The Clinical Research On The Treatment Of Patients With Post-stroke Shoulder Pain By Acupotomy Therapy By“loose Tendon And Node”combined With Rehabilitation

Objective:To compare the clinical efficacy between acupotomy therapy by“loose tendon and node”combined with rehabilitation and Acupuncture combined with rehabilitation on the treatment of patients with post-stroke shoulder pain,and explore the distribution of common tendons and nodes in patients with post-stroke shoulder pain.Methods:Sixty patients who met the inclusion criteria of this study were randomly divided into acupotomy therapy combined with rehabilitation group(treatment group)and acupuncture combined with rehabilitation group(control group)according to the order of treatment.There were 30 cases in each group.Both groups of patients underwent Conventional and basic and rehabilitation treatment.In addition,the treatment group was treated with acupotomy therapy by“loose tendon and node”,once a week for treatment,and a course of treatment for 4 weeks.The control group was treated with conventional acupuncture,once a day for treatment,and a course of treatment for 4 weeks.VAS、FMA and ROM as the observation index.According to the VAS score,the efficacy was assessed by the nimodipine method.Record all adverse reactions in the patient during treatment,including the time of occurrence,specific symptoms,treatment and results.Data processing was performed using SPSS 22.0 statistical software.Result:(1)The statistics analysis of gender,age,medical history and the VAS score,FMA score,shoulder ROM before treatment of two groups of patients,were no statistically significant difference(P﹥0.05),which Explained that the two groups are comparable.(2)VAS and FMA scores of shoulder joint pain: statistical analysis of repeated measures of variance,there were interaction effects between the two groups of time and group factors(F=21.980/248.667,P=0.000);there were groupings between the two groups of VAS and FMA score groups.Effect(F=34.059/97.404,P=0.000);both groups showed a downward trend with time effect(F=190.011/1148.484,P=0.000),but the downward trend of the two groups was not completely consistent;independent samples between groups According to the t-test,the VAS and FMA scores were statistically significant(P <0.01)in the follow-up of 1,2,4 and 3 months after treatment,indicating that the treatment group improved the pain and upper limb function.Significantly better than the control group and varied over time.(3)Shoulder joint AROM: statistical analysis of repeated measures of variance: interaction between active flexion and abduction time factors and grouping factors in 2 groups(P=0.000);active flexion and abduction difference between 2 groups of patients at different time points before and after treatment Statistically significant,that is,the time effect(P=0.000);the active flexion and abduction of the two groups showed an increasing trend,but the increase trend of the two groups was not completely consistent;At 2 weeks,there was no significant difference between the groups(P>0.05).The follow-up at 3 months after treatment was significantly different(P=0.000<0.01).It indicated that the active flexion and abduction of the treatment group and the control group improved with time,and the degree of improvement varied with time.The treatment group was superior to the control group.(4)Shoulder joint PROM: statistical analysis of repeated measures of variance,there were interaction effects between passive activity time and grouping factors in the two groups(P=0.000<0.05);there were grouping effects in the passive comparison between the two groups(P<0.05).The scores of both groups showed a downward trend with time effect(P=0.000),but the decline trend of the two groups was not completely consistent.The independent sample t-test analysis between groups showed that there was statistical improvement in passive flexion activity 1 week after treatment.Learning differences,2,4 weeks and 3 months after treatment,there was a statistically significant difference in passive activity improvement.It indicated that both the treatment group and the control group improved with time in improving the passive activity of the shoulder joint,and it was different with time.The treatment group was superior to the control group.(5)At 4 weeks after treatment,the clinical efficacy was compared between the two groups.The total effective rate was 90% in the treatment group and 66.7% in the control group.The clinical efficacy between the groups was statistically significant(P<0.05),indicating that the treatment group The effect is better than the control group.(6)The tendons and nodes closely related to PSSP mainly include: Jianyuci,Jianliaoci,Jianfengci,Jujianci Taijianci,Tianzongci,Naoshuci,Jianzhenci,and so on.Conclusions: Acupotomy therapy by“loose tendon and node”combined with rehabilitation can relieve the adhesion and sputum of the meridian and tendon,restore the mechanical balance,play the role of loosing tendon and node and dredging the meridian,and can obviously improve the symptoms of shoulder pain and activity disorder in PSSP patients.Thereby reducing the patient’s pain,speeding up the process of rehabilitation function and improving the quality of life of patients.The occurrence of PSSP is mainly caused by traction,extrusion,injury,etc.of the shoulder,resulting in aseptic inflammation,edema,and local tissue repair.This leads to scars,adhesions,hyperplasia and calcification in the lesion.Pathological causes of the formation of focal lesions.The tendons and nodes of PSSP patients are mainly distributed in the starting,ending and attachment points of muscle and tendon,mechanical stress point of soft tissue,bone depression and bone trochanter.