Objectives: To observe the effects of acupoint application with turmeric blistering moxibustion plaster on pain, shoulder range of motion (ROM) and upper limb motor function in the patients with post-stroke hemiplegic shoulder pain (PSHSP).
Methods: Eighty-two patients with PSHSP were randomly divided into an observation group (41 cases, 1 case was eliminated, 4 cases dropped out) and a control group (41 cases, 2 cases were eliminated and 2 cases dropped out). The routine treatment, nursing care and rehabilitation training were performed in the control group. On the basis of the intervention as the control group, in the observation group, the turmeric blistering moxibustion plaster was applied to bilateral ashi points, Jianyu (LI 15), Jianliao (TE 14), Binao (LI 14), Shousanli (LI 10) and Hegu (LI 4), once a day, remained for 6 hours each time. This moxibustion therapy was operated 5 times weekly, one course of treatment consisted of 2 weeks and 2 courses were required. Separately, before treatment and after 2 and 4 weeks of treatment, the score of visual analogue scale (VAS), shoulder ROM and the score of upper limbs in Fugl-Meyer assessment (U-FMA) were observed in the two groups.
Results: VAS scores were lower (P<0.05), ROM in shoulder flexion, abduction, internal rotation and external rotation was larger (P<0.05), and U-FMA scores were higher (P<0.05) after 2 and 4 weeks of treatment when compared with those before treatment in the two groups. After 4 weeks of treatment, VAS score decreased (P<0.05), and ROM in shoulder flexion, abduction, internal rotation, external rotation and U-FMA score increased (P<0.05) in comparison with those after 2 weeks of treatment in either group. In the observation group, VAS scores were dropped (P<0.05) after 2 and 4 weeks of treatment respectively, and ROM of shoulder flexion and abduction enlarged after 2 weeks of treatment (P<0.05) when compared with those in the control group. After 4 weeks of treatment, ROM in shoulder flexion, abduction, internal rotation and external rotation in the observation group was larger (P<0.05) and U-FMA score was higher (P<0.05) than those in the control group.
Conclusions: Acupoint application with turmeric blistering moxibustion plaster may effectively reduce the degree of shoulder pain and improve the shoulder range of motion and the upper limb motor function in the patients with post-stroke hemiplegic shoulder pain.
目的: 观察姜黄天灸膏穴位贴敷对脑卒中偏瘫肩痛患者疼痛、肩关节活动度和上肢运动功能的影响。方法: 将82例卒中后偏瘫肩痛患者随机分为观察组（41例，剔除1例、脱落4例）及对照组（41例，剔除2例、脱落2例）。对照组予常规治疗、护理及康复训练。观察组在对照组基础上，于患侧阿是穴、肩髃、肩髎、臂臑、手三里、合谷行姜黄天灸膏穴位贴敷，每次6 h，每天1次，每周5次，2周为一疗程，共治疗2个疗程。分别于治疗前及治疗2、4周后观察两组患者视觉模拟量表（VAS）评分、肩关节活动度（ROM）及Fugl-Meyer运动功能评定量表上肢部分（U-FMA）评分。结果: 两组患者治疗2、4周后VAS评分低于治疗前（P<0.05），肩关节屈曲、外展、内旋、外旋ROM大于治疗前（P<0.05），U-FMA评分高于治疗前（P<0.05）；治疗4周后VAS评分低于治疗2周后（P<0.05），肩关节屈曲、外展、内旋、外旋ROM大于治疗2周后（P<0.05），U-FMA评分高于治疗2周后（P<0.05）。观察组患者治疗2、4周后VAS评分低于对照组（P<0.05）；治疗2周后肩关节屈曲、外展ROM大于对照组（P<0.05）；治疗4周后肩关节屈曲、外展、内旋、外旋ROM大于对照组（P<0.05），U-FMA评分高于对照组（P<0.05）。结论: 姜黄天灸膏穴位贴敷可有效减轻脑卒中偏瘫肩痛患者肩痛程度，改善其肩关节活动度及提高上肢运动功能。.
Keywords: acupoint application; blistering moxibustion therapy; hemiplegic shoulder pain; pain degree; shoulder range of motion; stroke; turmeric; upper limb motor function.