We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accoun...We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accounted for 45.5% of the inpatients because of stroke. Results showed that the number of patients with hemiplegic shoulder pain post stroke increased yearly, attacking mainly males 50-69 years of age. Of 106 patients, there were 60 cases （56.6%） of adhesive capsulitis, 19 （17.9%） of shoulder subluxation, 14 （13.2%） of complex regional pain syndrome, and 13 （12.6%） of central pain. The main symptoms were shoulder pain （100%）, limit of shoulder mobility （98.1%）, and adhesion of the scapula （56.6%）. MRI of the shoulder showed tendon and ligament lesions （57.1%） and rotator cuff tear （38.1%）. 53.8% of central pain was related to the thalamus, in addition to the basal ganglia, brain stem, and cerebellopontine angle. Shoulder pain, upper limb motor function, and function independence were significantly improved after comprehensive rehabilitation. In par- ticular, electroacupuncture based on basic physical therapy exhibited efficacy on shoulder subluxa- tion and complex regional pain syndrome. Multiple linear regression results showed a negative re- lationship of efficacy of pain management with the attack period of shoulder pain, involvement of the posterior limb of the internal capsule, and duration between onset and rehabilitation treatment, but a positive correlation with pain-related education, pain regression period, and pain diagnosis.展开更多
BACKGROUND：Shoulder pain is a common complication of stroke.Bee venom acupuncture（BVA）is increasingly used in the treatment of post-stroke shoulder pain.OBJECTIVE：To summarize and evaluate evidence on the effectiv...BACKGROUND：Shoulder pain is a common complication of stroke.Bee venom acupuncture（BVA）is increasingly used in the treatment of post-stroke shoulder pain.OBJECTIVE：To summarize and evaluate evidence on the effectiveness of BVA in relieving shoulder pain after stroke.SEARCH STRATEGY：Nine databases,namely MEDLINE,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure（CNKI）,the Japan Science and Technology Information Aggregator,Electronic（J-STAGE）,and four Korean medical databases,namely,the National Assembly Library,the Research Information Service System,the National Discovery for Science Leaders,and OASIS,were searched from their inception through August 2014 without language restrictions.INCLUSION CRITERIA：Randomized controlled trials（RCTs）were included if BVA was used at acupoints as the sole treatment,or as an adjunct to other treatments,for shoulder pain after stroke.DATA EXTRACTION AND ANALYSIS：Two review authors independently selected trials for inclusion,assessed methodological quality and extracted data.RESULTS：A total of 138 potentially relevant articles were identifi ed,4 of which were RCTs that met our inclusion criteria.The quality of studies included was generally low,and a preponderance of positive results was demonstrated.All four trials reported favorable effects of BVA on shoulder pain after stroke.Two RCTs assessing the effects of BVA on post-stroke shoulder pain,as opposed to saline injections,were included in the meta-analysis.Pain was signifi cantly lower for BVA than for saline injections（standardized mean difference on 10-cm visual analog scale：1.46 cm,95%CI=0.30–2.62,P=0.02,n=86）CONCLUSION：This review provided evidence suggesting that BVA is effective in relieving shoulder pain after stroke.However,further studies are needed to confi rm the role of BVA in alleviating post-stroke shoulder pain.Future studies should be conducted with large samples and rigorous study designs.展开更多
In the present paper, the authors review some new results of acupuncture treatment of shoulder pain in stroke patients from ① application of filiform needle with different needling manipulations, ② selection and com...In the present paper, the authors review some new results of acupuncture treatment of shoulder pain in stroke patients from ① application of filiform needle with different needling manipulations, ② selection and combination of acupoints, and ③ some special needling methods including point-injection. Generally, if acupuncture therapy is used in combination with other rehabilitation methods, the therapeutic effect of shoulder-pain-relief will be much better. Regarding the acupoint selection, both local acupoints and those of the yang meridians are primarily used in clinical practice. Further studies on treating shoulder pain of hemiplegia based upon the basic theory of TCM are necessary.展开更多
BACKGROUND Aortic dissection(AD)is a life-threatening condition with a high mortality rate without immediate medical attention.Early diagnosis and appropriate treatment are critical in treating patients with AD.In the...BACKGROUND Aortic dissection(AD)is a life-threatening condition with a high mortality rate without immediate medical attention.Early diagnosis and appropriate treatment are critical in treating patients with AD.In the emergency department,patients with AD commonly present with classic symptoms of unanticipated severe chest or back pain.However,it is worth noting that atypical symptoms of AD are easily misdiagnosed.CASE SUMMARY A 51-year-old woman was first diagnosed with scapulohumeral periarthritis due to left shoulder pain.After careful examination of her previous medical history and contrast-enhanced computed tomography angiography,the patient was diagnosed with a new type A AD after chronic type B dissection in the ascending aorta.The patient was successfully treated with surgical replacement of the dissected aortic arch and remains in good health.CONCLUSION New retrograde type A AD after chronic type B dissection is relatively rare.It is worth noting that a physician who has a patient with suspected AD should be vigilant.Both patient medical history and imaging tests are crucial for a more precise diagnosis.展开更多
This study aimed to elucidate the key risk factors for shoulder pain in Japanese middle school-, high school-, and university-level badminton players and use a regression formula to predict the probability of shoulde...This study aimed to elucidate the key risk factors for shoulder pain in Japanese middle school-, high school-, and university-level badminton players and use a regression formula to predict the probability of shoulder pain onset based on risk factor combinations. Based on a self-report questionnaire survey, we included 461 individuals （102 middle school students, 134 high school students, and 225 university students） with a history of shoulder pain in the previous year and 541 individuals with no shoulder pain in the previous year. Then, we performed logistic regression analysis of individual characteristics and history of shoulder pain to analyze the factors associated with shoulder pain onset. Analysis of patients excluding those currently experiencing shoulder pain indicated that a history of shoulder pain （〉 1 year previously） predicted shoulder pain onset. Analysis of patients excluding those with a history of shoulder pain indicated that undergoing care, being of university age, having a long history of competing, and short cool-down times were associated with recurrent pain. However, results were different for each age group. The fact that half the Japanese middle school, high school, and university badminton players had a history of shoulder pain suggests that they will experience recurrent shoulder pain. The results also suggest that different factors are important in each age group. Thus, it is critical to establish evidence-based countermeasures to prevent shoulder pain that interferes with play.展开更多
