【目的】 观察针刺联合腧穴点按治疗中风后偏瘫肩痛的有效性。【方法】 选取 2024年 1月至 2024年 12月郑州大学第一 附属医院康复医学科病房收治的84例明确诊断为脑卒中偏瘫肩痛的患者为研究对象。按随机数字表将患者随机分为观察组 和对照组，每组42例。对照组在常规治疗的基础上，给予肢体功能康复训练。观察组在对照组治疗的基础上，给予针刺联 合穴位按摩治疗。共治疗4周。观察2组患者治疗前后疼痛视觉模拟量表（VAS）评分的变化情况，以及肩关节活动度（ROM） 的情况。比较2组患者治疗前后Fugl-Meyer运动功能评分（U-FMA）、改良Barthel指数评分（MBI）的变化情况。【结果】（1）研 究过程中，观察组失访3例，对照组失访5例。最终观察组39例、对照组37例纳入统计。（2）治疗后，2组患者的VAS评分明 显改善（P＜0.05），且观察组在改善 VAS 评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）治疗后，2 组患者的 ROM明显改善（P＜0.05），且观察组在改善ROM方面明显优于对照组，差异有统计学意义（P＜0.05）。（4）治疗后，2组患者的 U-FMA评分、MBI评分明显改善（P＜0.05），且观察组在改善U-FMA评分、MBI评分方面明显优于对照组，差异有统计学意 义（P＜0.05）。【结论】 针刺联合腧穴点按治疗中风后偏瘫肩痛，可明显减轻患者肩部疼痛程度，改善患者肩关节活动度，提 升患者肢体运动功能及日常生活活动能力。

Objective To observe the efficacy of acupuncture combined with acupoint pressing in the treatment of post-stroke hemiplegic shoulder pain （HSP）. Methods A total of 84 patients diagnosed with HSP were enrolled from the Rehabilitation Medicine Department ward of the First Affiliated Hospital of Zhengzhou University between January 2024 and December 2024. They were randomly divided into an observation group and a control group using a random number table method， with 42 patients in each group. The control group received limb function rehabilitation training in addition to conventional treatment， while the observation group received acupuncture combined with acupoint pressing in addition to the control group’s treatment. The treatment course for both groups was 4 weeks. The changes in the Visual Analogue Scale （VAS） score for pain and shoulder Range of Motion （ROM） were observed before and after treatment in both groups. Changes in the Fugl-Meyer Assessment for upper extremity （U-FMA） and the Modified Barthel Index （MBI） scores were compared before and after treatment in both groups. Results （1） During the study，3 patients were lost to follow-up in the observation group and 5 in the control group， resulting in 39 and 37 patients being included in the final analysis， respectively. （2） After treatment， VAS scores were significantly improved in both groups （P＜0.05）， and the improvement in the observation group was significantly greater than that in the control group，with a statistically significant difference （P＜0.05）.（3） Shoulder ROM was significantly improved in both groups after treatment （P＜0.05）， and the improvement in the observation group was significantly superior to that in the control group，with a statistically significant difference （P＜0.05）.（4） Furthermore，U-FMA and MBI scores were significantly improved in both groups after treatment （P＜0.05），and the improvements in the observation group were significantly greater than those in the control group，with statistically significant differences （P＜0.05）. Conclusion Acupuncture combined with acupoint pressing can significantly alleviate shoulder pain，improve shoulder range of motion，and enhance limb motor function and activities of daily living in patients with post-stroke HSP.

R246.9

河南省医学科技攻关联合共建项目（编号：LHGJ20220348）；河南省自然科学基金资助项目（编号：232300420256）