]90号)南昌市重点专科建设项目([2021]7号)
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