Objective:To study the effect of spa therapy on relieving knee and shoulder pain.Methods:Participants were randomized to an intervention group(n=26)or a control group(n=23).The intervention group received the hot spri...Objective:To study the effect of spa therapy on relieving knee and shoulder pain.Methods:Participants were randomized to an intervention group(n=26)or a control group(n=23).The intervention group received the hot spring intervention program(1-2 times a day for two weeks),while the control group didn’t receive any intervention.Primary outcomes were assessed by the Western Ontario and McMaster University Osteoarthritis Index(WOMAC)and Shoulder Pain and Disability Index(SPADI).Secondary outcomes were assessed by general physical symptoms and Short Form-36(SF-36)health survey.Results:All parameters before intervention were homogenous between the groups.At baseline,there was no significant difference in WOMAC and SPADI index between the two groups,but there was a statistically significant difference in blurred vision,which was worse in the intervention group than in the control group(P<0.05).After intervention,general physical symptoms were relieved significantly in the intervention group compared with the control group(P<0.05).WOMAC index,SPADI index,social functioning,and general physical symptoms were relieved significantly after intervention in the intervention group(P<0.05).There is a significant difference in the blurred vision before and after the comparison of the control group(P<0.05).Conclusion:Spa therapy may relieve knee and shoulder pain and improve general physical symptoms and quality of life.展开更多
BACKGROUND Stroke is a type of cerebrovascular disease with high prevalence,mortality,and onset of disability.As a neurodevelopmental therapy,neuromuscular joint facilitation(NJF)is widely used in the treatment of ort...BACKGROUND Stroke is a type of cerebrovascular disease with high prevalence,mortality,and onset of disability.As a neurodevelopmental therapy,neuromuscular joint facilitation(NJF)is widely used in the treatment of orthopedic and neurological disorders in the clinical practice.It is mainly used for central nervous system diseases or orthopedic diseases,movement disorders,and pain rehabilitation.According to related studies,NJF can also be used as a rehabilitation treatment in patients with hemiplegic shoulder pain(HSP).AIM To investigate the clinical efficacy of acupuncture combined with NJF in patients with HSP.METHODS Forty patients with HSP were randomly divided into a treatment group and a control group.The treatment group was treated with acupuncture combined with NJF and the control group was treated with acupuncture alone.All patients were assessed by using the visual analogue scale(VAS),Fugl-Meyer assessment(FMA),Barthel index(BI),and passive range of motion(PROM)before and after the training.All the clinical data were analyzed using SPSS 20.0 statistical software.RESULTS There was no statistical difference in the general characteristics between the two groups.In the terms of duration of treatment,age,and pre-treatment indicators,the two groups were comparable(P>0.05).After the treatment,VAS,PROM,BI,and FMA scores were significantly improved in the two groups of patients(P<0.05).The VAS,PROM and FMA scores were significantly higher in the treatment group than in the control group(P<0.05).However,there was no significant difference in BI scores between the two groups(P>0.05).CONCLUSION Both acupuncture alone and acupuncture combined with NJF in the treatment of HSP are effective,and can improve the clinical symptoms of patients.Acupuncture combined with NJF can improve the upper limb motor function,relieve pain,and increase joint mobility in patients with HSP.The combination therapy is better than acupuncture alone.However,there is no significant difference in improving the score of patients’self-care ability.展开更多
Background: The relationship between chronic neck and shoulder pain and posture remains controversial. The purpose of this study was to investigate the relationship between chronic neck and shoulder pain and spinal sa...Background: The relationship between chronic neck and shoulder pain and posture remains controversial. The purpose of this study was to investigate the relationship between chronic neck and shoulder pain and spinal sagittal alignment in standing posture in younger generation. Methods: Subjects included 57 females and 32 males (average age, 29.9 ± 5.7 years). All subjects were 20s or 30s. Spinal curvature was assessed using SpinalMouse. The subjects were also divided into a normal group (VAS zero group) and a pain group by VAS results. Statistical analysis was performed by Student’s t-test. Significance was defined as p < 0.05. Results: The normal group and pain group included 29 and 60 subjects, respectively. In terms of location of pain, thirty-one subjects felt neck pain, 50 felt pain above the scapula, and 17 felt pain between the thoracic spine and scapula. Thoracic kyphosis and lumbar lordosis in the pain group were significantly higher than those in the normal group (p = 0.013 and p = 0.020, respectively). Thoracic kyphosis in subjects with neck pain or pain above scapula was significantly higher than that in subjects without pain (p = 0.0075 and p = 0.025, respectively). Lumbar lordosis in subjects with pain above the scapula or interscapula was significantly higher than that in subjects without pain (p = 0.016).展开更多
Background: Neural blockade is widely used in clinical practice to alleviate acute or chronic pain, including pain during rehabilitation. To date there is little controlled evidence to confirm the efficacy of nerve bl...Background: Neural blockade is widely used in clinical practice to alleviate acute or chronic pain, including pain during rehabilitation. To date there is little controlled evidence to confirm the efficacy of nerve blocks in hemiparetic shoulder pain after stroke. Design: This study is a prospective, open label, cohort trial reporting result from a cohort of stroke patients affected by shoulder pain. Aim: As a cohort study report, in which it is often firstly reported the possibility of an association between an observed effect and a specific environmental based on detailed clinical evaluations and histories, we aim to firstly provide clues in identifying Suprascapularis Nerve blockade as further valuable approach for shoulder pain after stroke. Population: We studied a cohort of patients affected by hemiparetic shoulder pain after Stroke. Methods: Our protocol foresees nerve blocks to be performed each 3 out of 4 days (treatment lasting 30 days) in conjunction with a rehabilitation program with the first aim to provide the window of opportunity to proceed with effective rehabilitation. 47 potential study subjects fulfilled the study criteria and were enrolled. Twenty-four subjects were randomised to the study Group to receive SSNB for the pain of their hemiparetic shoulder while 23 subjects randomized to the control Group whose member did not receive SSNB. They received serial blocks each 3 out of 4 days during rehabilitation.Results: Both treatment reported a reduction in the intensity of their shoulder pain, according to data collected from day 1 through day 42 (6 weeks). Study Group patients, receiving SSNBs, reported significant improvement from entry through the whole follow-up period. The efficiency data were higher for SSNB Group after 2 weeks and again for SSNb group at the end of treatment. Conclusion: Excellent pain relief was achieved in SSNB without clinically relevant complications, these patients having a better improvement on pain during rehabilitation, than the control subjects. Great efficacy has been achieved by combining a nerve block and rehabilitation. About Clinical Rehabilitation Impact, we believe that Suprascapularis nerve blocks can help the stroke survivors maintain an ambulatory or outpatient treatment status, maintain participation in a physical therapy or rehabilitation program, decrease the need for analgesics and in some cases lead to a complete pain relief.展开更多
