经皮神经电刺激联合前列地尔治疗卒中后中枢性疼痛*

Effects of transcutaneous electrical nerve stimulation combined with alprostadil on central pain in patients with spastic hemiplegia after stroke

摘要:

目的：探讨经皮神经电刺激联合前列地尔对卒中后痉挛性偏瘫患者中枢性疼痛的影响。方法：91例卒中后痉挛性偏瘫患者依据随机数字表法分为44例对照组和47例试验组。对照组给予早期康复训练,包含上下肢主动训练,个人生活能力训练等,同时进行经皮神经电刺激治疗,试验组在对照组基础上联合前列地尔治疗。结果：治疗后,试验组和对照组BrunnstromⅡ级、Ⅲ级、Ⅳ级分别为0/42/5与11/31/2,疼痛缓解率分别为65.91%和78.72%,差异有统计学意义(P < 0.05)。神经功能缺损评分 (national institutes of health stroke scale, NIHSS)评分分别为 (8.77±1.18) 分和 (11.39±1.02) 分,Fugl-Meyer运动功能量表 (Fugl-meyer assessment, FMA) 评分分别为 (56.15±7.47) 分和 (49.77±7.80) 分,对照组无不良反应发生,试验组不良反应以胃肠道不适、皮疹、注射部位疼痛为主,试验组不良反应总发生率为12.77%,两组各不良反应发生率比较有统计学差异 (P < 0.05) 。结论：经皮神经电刺激联合前列地尔能够有效缓解患者中枢性疼痛,从而改善卒中后痉挛性偏瘫患者生活质量,提高日常生活能力,缓解患者不良情绪。

Abstract:

Objective: To explore the effect of transcutaneous electrical nerve stimulation combined with alprostadil on central pain in patients with spastic hemiplegia after stroke. Methods: 91 patients with spastic hemiplegia after stroke were divided into 44 control groups and 47 experimental groups according to random number table method. The control group was given early rehabilitation training, including keeping good limb position, passive movement of limbs in bed, roll-up training, bed chair transfer training, active training of upper and lower limbs, personal living ability training, et al. At the same time, transcutaneous electrical nerve stimulation and microwave treatment were performed. The experimental group was treated with alprostadil on the basis of the control group. Results: After treatment, BrunnstromⅡ grade Ⅱ, Ⅲ and Ⅳ were 0/42/5 and 11/31/2, national institutes of health stroke scale (NIHSS) scores were (8.77±1.18) and (11.39±1.02), Fugl-meyer assessment (FMA) scores were (56.15±7.47) and (49.77±7.80). No adverse reactions occurred in the control group, while the main adverse reactions in the experimental group were gastrointestinal discomfort, rash and pain at injection site. The total incidence of adverse reactions in the experimental group was 12.77%, and there was a statistical difference between the two groups (P < 0.05). Conclusion: Transcutaneous electrical nerve stimulation combined with alprostadil can effectively relieve patients’ central pain, improve the ability of daily living, and relieve the patients" bad mood.