Clinical efficacy of matrix acupuncture combined with Jingulian capsules for post-stroke shoulder pain

doi:10.3760/cma.j.issn.1007-1245.2024.24.032

Abstract

Abstract:

Objective　To evaluate the clinical efficacy of matrix acupuncture combined with Jingulian capsules in patients with post-stroke shoulder pain. Methods　This study was a randomized controlled trial. Ninety-eight patients with post-stroke shoulder pain admitted to Ankang Hospital of Traditional Chinese Medicine from March 2022 to February 2024 were randomly divided into a control group and an observation group, with 49 patients in each group. In the control group, 28 males and 21 females, aged (63.49±7.60) years, with a duration of disease of (3.32±1.19) months, received oral Jingulian capsules, 2 capsules each time, 3 times a day. In the observation group, 26 males and 23 females, aged (64.60±8.37) years, with a duration of disease of (3.56±1.30) months, were treated with matrix acupuncture on the basis of the control group, 30 min each time, 3 times a week. Both groups were treated continuously for 8 weeks. The changes in Visual Analogue Scale (VAS), Fugl-Meyer Motor Function Assessment (FMA), Constant-Murley Shoulder Joint Scale (CMS), and ability of daily living (Barthel index) scores before and after treatment were compared between the two groups. Serum levels of endorphin, enkephalin, dynorphin, and inflammatory markers [interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), and nitric oxide (NO)] were detected, and the clinical efficacy was evaluated. t test and χ² test were used for statistical analysis. Results　After 8 weeks of treatment, the VAS score of the observation group was lower than that of the control group [(3.67±1.23) points vs. (4.52±1.47) points], with a statistically significant difference (t=3.104, P=0.003); the FMA score, CMS score, and Barthel index of the observation group were higher than those of the control group [(26.43±5.89) points vs. (21.78±5.64) points, (30.22±6.83) points vs. (25.79±5.60) points, (60.65±7.15) points vs. (55.91±6.56) points], with statistically significant differences (t=3.991, 3.511, and 3.419, all P<0.001). Serum levels of endorphin, enkephalin, and dynorphin of the observation group were higher than those of the control group [(932.85±102.44) ng/L vs. (858.33±82.67) ng/L, (61.94±12.10) ng/L vs. (54.75±9.73) ng/L, (110.42±16.58) ng/L vs. (98.63±13.47) ng/L], with statistically significant differences (t=3.963, 3.241, and 3.863, all P<0.05); the levels of IL-6, TNF-α, and NO were lower than those of the control group [(47.22±8.54) pg/L vs. (54.68±9.10) pg/L, (16.41±4.12) ng/L vs. (19.88±5.47) ng/L, (19.48±4.12) µmol/L vs. (22.88±4.60) µmol/L], with statistically significant differences (t=4.184, 3.547, and 3.854, all P<0.001). The total effective rate of the observation group was higher than that of the control group [95.92% (47/49) vs. 83.67% (41/49)], with a statistically significant difference (χ²=4.009, P=0.045). Conclusion　Matrix acupuncture combined with Jingulian capsules can significantly improve the degree of pain and dysfunction in patients with post-stroke shoulder pain, and has anti-inflammatory effects, which is worthy of clinical application.

Key words:

Stroke, Shoulder pain, Matrix acupuncture, Jingulian capsules, Clinical efficacy

摘要：

目的　评估矩阵针法联合金骨莲胶囊对中风后肩痛患者的临床疗效。方法　本研究为随机对照试验。选取2022年3月至2024年2月安康市中医医院收治的98例中风后肩痛患者，按照随机数字表法分为对照组和观察组，各49例。对照组中男28例、女21例，年龄（63.49±7.60）岁，病程（3.32±1.19）个月，给予口服金骨莲胶囊治疗，每次2粒，每日3次。观察组中男26例、女23例，年龄（64.60±8.37）岁，病程（3.56±1.30）个月，在对照组基础上联合矩阵针法治疗，矩阵针法每周治疗3次，每次治疗30 min。两组患者均连续治疗8周。比较两组患者治疗前后视觉模拟评分法（VAS）、Fugl-Meyer运动功能评分量表（FMA）、Constant-Murley肩关节评分量表（CMS）、日常生活能力（Barthel指数）评分的变化，检测血清内啡肽、脑啡肽、强啡肽及炎症指标［白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、一氧化氮（NO）］水平，并评估临床疗效。采用χ²检验、t检验进行统计分析。结果　治疗8周后，观察组VAS评分低于对照组［（3.67±1.23）分比（4.52±1.47）分］，FMA评分、CMS评分和Barthel指数均高于对照组［（26.43±5.89）分比（21.78±5.64）分、（30.22±6.83）分比（25.79±5.60）分、（60.65±7.15）分比（55.91±6.56）分］，差异均有统计学意义（t=3.104、3.991、3.511、3.419，均P<0.05）；观察组血清内啡肽、脑啡肽、强啡肽均高于对照组［（932.85±102.44）ng/L比（858.33±82.67）ng/L、（61.94±12.10）ng/L比（54.75±9.73）ng/L、（110.42±16.58）ng/L比（98.63±13.47）ng/L］，IL-6、TNF-α和NO均低于对照组［（47.22±8.54）pg/L比（54.68±9.10）pg/L、（16.41±4.12）ng/L比（19.88±5.47）ng/L、（19.48±4.12）µmol/L比（22.88±4.60）µmol/L］，差异均有统计学意义（t=3.963、3.241、3.863、4.184、3.547、3.854，均P<0.05）。观察组总有效率高于对照组［95.92%（47/49）比83.67%（41/49）］，差异有统计学意义（χ²=4.009，P=0.045）。结论　矩阵针法联合金骨莲胶囊能够显著改善中风后肩痛患者的疼痛程度和功能障碍，且具有抗炎作用，值得临床推广应用。

关键词:

中风, 肩痛, 矩阵针法, 金骨莲胶囊, 临床疗效

Chen Yifang, Chen Rong, Wu Guoqiang, Hu Xinyao.

Clinical efficacy of matrix acupuncture combined with Jingulian capsules for post-stroke shoulder pain [J]. International Medicine and Health Guidance News, 2024, 30(24): 4221-4225.

陈义芳陈蓉吴国强胡新耀.

矩阵针法联合金骨莲胶囊治疗中风后肩痛的临床疗效 [J]. 国际医药卫生导报, 2024, 30(24): 4221-4225.

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