Objective： To explore the clinical efficacy of ear acupuncture plus injection at Zusanli（ST 36） in treating shoulder pain after laparoscopic gynecological surgery, and to observe its effect on cytokines.Methods： T...Objective： To explore the clinical efficacy of ear acupuncture plus injection at Zusanli（ST 36） in treating shoulder pain after laparoscopic gynecological surgery, and to observe its effect on cytokines.Methods： Two hundred patients with shoulder pain after laparoscopic gynecological surgery were randomized into two groups based on their visiting sequence, 100 cases each. The observation group was intervened by ear acupuncture plus injection at Zusanli（ST 36）, and the control group was intervened by oral administration of Ibuprofen, 10 d as a treatment course. The clinical efficacies of the two groups were compared after 2 treatment courses; the visual analogue scale（VAS）,present pain intensity（PPI） and 36-item short-form health survey（SF-36） were measured before and after the treatment;the changes of interleukin（IL）-6 and IL-10 after the treatment were also observed.Results： The VAS and PPI scores were significantly changed after the treatment in both groups（both P〈0.01）. After the treatment, the VAS score in the observation group was significantly different from that in the control group（P〈0.05）. The component scores of SF-36 were significantly changed after the treatment in both groups（P〈0.01）; after the treatment, the scores of physical functioning（PF）, bodily pain（BP）, social functioning（SF）, and mental health（MH） in the observation group were significantly different from those in the control group（all P〈0.05）. The contents of IL-6 and IL-10 dropped significantly after the intervention in both groups（both P〈0.01）, and the between-group differences were also statistically significant（both P〈0.01）. The total effective rate of the observation group was higher than that of the control group（P〈0.05）.Conclusion： Ear acupuncture plus injection at Zusanli（ST 36） can significantly improve the shoulder pain after laparoscopic gynecological surgery, down-regulate the expressions of IL-6 and IL-10, and boost the recovery.展开更多
Objective： To reveal the therapeutic effect of acupuncmre-moxibustion therapy for the treatment of post-stroke shoulder pain. Methods： Ninety patients with post-stroke shoulder pain were randomized into three groups...Objective： To reveal the therapeutic effect of acupuncmre-moxibustion therapy for the treatment of post-stroke shoulder pain. Methods： Ninety patients with post-stroke shoulder pain were randomized into three groups at ratio of 1：1：1, to receive acupuncture-moxibustion therapy （AM）, acupuncture-moxibustion plus Chinese herbal decoction （AMCH）, and Chinese herbal decoction （CH） respectively. Results： In the comparison of the therapeutic effects and blood viscosity, there was significant difference between the AM and CH group, as well as between the AMCH and CH group （P〈0.01）; the difference was not significant between the AM and AMCH group. Conclusion： Acupuncture-moxibustion is an effective therapy in the treatment of the post-stroke shoulder pain, and it can also reduce the blood viscosity in short-term.展开更多
Sboulder pain is the most common complication of laparoscopic operations.1 The incidence and severityof shoulder pain has been well documented.2 This complication was commonly regarded as the result of CO2 pneumoperit...Sboulder pain is the most common complication of laparoscopic operations.1 The incidence and severityof shoulder pain has been well documented.2 This complication was commonly regarded as the result of CO2 pneumoperitoneum, which induced extension and stimulation to the diaphragmatic muscle. The incidence and severity of shoulder pain was correlated to the pressure and duration of CO2 pneumoperitoneum.3,4 However, we noticed that in non-pneumoperitoneum laparoscopic operations, patients experienced a higher incidence and more severe post-operative shoulder pain. This was a challenge to the theory that pneumoperitoneum induces shoulder pain. Therefore a more detailed study was required to provide more objective data to explain this phenomenon.展开更多
Objective： To provide an evidence-based overview regarding the efficacy of Ashi points stimulation for the treatment of shoulder pain. Methods： A comprehensive search [PubMed, Chinese Biomedical Literature Database,...Objective： To provide an evidence-based overview regarding the efficacy of Ashi points stimulation for the treatment of shoulder pain. Methods： A comprehensive search [PubMed, Chinese Biomedical Literature Database, China National Knowledge Infrastructure （CNKI）, Chongqing Weipu Database for Chinese Technical Periodicals （VIP） and Wanfang Database] was conducted to identify randomized or quasi-randomized controlled trials that evaluated the effectiveness of Ashi points stimulation for shoulder pain compared with conventional treatment. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool. RevMan 5.0 was used for data synthesis. Results： Nine trials were included. Seven studies assessed the effectiveness of Ashi points stimulation on response rate compared with conventional acupuncture. Their results suggested significant effect in favour of Ashi points stimulation [odds ratio （OR）： 5.89, 95% confidence interval （CI）： 2.97 to 11.67, P〈0.01, heterogeneity： x 2=3.81, P=0.70, 12=0% ]. One trial compared Ashi points stimulation with drug therapy. The result showed there was a significantly greater recovery rate in group of Ashi points stimulation （OR： 9.58, 95% CI： 2.69 to 34.12）. One trial compared comprehensive treatment on the myofascial trigger points （MTrPs） with no treatment and the result was in favor of MTrPs. Conclusions： Ashi points stimulation might be superior to conventional acupuncture, drug therapy and no treatment for shoulder pain. However, due to the low methodological quality of included studies, a firm conclusion could not be reached until further studies of high quality are available.展开更多
