Abstract:

Objective　To observe the clinical effect of Fu's subcutaneous needling (FSN) combined with kinesiology tape on shoulder pain after stroke with hemiplegia. Methods　This study was a randomized controlled trial. Sixty patients with shoulder pain after stroke with hemiplegia who received treatment in the Rehabilitation Medicine Department of the Ninth People's Hospital of Zibo from August 2023 to May 2024 were selected and were divided into a FSN treatment group and a control group with 30 cases in each group according to the random number table method. The FSN treatment group included 19 males and 11 females, aged (58.67±8.68) years. The control group included 20 males and 10 females, aged (58.63±7.07) years. The control group received kinesiology tape and routine rehabilitation training, rehabilitation training once a day, a total of 7 times, and kinesiology tape treatment was given on the 4th day and was maintained for 3 days; the FSN treatment group received FSN combined with kinesiology tape and routine rehabilitation training, FSN treatment was given once a day for 3 times in total, kinesiology tape was given on the 4th day and was maintained for 3 days, and FSN treatment was given again on the 7th day. After 7 days of treatment, the Visual Analogue Scale (VAS) was used to evaluate the pain situation, and the Fugl-Meyer Assessment Upper Extremity (FMA-UE) was used to evaluate the recovery of upper limb function, and the modified Barthel index (MBI) was used to evaluate the activities of daily living. t test and χ² test were used for statistical analysis. Results　Before treatment, there was no statistically significant difference in the VAS score between the two groups (P>0.05). After 3 days of treatment, the VAS score of the FSN treatment group was lower than that before treatment [(2.23±1.10) points vs. (5.43±0.73) points] (P<0.05); after 7 days of treatment, the VAS score of the FSN treatment group was lower than those after 3 days of treatment and before treatment [(2.03±1.25) points vs. (2.23±1.10) points and (5.43±0.73) points] (both P<0.05), and the VAS score of the control group was lower than that before treatment [(4.00±1.66) points vs. (5.40±0.72) points] (P<0.05). After 7 days of treatment, the VAS score of the FSN treatment group was lower than that of the control group [(2.03±1.25) points vs. (4.00±1.66) points] (P<0.05). Before treatment and after 7 days of treatment, there were no statistically significant differences in the FMA-UE or MBI score between the two groups (all P>0.05). The total effective rate of the FSN treatment group was higher than that of the control group [63.33% (19/30) vs. 36.67% (11/30)], with a statistically significant difference (χ²=4.267, P=0.039). Conclusion　FSN combined with kinesiology tape and routine rehabilitation training can improve shoulder pain in stroke patients with hemiplegia, which is superior to kinesiology tape combined with routine rehabilitation training.

Key words:

Stroke, Hemiplegia, Shoulder pain, Fu's subcutaneous needling, Kinesiology tape

摘要：

目的　观察浮针结合肌内效贴治疗脑卒中偏瘫肩痛的临床疗效。方法　本研究为随机对照试验。选取2023年8月至2024年5月于淄博市第九人民医院康复医学科接受治疗的脑卒中偏瘫肩痛患者60例，按随机数字表法分为浮针治疗组和对照组各30例。浮针治疗组男19例、女11例，年龄（58.67±8.68）岁。对照组男20例、女10例，年龄（58.63±7.07）岁。对照组接受肌内效贴及常规康复训练，康复训练每天1次，共7次，第4天予以肌内效贴治疗，贴扎时间维持3 d；浮针治疗组接受浮针结合肌内效贴及常规康复训练，浮针治疗每天1次，共3次，第4天予以肌内效贴治疗，贴扎时间维持3 d，第7天再予以浮针治疗1次。治疗7 d后，采用视觉模拟评分法（Visual Analogue Scale，VAS）评价疼痛情况，简化Fugl-Meyer上肢运动功能量表（Fugl-Meyer Assessment Upper Extremity，FMA-UE）评价上肢功能恢复情况，改良Barthel指数（modified Barthel index，MBI）评价日常生活活动能力。统计学方法采用t检验和χ²检验。结果　治疗前，两组VAS评分比较差异无统计学意义（P>0.05）。治疗3 d后，浮针治疗组VAS评分低于治疗前［（2.23±1.10）分比（5.43±0.73）分］（P<0.05）；治疗7 d后，浮针治疗组VAS评分低于治疗3 d后及治疗前［（2.03±1.25）分比（2.23±1.10）分、（5.43±0.73）分］（均P<0.05），对照组VAS评分低于治疗前［（4.00±1.66）分比（5.40±0.72）分］（P<0.05）。浮针治疗组治疗7 d后VAS评分低于对照组［（2.03±1.25）分比（4.00±1.66）分］（P<0.05）。治疗前及治疗7 d后，两组FMA-UE、MBI评分比较差异均无统计学意义（均P>0.05）。浮针治疗组总有效率高于对照组［63.33%（19/30）比36.67%（11/30）］，差异有统计学意义（χ²=4.267，P=0.039）。结论　浮针结合肌内效贴及常规康复训练治疗能改善脑卒中偏瘫患者肩痛，优于肌内效贴联合常规康复训练。

关键词:

脑卒中, 偏瘫, 肩痛, 浮针, 肌内效贴