Clinical Observation On Treatment Of Patients With Hemiplegic Shoulder Pain With Directional Drug Penetration Therapy Of Traditional Chinese Medicine

Purpose: This paper mainly compares the clinical efficacy of Directional Drug Penetration Therapy of Traditional Chinese Medicine(DM)and modulated medium frequency electrical therapy in treating patiens with hemiplegic shoulder pain through a randomized controlled clinical study.We hope to provide one new and effective treatment for hemiplegic shoulder pain.Methods: A total of 61 cases of hemiplegic shoulder pain were randomly divided into two groups: the treatment group(31 cases)and control group(30 cases).The treatment group was treated with DM,the control group with modulated medium frequency electrical therapy.Two sets of electrical patches were both placed on the supraspinatus muscle,medial and posterior bundle of deltoid muscle.The two groups both treated for25 min once a day,5 times once a week,for a total of 20 times.The two groups were also given routine rehabilitation treatment.After entering the groups,4 rehabilitation evaluations were performed on all the cases after 0 week(baseline),2 weeks,4 weeks and 8 week with visual analogue scale(VAS),Fugl-Meyer Motor Assessment Scale(FMA),Passive Range of Motion(PROM),Active Range of Motion(AROM),Barthel Index(BI),Patient Health Questionnaire(PHQ-9)and health survey questionnaire,to evaluate pain,upper limb motor function,activity of shoulder joint and self-care ability,depression and life health.The main evaluation time was the fourth week.Results:1.A total of 60 cases completed the clinical study:30 cases in the treatment group and 30 cases in the control group.Only 1 case dropped out because he was discharged from the hospital for personal reason.No adverse reactions occurred duringthe course of the treatment.2.VAS scores for treatment group and control group decreased 1.74 and 0.95 after 4weeks compared with baseline levels(P=0.000,P=0.000).There were significant differences between the two groups(P=0.000).3.FMA scores for the two groups had significant differences after 4 weeks compared with baseline levels.There was significant difference between the two groups(P=0.000,P=0.000,P=0.017).4.PROM flexion,abduction,pronation and supination in the two groups increased after4 weeks compared with baseline levels.(treatment group:P=0.000,P=0.000,P=0.000,P=0.005;control group:P=0.000,P=0.000,P=0.000,P=0.000)?There was a significant difference in PROM flexion between groups(P = 0.031).There were no significant differences in PROM abduction,internal rotation,and external rotation between groups(P = 0.238,P = 0.484,P = 0.598).5.AROM flexion,abduction and internal rotation,external rotation in the two groups increased after 4 weeks compared with baseline levels,in addition to AROM external rotation in control group(P = 0.184),AROM had significant differences(treatment group: P=0.000,P=0.000,P=0.001,P=0.003;control group: P=0.012,P=0.001,P=0.023).There were significant differences in AROM between the two groups(P =0.045,P = 0.045,P = 0.028,P = 0.035).6.BI,PHQ-9 and health questionnaire in the two groups had significant differences after 4 weeks compared with baseline scores(treatment group: P=0.000,P=0.000,P=0.000;control group: P=0.001,P=0.000,P=0.003).There were also significant differences between groups in BI,PHQ-9 and health questionnaire(P=0.041,P=0.040,P=0.046).Conclusion: DM and modulated medium frequency electrical therapy can improve the hemiplegic shoulder pain,and the former is better,and its lasting analgesic effect is more obvious.They can also improve the activity of shoulder,upper limb function,self-care ability,depression and the quality of life,DM is better.