Purpose: The purpose of this study is to determine the effects of interferential stimulation on pain and motion after shoulder surgery. Study Design: Randomized Controlled Trial. Methods: 102 patients undergoing arthr...Purpose: The purpose of this study is to determine the effects of interferential stimulation on pain and motion after shoulder surgery. Study Design: Randomized Controlled Trial. Methods: 102 patients undergoing arthroscopic rotator cuff repair or labral repair were prospectively randomized to receive either an interferential stimulation unit immediately after surgery (STIM) or not to receive the unit (NO-STIM). Each patient was measured for the range of motion (ROM) in forward flexion (FF), abduction (ABD), internal rotation (IR) and external rotation (ER). These measurements were taken prior to surgery and at the 6 weeks post-operative time point. Visual Analogue Scale (VAS) scores (0 - 10) and the amount of narcotic taken (standardized to 10 mg equivalents of hydrocodone) were measured and compared between the two groups at 2 days and 4 weeks post-operatively. 51 patients were excluded due to failure to document VAS scores and medication usage, lack of follow-up at the 6 weeks post-operative time point or hospitalization after surgery. This left 27 patients in the STIM group and 24 patients in the NO-STIM group. Results: No difference was found in the amount of narcotic taken after 2 days (STIM 14.37 ± 1.02, NO-STIM 15.88 ± 1.22, p = 0.34) or after 4 weeks (STIM 45.32 ± 4.36, NO-STIM 48.96 ± 5.50, p = 0.60). No difference in mean VAS scores were found at 2 days (STIM 5.56 ± 0.53, NO-STIM 4.63 ± 0.57, p = 0.24) or 4 weeks (STIM 1.68 ± 0.39, NO-STIM 1.38 ± 0.34, p = 0.57). At 6 weeks post-operatively, a difference was found in ER (STIM 62.5 ± 4.09, NO-STIM 50.4 ± 4.09, p = 0.04), and no differences found in FF (STIM 134.2 ± 5.29, NO-STIM 133.3 ± 4.85, p = 0.60), ABD (STIM 124.8 ± 6.22, NO-STIM 119.6 ± 5.42, p = 0.53) or IR (STIM 60.0 ± 3.69, NO-STIM 55.9 ± 3.03, p = 0.39). A post-hoc power analysis performed using an á = 0.05 revealed the study to be 90% powered to identify a difference of one narcotic equivalent between groups and 90% powered to identify a 0.3 difference in VAS scores. Conclusions: The use of an interferential stimulator in the immediate post-operative period had no effect on pain or narcotic usage following arthroscopic rotator cuff repair or labral repair. External rotation was significantly greater in the interferential stimulator group while no differences were found in other motion parameters.展开更多
Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time peri...Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time period of analgesia. Methods A total of 120 patients with SHS after stroke（stage I） were recruited and superficial needling therapy was applied. Two obvious tenderness points on the affected shoulder of patients were found out. The site 80–100 mm down each tenderness point was selected for superficial needling. Bimanual needling technique was applied after inserting needles. The surrounding of tenderness points was pinched and grasped by left hand above the needling, and the technique of green dragon swaying tail was applied by right hand. The needles at each acupoint were manipulated for3 min and retained for 30 min. The analgesic effect was evaluated dynamically by visual analogue scale（VAS） in 120 patients before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The analgesic effects at different time were statistically analyzed by generalized estimating equation. Results The mean values of VAS were 7.483, 3.950, 4.767, 5.917 and 7.217, respectively, before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The difference of analgesic effect at different time was statistically significant（P〈0.01）; the difference of analgesic effect of superficial needling in treatment of SHS after stroke was significant between immediately after treatment and 30 min after treatment（both P〈0.05）, while there was no significant difference between 1 h after treatment and 24 h after treatment（both P〈0.05）. Conclusion Analgesic effect of superficial needling for shoulder pain of SHS after stroke was different at different time points and decreased over time; analgesic effect was the most significant immediately after treatment and the optimal duration of analgesic effect was from immediately to 30 min after superficial needling therapy.展开更多
Objective: to explore the effect and rehabilitation effect of nursing intervention on patients with neck, shoulder, waist and leg pain. Methods: a total of 80 patients with neck shoulder lumbago and leg pain in our ho...Objective: to explore the effect and rehabilitation effect of nursing intervention on patients with neck, shoulder, waist and leg pain. Methods: a total of 80 patients with neck shoulder lumbago and leg pain in our hospital from January to June 2021 were randomly divided into two groups by number table method. The control group received conventional western medicine nursing, the experimental group carried out conventional western medicine nursing combined with traditional Chinese medicine nursing. Quality of life score, neck and shoulder pain score, lumbar and leg pain score, average length of stay and rehabilitation effect were compared between the two groups before and after nursing. Results: the score of quality of life in the experimental group was higher than that in the control group, and the score of neck and shoulder pain and lumbar and leg pain was lower than that in the control group. The average hospital stay was shorter than that in the control group, and the rehabilitation effect was higher than that in the control group, with significant difference (P < 0.05). Conclusion: the combination of Traditional Chinese and western medicine nursing intervention for patients with neck, shoulder and waist and leg pain is effective in relieving neck, shoulder and waist and leg pain, reducing the occurrence of complications, shortening the length of hospital stay, with high clinical safety and feasibility, worthy of promotion and use.展开更多
Objective: to analyze the curative effect of TCM acupuncture combined with TCM hot compress in the treatment of neck, shoulder, waist and leg pain. Methods: a total of 80 patients with neck, shoulder, waist and leg pa...Objective: to analyze the curative effect of TCM acupuncture combined with TCM hot compress in the treatment of neck, shoulder, waist and leg pain. Methods: a total of 80 patients with neck, shoulder, waist and leg pain were treated in our hospital from January 2019 to December 2020. The patients were divided into groups for treatment by the numeral labeling method. The 40 patients receiving TCM acupuncture therapy alone were the control group, and the 40 patients receiving TCM hot compress therapy were the experimental group. Results: the total effective rate of experimental group (95.00%) was higher than that of control group (80.00%), and the difference was significant (P < 0.05). The pain score and sleep quality score in experimental group were lower than those in control group, and the differences were significant (P < 0.05). Conclusion: the treatment of shoulder, neck, waist and leg pain combined with traditional Chinese acupuncture and hot compress can achieve a definite effect and is worthy of further promotion.展开更多
