| Objective:To evaluate the clinical efficacy of tuina manipulation for neuropathic pain after brachial plexus injury repair,and to provide evidence for clinical treatment after brachial plexus injury repair;to verify the superiority of tuina for neuropathic pain after brachial plexus injury repair.Methods:The patients were all from Huashan Hospital affiliated to Fudan University,and completed the brachial plexus injury repair operation.72 patients with neuropathic pain after brachial plexus injury repair were randomly divided into tuina+physical factor test group and simple physical factor control group,treated five times a week,ten times as a course of treatment,a total of two During the course of treatment,before the first treatment and after the second treatment,the internationally recognized simplified McGill Pain Questionnaire for describing and measuring pain was used as an objective indicator to assess the pain of the affected limb and to evaluate the peripheral nerve function assessment of the upper limb SDS/SAS was used to assess the emotional changes of anxiety and depression before and after treatment.The SF-36 scale was used to assess the quality of life of patients before and after treatment,and the severity of insomnia was used to assess the sleep of patients before and after treatment.Each patient completed the VAS,DASH,SDS,SAS,SF-36,and ISI scale assessment at three assessment time points of zero,two,and four weeks,and selected three patients in the tuina treatment group before treatment and treatment.After fMRI,the changes of amygdala and nucleus accumbens were observed,and then statistical analysis was performed.Results:1.The comparison of the pain visual analogue scale scores,the difference between the first treatment group and the control group was statistically significant(P<0.05);the difference between the second treatment group and the control group was Statistical significance(P<0.05);the difference between the first course of treatment in the experimental group and the pre-treatment period was statistically significant(P<0.05);the difference between the second course of treatment in the experimental group and the pre-treatment was statistically significant(P<0.05).2.The comparison of the sensory phase scores in the pain grading index was compared with the control group.The difference between the experimental group and the control group was statistically significant(P<0.05).The first course in the experimental group was compared with that before the treatment.The difference was statistically significant(P<0.05);the difference between the second course of treatment in the experimental group and the pre-treatment was statistically significant(P<0.05);the comparison of the emotional item score in the pain grading index,the experimental group Compared with the control group,the difference was statistically significant(P<0.05).The difference between the second course of treatment and the pre-treatment group was statistically significant(P<0.05).3.Compared with the control group,the difference between the first course of treatment and the control group was statistically significant(P<0.05).The difference between the second course of treatment and the control group was statistically significant.The significance of learning(P<0.05);the difference between the second course of treatment and the pre-treatment group was statistically significant(P<0.05).The difference between the second course of treatment and the pre-treatment was statistically significant(P<0.05).4.The comparison of the upper extremity dysfunction scores,the difference between the second course of the experimental group and the pre-treatment was statistically significant(P<0.05).5.The comparison of the scores of the anxiety self-rating scale,the difference between the second course of the experimental group and the pre-treatment was statistically significant(P<0.05);the comparison of the the self-rating scale of depression The difference between the second course of treatment in the experimental group and the pre-treatment was statistically significant(P<0.05).6.Comparison of the severity of insomnia scores:The difference between the first course of treatment and the control group was statistically significant(P<0.05).The difference between the second course of treatment and the control group was statistically significant.Significance(P<0.05);the difference between the first course of treatment and the treatment before treatment was statistically significant(P<0.05);the difference between the second course of treatment and the treatment was statistically significant(P<0.05).The difference between the first course of treatment and the treatment was statistically significant(P<0.05).The difference between the second course of treatment and the treatment was statistically significant(P<0.05).7.The quality of life scale scores were compared,and the experimental group was not statistically significant compared with the control group;8.The results of functional magnetic resonance showed that the voxel level was P<0.01,k=20,the effect of left nucleus accumbens was statistically significant,and there was no result on the right side;voxel level P<0.01,k=20 The amygdala effect was significant and statistically significant.Discussion:(1)Through tuina intervention,it can alleviate the symptoms of neuropathic pain after repair of brachial plexus injury and improve the quality of sleep.(2)Interfering with the acupoints of the hand-yangming large intestine of the patient through massage,according to the theory of treating Yangming alone,it may regulate and activate the amygdala and nucleus accumbens in the brain to exert an analgesic effect.(3)Tuina can be used as one of the alternative treatments for neuropathic pain after brachial plexus injury repair.This study also provides a research idea for exploring the correlation between tuina analgesia and reward loop nuclear activation. |
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