肌内效贴联合经皮神经电刺激对脑卒中后偏瘫肩痛患者肩关节疼痛、肩关节功能和血液流变学的影响

摘要 目的：探讨肌内效贴联合经皮神经电刺激（TENS）对脑卒中后偏瘫肩痛患者肩关节疼痛、肩关节功能和血液流变学的影响。方法：选取2019年5月~2022年1月期间江苏省人民医院收治的脑卒中后偏瘫肩痛患者100例，根据随机数字表法将其分为对照组（n=50）和研究组（n=50），在常规康复训练的基础上，对照组接受肌内效贴干预，研究组接受肌内效贴联合TENS干预。对比两组视觉模拟评分法（VAS）评分、上肢Fugl-Meyer运动功能评定量表（FMA）、改良Barthel指数（MBI）、Constant-Murley肩关节功能评分量表（CMS）评分、血液流变学指标、肩关节功能变化情况。结果：研究组干预后VAS评分低于同期对照组（P<0.05）。研究组干预后FMA、MBI、CMS评分高于同期对照组（P<0.05）。研究组干预后血浆黏度、纤维蛋白原、全血黏度、红细胞压积均低于同期对照组（P<0.05）。研究组干预后患侧肩关节的外旋、前屈、外展的主动/被动活动度（AROM/PROM）均大于对照组同期（P<0.05）。结论：肌内效贴联合TENS应用于脑卒中后偏瘫肩痛患者，可有效改善肩关节疼痛、肩关节功能和血液流变学。

Effect of Intramuscular Plaster Combined with Transcutaneous Electrical Nerve Stimulation on Shoulder Joint Pain, Shoulder Joint Function and Hemorheology in Patients with Hemiplegic Shoulder Pain after Stroke

ABSTRACT Objective: To observe the effect of intramuscular plaster combined with transcutaneous electrical nerve stimulation (TENS) on shoulder joint pain, shoulder joint function and hemorheology in patients with hemiplegic shoulder pain after stroke. Methods: 100 patients with hemiplegic shoulder pain after stroke who were admitted to Jiangsu Provincial People''s Hospital from May 2019 to January 2022 were selected, and they were divided into control group (n=50) and study group (n=50) according to random number table method. Based on routine rehabilitation training, the control group received intramuscular plaster intervention, and the study group received intramuscular plaster combined with TENS intervention. Visual analog scale (VAS) score, upper limb Fugl-Meyer Motor Function Rating Scale (FMA), Modified Barthel index (MBI), Constant-Murley Shoulder Function Rating Scale (CMS) score, hemorheology index and shoulder joint function changes in the two groups were compared. Results: The VAS score in the study group after intervention was lower than that in the control group (P<0.05). The FMA, MBI and CMS scores in the study group after intervention were higher than those in the control group (P<0.05). The plasma viscosity, fibrinogen, whole blood viscosity and hematocrit in the study group after intervention were lower than those in the control group (P<0.05). The active/passive motion (AROM/PROM) of external rotation, forward flexion and abduction of the affected shoulder in the study group after intervention were higher than those in the control group (P<0.05). Conclusion: The intramuscular plaster combined with combined with TENS can effectively improve shoulder joint pain, shoulder joint function and hemorheology in patients with hemiplegic shoulder pain after stroke.