目的通过荟萃分析探讨慢性颈肩痛(chronic neck and shoulder pain,CNSP)患者的脑自发活动改变特点,从而揭示CNSP可能的中枢神经机制,为后期定位CNSP患者疼痛治疗中枢靶点及客观评估治疗效果奠定基础。方法在线检索14年4月至24年4月发表...目的通过荟萃分析探讨慢性颈肩痛(chronic neck and shoulder pain,CNSP)患者的脑自发活动改变特点,从而揭示CNSP可能的中枢神经机制,为后期定位CNSP患者疼痛治疗中枢靶点及客观评估治疗效果奠定基础。方法在线检索14年4月至24年4月发表在PubMed、Web of Science、EMBase、The Cochrane Library、CNKI、CBM、维普网、万方数据库中采用低频振幅(amplitude of low-frequency fluctuation,ALFF)/比率低频振幅(fractional amplitude of low-frequency fluctuation,fALFF)及局部一致性(regional homogeneity,ReHo)分析方法研究CNSP患者脑自发活动改变的文献。采用激活似然估计法(activation likelihood estimation,ALE)对纳入研究中CNSP患者相对于健康对照组(healthy controls,HCs)脑自发活动出现异常改变的脑区进行元分析。结果共纳入11篇文献,包括6项ALFF/fALFF、5项ReHo研究(CNSP患者445例,健康受试者384例)的数据。分析结果显示:CNSP患者相对于健康对照组(HCs)左侧岛叶皮层和纹状体的脑自发活动增高,而左侧中央前回、左侧中央后回和左侧顶上小叶的脑自发活动减低。结论慢性颈肩痛患者在与感觉、运动、情感以及疼痛的上行传导和下行调控方面相关的多个大脑区域存在脑自发活动的异常改变,这些变化可能是长期的慢性颈肩痛所导致的,本研究为后期通过CNSP患者的脑自发活动改变定位CNSP患者疼痛治疗中枢靶点以及客观评估CNSP治疗效果提供了重要参考。展开更多
基金supported by the Qinglan Engineering of Higher Institutes Foundation for Outstanding Young Teachers of Jiangsu Province in China
文摘We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accounted for 45.5% of the inpatients because of stroke. Results showed that the number of patients with hemiplegic shoulder pain post stroke increased yearly, attacking mainly males 50-69 years of age. Of 106 patients, there were 60 cases （56.6%） of adhesive capsulitis, 19 （17.9%） of shoulder subluxation, 14 （13.2%） of complex regional pain syndrome, and 13 （12.6%） of central pain. The main symptoms were shoulder pain （100%）, limit of shoulder mobility （98.1%）, and adhesion of the scapula （56.6%）. MRI of the shoulder showed tendon and ligament lesions （57.1%） and rotator cuff tear （38.1%）. 53.8% of central pain was related to the thalamus, in addition to the basal ganglia, brain stem, and cerebellopontine angle. Shoulder pain, upper limb motor function, and function independence were significantly improved after comprehensive rehabilitation. In par- ticular, electroacupuncture based on basic physical therapy exhibited efficacy on shoulder subluxa- tion and complex regional pain syndrome. Multiple linear regression results showed a negative re- lationship of efficacy of pain management with the attack period of shoulder pain, involvement of the posterior limb of the internal capsule, and duration between onset and rehabilitation treatment, but a positive correlation with pain-related education, pain regression period, and pain diagnosis.
基金supported by a grant(12-D-02,13-B-04)from the Korea National Rehabilitation Center
文摘BACKGROUND：Shoulder pain is a common complication of stroke.Bee venom acupuncture（BVA）is increasingly used in the treatment of post-stroke shoulder pain.OBJECTIVE：To summarize and evaluate evidence on the effectiveness of BVA in relieving shoulder pain after stroke.SEARCH STRATEGY：Nine databases,namely MEDLINE,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure（CNKI）,the Japan Science and Technology Information Aggregator,Electronic（J-STAGE）,and four Korean medical databases,namely,the National Assembly Library,the Research Information Service System,the National Discovery for Science Leaders,and OASIS,were searched from their inception through August 2014 without language restrictions.INCLUSION CRITERIA：Randomized controlled trials（RCTs）were included if BVA was used at acupoints as the sole treatment,or as an adjunct to other treatments,for shoulder pain after stroke.DATA EXTRACTION AND ANALYSIS：Two review authors independently selected trials for inclusion,assessed methodological quality and extracted data.RESULTS：A total of 138 potentially relevant articles were identifi ed,4 of which were RCTs that met our inclusion criteria.The quality of studies included was generally low,and a preponderance of positive results was demonstrated.All four trials reported favorable effects of BVA on shoulder pain after stroke.Two RCTs assessing the effects of BVA on post-stroke shoulder pain,as opposed to saline injections,were included in the meta-analysis.Pain was signifi cantly lower for BVA than for saline injections（standardized mean difference on 10-cm visual analog scale：1.46 cm,95%CI=0.30–2.62,P=0.02,n=86）CONCLUSION：This review provided evidence suggesting that BVA is effective in relieving shoulder pain after stroke.However,further studies are needed to confi rm the role of BVA in alleviating post-stroke shoulder pain.Future studies should be conducted with large samples and rigorous study designs.
文摘In the present paper, the authors review some new results of acupuncture treatment of shoulder pain in stroke patients from ① application of filiform needle with different needling manipulations, ② selection and combination of acupoints, and ③ some special needling methods including point-injection. Generally, if acupuncture therapy is used in combination with other rehabilitation methods, the therapeutic effect of shoulder-pain-relief will be much better. Regarding the acupoint selection, both local acupoints and those of the yang meridians are primarily used in clinical practice. Further studies on treating shoulder pain of hemiplegia based upon the basic theory of TCM are necessary.
文摘BACKGROUND Aortic dissection(AD)is a life-threatening condition with a high mortality rate without immediate medical attention.Early diagnosis and appropriate treatment are critical in treating patients with AD.In the emergency department,patients with AD commonly present with classic symptoms of unanticipated severe chest or back pain.However,it is worth noting that atypical symptoms of AD are easily misdiagnosed.CASE SUMMARY A 51-year-old woman was first diagnosed with scapulohumeral periarthritis due to left shoulder pain.After careful examination of her previous medical history and contrast-enhanced computed tomography angiography,the patient was diagnosed with a new type A AD after chronic type B dissection in the ascending aorta.The patient was successfully treated with surgical replacement of the dissected aortic arch and remains in good health.CONCLUSION New retrograde type A AD after chronic type B dissection is relatively rare.It is worth noting that a physician who has a patient with suspected AD should be vigilant.Both patient medical history and imaging tests are crucial for a more precise diagnosis.
文摘This study aimed to elucidate the key risk factors for shoulder pain in Japanese middle school-, high school-, and university-level badminton players and use a regression formula to predict the probability of shoulder pain onset based on risk factor combinations. Based on a self-report questionnaire survey, we included 461 individuals （102 middle school students, 134 high school students, and 225 university students） with a history of shoulder pain in the previous year and 541 individuals with no shoulder pain in the previous year. Then, we performed logistic regression analysis of individual characteristics and history of shoulder pain to analyze the factors associated with shoulder pain onset. Analysis of patients excluding those currently experiencing shoulder pain indicated that a history of shoulder pain （〉 1 year previously） predicted shoulder pain onset. Analysis of patients excluding those with a history of shoulder pain indicated that undergoing care, being of university age, having a long history of competing, and short cool-down times were associated with recurrent pain. However, results were different for each age group. The fact that half the Japanese middle school, high school, and university badminton players had a history of shoulder pain suggests that they will experience recurrent shoulder pain. The results also suggest that different factors are important in each age group. Thus, it is critical to establish evidence-based countermeasures to prevent shoulder pain that interferes with play.
