电针治疗帕金森病骨骼肌疼痛的疗效:临床随机对照试验。

Wang Shaosong, Sun Jingqing, Feng Qingyin, L I Bin, Wang Xin, Yuan Fan, Cui Yingxue
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引用次数: 0

摘要

目的:探讨电针对帕金森病(PD)患者骨骼肌疼痛的影响:探讨电针对帕金森病(PD)骨骼肌疼痛的影响:采用单中心随机对照试验的方法,将60例伴有骨骼肌疼痛的帕金森病患者随机分为电针组和假针刺对照组,每组30例。电针组采用电针治疗,对照组采用朴针假针灸治疗。两组均每周治疗 5 次,共 4 周,两组均完成 20 次治疗。治疗前后采用帕金森氏疼痛金氏量表(KPPS)和视觉模拟量表(VAS)评估患者的疼痛程度。实时剪切波弹性成像(SWE)和改良阿什沃斯评分(MAS)用于评估肌张力的变化。帕金森综合评分量表(MDS-UPDRS,包括UPDRSⅡ和UPDRSⅢ)用于评估运动能力。汉密尔顿抑郁量表(HAMD)用于评估患者的情绪变化。采用斯皮尔曼相关分析探讨疼痛程度与肌张力、运动能力和情绪之间的相关性:研究期间,对照组有一例脱落,最终分析治疗组有 30 例,对照组有 29 例。治疗后,电针组肱二头肌、股四头肌的杨氏模量和肱二头肌剪切波速度较治疗前均有所下降,KPPS评分、VAS评分、UPDRSⅡ、UPDRSⅢ和改良Ashworth评分均有所下降,差异有统计学意义(P0.05)。对照组无统计学意义(P>0.05)。治疗后,电针组的 KPPS 评分、VAS 评分、UPDRSⅡ和 UPDRSⅢ、MAS、HAMD 评分、肱二头肌杨氏模量和剪切波速度均显著低于对照组(P 0.05)。斯皮尔曼相关分析显示,KPPS 评分与 UPDRS Ⅲ 呈正相关(r = 0.414,P 0.05)。KPPS评分与HAMD评分呈正相关(r = 0.576,P 0.01):结论:电针治疗能有效改善帕金森病患者的骨骼肌疼痛,减轻患者的肌肉硬度,提高患者的日常生活能力,改善患者的情绪障碍。帕金森病患者骨骼肌疼痛程度与运动能力和情绪障碍相关,但骨骼肌疼痛程度与帕金森病患者肌张力无明显相关性。
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Effectivenss of electroacupuncture for skeletal muscle pain in Parkinson's disease: a Clinical randomized controlled trial.

Objective: To explore the effect of electroacupuncture on skeletal muscle pain in Parkinson's disease (PD).

Methods: A single-center randomized controlled trial was conducted with sixty patients with Parkinson's disease with skeletal muscle pain were randomly divided into electroacupuncture group and sham acupuncture control group with 30 patients each. The electric acupuncture group was treated with electric acupuncture, while the control group was treated with Park needle pseudoacupuncture. Both groups were treated 5 times a week for a total of 4 weeks, and both groups completed 20 treatments. King's Parkinson's Pain Scale (KPPS) and visual analog scale (VAS) were used before and after treatment to evaluate the pain degree of patients. Real-time shear wave elastography (SWE) and modified Ashworth score (MAS) were used to evaluate the changes of muscle tone. Parkinson's comprehensive Score Scale (MDS-UPDRS, including UPDRSⅡ and UPDRS Ⅲ) was used to evaluate exercise ability. Hamilton Depression Scale (HAMD) score was used to evaluate the emotional changes of patients. Spearman correlation analysis was used to explore the correlation between pain degree and muscle tone, exercise ability and emotion.

Results: During the study, one case fell off in the control group, and 30 cases were eventually included in the analysis and treatment group and 29 cases in the control group. After treatment, Young's modulus of biceps and quadriceps and shear wave velocity of biceps were decreased in electroacupuncture group compared with before treatment, while KPPS score, VAS score, UPDRSⅡ, UPDRS Ⅲ and modified Ashworth score were decreased, with statistical significance (P < 0.05). There was no statistical significance in control group (P > 0.05). After treatment, KPPS score, VAS score, UPDRSⅡ and UPDRS Ⅲ, MAS, HAMD score, Young's modulus of biceps and shear wave velocity in electroacupuncture group were significantly lower than those in control group (P < 0.05). Spearman correlation analysis showed that KPPS score was positively correlated with UPDRS Ⅲ (r = 0.414, P < 0.05). KPPS score was positively correlated with HAMD score (r = 0.576, P < 0.01).

Conclusion: Electroacupuncture therapy can effectively improve skeletal muscle pain in patients with Parkinson's disease, reduce the muscle hardness of patients, improve patients' daily life ability, and improve patients' emotional disorders. The degree of skeletal muscle pain in PD patients is correlated with motor ability and emotional disorders, but there is no significant correlation between the degree of skeletal muscle pain and the muscle tone of PD patients.

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