基金This work was supported by Hydrotherapy and Climatotherapy Tourism for their sincere cooperation(No.X7773)。
文摘Objective:To study the effect of spa therapy on relieving knee and shoulder pain.Methods:Participants were randomized to an intervention group(n=26)or a control group(n=23).The intervention group received the hot spring intervention program(1-2 times a day for two weeks),while the control group didn’t receive any intervention.Primary outcomes were assessed by the Western Ontario and McMaster University Osteoarthritis Index(WOMAC)and Shoulder Pain and Disability Index(SPADI).Secondary outcomes were assessed by general physical symptoms and Short Form-36(SF-36)health survey.Results:All parameters before intervention were homogenous between the groups.At baseline,there was no significant difference in WOMAC and SPADI index between the two groups,but there was a statistically significant difference in blurred vision,which was worse in the intervention group than in the control group(P<0.05).After intervention,general physical symptoms were relieved significantly in the intervention group compared with the control group(P<0.05).WOMAC index,SPADI index,social functioning,and general physical symptoms were relieved significantly after intervention in the intervention group(P<0.05).There is a significant difference in the blurred vision before and after the comparison of the control group(P<0.05).Conclusion:Spa therapy may relieve knee and shoulder pain and improve general physical symptoms and quality of life.
文摘BACKGROUND Stroke is a type of cerebrovascular disease with high prevalence,mortality,and onset of disability.As a neurodevelopmental therapy,neuromuscular joint facilitation(NJF)is widely used in the treatment of orthopedic and neurological disorders in the clinical practice.It is mainly used for central nervous system diseases or orthopedic diseases,movement disorders,and pain rehabilitation.According to related studies,NJF can also be used as a rehabilitation treatment in patients with hemiplegic shoulder pain(HSP).AIM To investigate the clinical efficacy of acupuncture combined with NJF in patients with HSP.METHODS Forty patients with HSP were randomly divided into a treatment group and a control group.The treatment group was treated with acupuncture combined with NJF and the control group was treated with acupuncture alone.All patients were assessed by using the visual analogue scale(VAS),Fugl-Meyer assessment(FMA),Barthel index(BI),and passive range of motion(PROM)before and after the training.All the clinical data were analyzed using SPSS 20.0 statistical software.RESULTS There was no statistical difference in the general characteristics between the two groups.In the terms of duration of treatment,age,and pre-treatment indicators,the two groups were comparable(P>0.05).After the treatment,VAS,PROM,BI,and FMA scores were significantly improved in the two groups of patients(P<0.05).The VAS,PROM and FMA scores were significantly higher in the treatment group than in the control group(P<0.05).However,there was no significant difference in BI scores between the two groups(P>0.05).CONCLUSION Both acupuncture alone and acupuncture combined with NJF in the treatment of HSP are effective,and can improve the clinical symptoms of patients.Acupuncture combined with NJF can improve the upper limb motor function,relieve pain,and increase joint mobility in patients with HSP.The combination therapy is better than acupuncture alone.However,there is no significant difference in improving the score of patients’self-care ability.
文摘Background: The relationship between chronic neck and shoulder pain and posture remains controversial. The purpose of this study was to investigate the relationship between chronic neck and shoulder pain and spinal sagittal alignment in standing posture in younger generation. Methods: Subjects included 57 females and 32 males (average age, 29.9 ± 5.7 years). All subjects were 20s or 30s. Spinal curvature was assessed using SpinalMouse. The subjects were also divided into a normal group (VAS zero group) and a pain group by VAS results. Statistical analysis was performed by Student’s t-test. Significance was defined as p < 0.05. Results: The normal group and pain group included 29 and 60 subjects, respectively. In terms of location of pain, thirty-one subjects felt neck pain, 50 felt pain above the scapula, and 17 felt pain between the thoracic spine and scapula. Thoracic kyphosis and lumbar lordosis in the pain group were significantly higher than those in the normal group (p = 0.013 and p = 0.020, respectively). Thoracic kyphosis in subjects with neck pain or pain above scapula was significantly higher than that in subjects without pain (p = 0.0075 and p = 0.025, respectively). Lumbar lordosis in subjects with pain above the scapula or interscapula was significantly higher than that in subjects without pain (p = 0.016).
文摘Background: Neural blockade is widely used in clinical practice to alleviate acute or chronic pain, including pain during rehabilitation. To date there is little controlled evidence to confirm the efficacy of nerve blocks in hemiparetic shoulder pain after stroke. Design: This study is a prospective, open label, cohort trial reporting result from a cohort of stroke patients affected by shoulder pain. Aim: As a cohort study report, in which it is often firstly reported the possibility of an association between an observed effect and a specific environmental based on detailed clinical evaluations and histories, we aim to firstly provide clues in identifying Suprascapularis Nerve blockade as further valuable approach for shoulder pain after stroke. Population: We studied a cohort of patients affected by hemiparetic shoulder pain after Stroke. Methods: Our protocol foresees nerve blocks to be performed each 3 out of 4 days (treatment lasting 30 days) in conjunction with a rehabilitation program with the first aim to provide the window of opportunity to proceed with effective rehabilitation. 47 potential study subjects fulfilled the study criteria and were enrolled. Twenty-four subjects were randomised to the study Group to receive SSNB for the pain of their hemiparetic shoulder while 23 subjects randomized to the control Group whose member did not receive SSNB. They received serial blocks each 3 out of 4 days during rehabilitation.Results: Both treatment reported a reduction in the intensity of their shoulder pain, according to data collected from day 1 through day 42 (6 weeks). Study Group patients, receiving SSNBs, reported significant improvement from entry through the whole follow-up period. The efficiency data were higher for SSNB Group after 2 weeks and again for SSNb group at the end of treatment. Conclusion: Excellent pain relief was achieved in SSNB without clinically relevant complications, these patients having a better improvement on pain during rehabilitation, than the control subjects. Great efficacy has been achieved by combining a nerve block and rehabilitation. About Clinical Rehabilitation Impact, we believe that Suprascapularis nerve blocks can help the stroke survivors maintain an ambulatory or outpatient treatment status, maintain participation in a physical therapy or rehabilitation program, decrease the need for analgesics and in some cases lead to a complete pain relief.
基金supported by Project of Science and Technology Innovation Committee of Shenzhen Municipality,No.JCY201404143700889~~
文摘Objective： To explore the clinical efficacy of ear acupuncture plus injection at Zusanli（ST 36） in treating shoulder pain after laparoscopic gynecological surgery, and to observe its effect on cytokines.Methods： Two hundred patients with shoulder pain after laparoscopic gynecological surgery were randomized into two groups based on their visiting sequence, 100 cases each. The observation group was intervened by ear acupuncture plus injection at Zusanli（ST 36）, and the control group was intervened by oral administration of Ibuprofen, 10 d as a treatment course. The clinical efficacies of the two groups were compared after 2 treatment courses; the visual analogue scale（VAS）,present pain intensity（PPI） and 36-item short-form health survey（SF-36） were measured before and after the treatment;the changes of interleukin（IL）-6 and IL-10 after the treatment were also observed.Results： The VAS and PPI scores were significantly changed after the treatment in both groups（both P〈0.01）. After the treatment, the VAS score in the observation group was significantly different from that in the control group（P〈0.05）. The component scores of SF-36 were significantly changed after the treatment in both groups（P〈0.01）; after the treatment, the scores of physical functioning（PF）, bodily pain（BP）, social functioning（SF）, and mental health（MH） in the observation group were significantly different from those in the control group（all P〈0.05）. The contents of IL-6 and IL-10 dropped significantly after the intervention in both groups（both P〈0.01）, and the between-group differences were also statistically significant（both P〈0.01）. The total effective rate of the observation group was higher than that of the control group（P〈0.05）.Conclusion： Ear acupuncture plus injection at Zusanli（ST 36） can significantly improve the shoulder pain after laparoscopic gynecological surgery, down-regulate the expressions of IL-6 and IL-10, and boost the recovery.
文摘Objective： To reveal the therapeutic effect of acupuncmre-moxibustion therapy for the treatment of post-stroke shoulder pain. Methods： Ninety patients with post-stroke shoulder pain were randomized into three groups at ratio of 1：1：1, to receive acupuncture-moxibustion therapy （AM）, acupuncture-moxibustion plus Chinese herbal decoction （AMCH）, and Chinese herbal decoction （CH） respectively. Results： In the comparison of the therapeutic effects and blood viscosity, there was significant difference between the AM and CH group, as well as between the AMCH and CH group （P〈0.01）; the difference was not significant between the AM and AMCH group. Conclusion： Acupuncture-moxibustion is an effective therapy in the treatment of the post-stroke shoulder pain, and it can also reduce the blood viscosity in short-term.
文摘Sboulder pain is the most common complication of laparoscopic operations.1 The incidence and severityof shoulder pain has been well documented.2 This complication was commonly regarded as the result of CO2 pneumoperitoneum, which induced extension and stimulation to the diaphragmatic muscle. The incidence and severity of shoulder pain was correlated to the pressure and duration of CO2 pneumoperitoneum.3,4 However, we noticed that in non-pneumoperitoneum laparoscopic operations, patients experienced a higher incidence and more severe post-operative shoulder pain. This was a challenge to the theory that pneumoperitoneum induces shoulder pain. Therefore a more detailed study was required to provide more objective data to explain this phenomenon.
基金Supported by the National Natural Science Foundation of China(No.81303028)
文摘Objective： To provide an evidence-based overview regarding the efficacy of Ashi points stimulation for the treatment of shoulder pain. Methods： A comprehensive search [PubMed, Chinese Biomedical Literature Database, China National Knowledge Infrastructure （CNKI）, Chongqing Weipu Database for Chinese Technical Periodicals （VIP） and Wanfang Database] was conducted to identify randomized or quasi-randomized controlled trials that evaluated the effectiveness of Ashi points stimulation for shoulder pain compared with conventional treatment. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool. RevMan 5.0 was used for data synthesis. Results： Nine trials were included. Seven studies assessed the effectiveness of Ashi points stimulation on response rate compared with conventional acupuncture. Their results suggested significant effect in favour of Ashi points stimulation [odds ratio （OR）： 5.89, 95% confidence interval （CI）： 2.97 to 11.67, P〈0.01, heterogeneity： x 2=3.81, P=0.70, 12=0% ]. One trial compared Ashi points stimulation with drug therapy. The result showed there was a significantly greater recovery rate in group of Ashi points stimulation （OR： 9.58, 95% CI： 2.69 to 34.12）. One trial compared comprehensive treatment on the myofascial trigger points （MTrPs） with no treatment and the result was in favor of MTrPs. Conclusions： Ashi points stimulation might be superior to conventional acupuncture, drug therapy and no treatment for shoulder pain. However, due to the low methodological quality of included studies, a firm conclusion could not be reached until further studies of high quality are available.
文摘Purpose: The purpose of this study is to determine the effects of interferential stimulation on pain and motion after shoulder surgery. Study Design: Randomized Controlled Trial. Methods: 102 patients undergoing arthroscopic rotator cuff repair or labral repair were prospectively randomized to receive either an interferential stimulation unit immediately after surgery (STIM) or not to receive the unit (NO-STIM). Each patient was measured for the range of motion (ROM) in forward flexion (FF), abduction (ABD), internal rotation (IR) and external rotation (ER). These measurements were taken prior to surgery and at the 6 weeks post-operative time point. Visual Analogue Scale (VAS) scores (0 - 10) and the amount of narcotic taken (standardized to 10 mg equivalents of hydrocodone) were measured and compared between the two groups at 2 days and 4 weeks post-operatively. 51 patients were excluded due to failure to document VAS scores and medication usage, lack of follow-up at the 6 weeks post-operative time point or hospitalization after surgery. This left 27 patients in the STIM group and 24 patients in the NO-STIM group. Results: No difference was found in the amount of narcotic taken after 2 days (STIM 14.37 ± 1.02, NO-STIM 15.88 ± 1.22, p = 0.34) or after 4 weeks (STIM 45.32 ± 4.36, NO-STIM 48.96 ± 5.50, p = 0.60). No difference in mean VAS scores were found at 2 days (STIM 5.56 ± 0.53, NO-STIM 4.63 ± 0.57, p = 0.24) or 4 weeks (STIM 1.68 ± 0.39, NO-STIM 1.38 ± 0.34, p = 0.57). At 6 weeks post-operatively, a difference was found in ER (STIM 62.5 ± 4.09, NO-STIM 50.4 ± 4.09, p = 0.04), and no differences found in FF (STIM 134.2 ± 5.29, NO-STIM 133.3 ± 4.85, p = 0.60), ABD (STIM 124.8 ± 6.22, NO-STIM 119.6 ± 5.42, p = 0.53) or IR (STIM 60.0 ± 3.69, NO-STIM 55.9 ± 3.03, p = 0.39). A post-hoc power analysis performed using an á = 0.05 revealed the study to be 90% powered to identify a difference of one narcotic equivalent between groups and 90% powered to identify a 0.3 difference in VAS scores. Conclusions: The use of an interferential stimulator in the immediate post-operative period had no effect on pain or narcotic usage following arthroscopic rotator cuff repair or labral repair. External rotation was significantly greater in the interferential stimulator group while no differences were found in other motion parameters.
基金Supported by State Administration of Traditional Chinese Medicine of the People’s Republic of China "Twelfth FiveYear Plan" key specialty construction projectMajor scientific project of Changning District Science and Technology Commission:CNKW2013Z05+1 种基金Traditional Chinese medicine scientific research fund project of Shanghai Municipal Commission of Health and Family Planning:2014LQ021ATCM of Shanghai style heritage research base project of Shanghai Municipal Health Bureau:ZYSNXD-CCHPGC-JD-004
文摘Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time period of analgesia. Methods A total of 120 patients with SHS after stroke（stage I） were recruited and superficial needling therapy was applied. Two obvious tenderness points on the affected shoulder of patients were found out. The site 80–100 mm down each tenderness point was selected for superficial needling. Bimanual needling technique was applied after inserting needles. The surrounding of tenderness points was pinched and grasped by left hand above the needling, and the technique of green dragon swaying tail was applied by right hand. The needles at each acupoint were manipulated for3 min and retained for 30 min. The analgesic effect was evaluated dynamically by visual analogue scale（VAS） in 120 patients before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The analgesic effects at different time were statistically analyzed by generalized estimating equation. Results The mean values of VAS were 7.483, 3.950, 4.767, 5.917 and 7.217, respectively, before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The difference of analgesic effect at different time was statistically significant（P〈0.01）; the difference of analgesic effect of superficial needling in treatment of SHS after stroke was significant between immediately after treatment and 30 min after treatment（both P〈0.05）, while there was no significant difference between 1 h after treatment and 24 h after treatment（both P〈0.05）. Conclusion Analgesic effect of superficial needling for shoulder pain of SHS after stroke was different at different time points and decreased over time; analgesic effect was the most significant immediately after treatment and the optimal duration of analgesic effect was from immediately to 30 min after superficial needling therapy.
文摘Objective: to explore the effect and rehabilitation effect of nursing intervention on patients with neck, shoulder, waist and leg pain. Methods: a total of 80 patients with neck shoulder lumbago and leg pain in our hospital from January to June 2021 were randomly divided into two groups by number table method. The control group received conventional western medicine nursing, the experimental group carried out conventional western medicine nursing combined with traditional Chinese medicine nursing. Quality of life score, neck and shoulder pain score, lumbar and leg pain score, average length of stay and rehabilitation effect were compared between the two groups before and after nursing. Results: the score of quality of life in the experimental group was higher than that in the control group, and the score of neck and shoulder pain and lumbar and leg pain was lower than that in the control group. The average hospital stay was shorter than that in the control group, and the rehabilitation effect was higher than that in the control group, with significant difference (P < 0.05). Conclusion: the combination of Traditional Chinese and western medicine nursing intervention for patients with neck, shoulder and waist and leg pain is effective in relieving neck, shoulder and waist and leg pain, reducing the occurrence of complications, shortening the length of hospital stay, with high clinical safety and feasibility, worthy of promotion and use.
文摘Objective: to analyze the curative effect of TCM acupuncture combined with TCM hot compress in the treatment of neck, shoulder, waist and leg pain. Methods: a total of 80 patients with neck, shoulder, waist and leg pain were treated in our hospital from January 2019 to December 2020. The patients were divided into groups for treatment by the numeral labeling method. The 40 patients receiving TCM acupuncture therapy alone were the control group, and the 40 patients receiving TCM hot compress therapy were the experimental group. Results: the total effective rate of experimental group (95.00%) was higher than that of control group (80.00%), and the difference was significant (P < 0.05). The pain score and sleep quality score in experimental group were lower than those in control group, and the differences were significant (P < 0.05). Conclusion: the treatment of shoulder, neck, waist and leg pain combined with traditional Chinese acupuncture and hot compress can achieve a definite effect and is worthy of further promotion.
文摘目的通过荟萃分析探讨慢性颈肩痛(chronic neck and shoulder pain,CNSP)患者的脑自发活动改变特点,从而揭示CNSP可能的中枢神经机制,为后期定位CNSP患者疼痛治疗中枢靶点及客观评估治疗效果奠定基础。方法在线检索14年4月至24年4月发表在PubMed、Web of Science、EMBase、The Cochrane Library、CNKI、CBM、维普网、万方数据库中采用低频振幅(amplitude of low-frequency fluctuation,ALFF)/比率低频振幅(fractional amplitude of low-frequency fluctuation,fALFF)及局部一致性(regional homogeneity,ReHo)分析方法研究CNSP患者脑自发活动改变的文献。采用激活似然估计法(activation likelihood estimation,ALE)对纳入研究中CNSP患者相对于健康对照组(healthy controls,HCs)脑自发活动出现异常改变的脑区进行元分析。结果共纳入11篇文献,包括6项ALFF/fALFF、5项ReHo研究(CNSP患者445例,健康受试者384例)的数据。分析结果显示:CNSP患者相对于健康对照组(HCs)左侧岛叶皮层和纹状体的脑自发活动增高,而左侧中央前回、左侧中央后回和左侧顶上小叶的脑自发活动减低。结论慢性颈肩痛患者在与感觉、运动、情感以及疼痛的上行传导和下行调控方面相关的多个大脑区域存在脑自发活动的异常改变,这些变化可能是长期的慢性颈肩痛所导致的,本研究为后期通过CNSP患者的脑自发活动改变定位CNSP患者疼痛治疗中枢靶点以及客观评估CNSP治疗效果提供了重要参考。
