经皮神经电刺激联合刺络放血疗法治疗老年卒中后患者中枢性疼痛的疗效观察

Observation on therapeutic effects of percutaneous electrical nerve stimulation combined with bloodletting therapy on central pain in elderly patients after stroke

中文关键词: 老年    卒中后中枢性疼痛    经皮神经电刺激    刺络放血

英文关键词: elderly  central post-stroke pain  transcutaneous electric nerve stimulation  bloodletting

中文摘要:

      目的 观察经皮神经电刺激联合刺络放血疗法治疗老年卒中后患者中枢性疼痛(CPSP)的临床疗效。方法 选取2024年2月至2025年2月在北京积水潭医院贵州医院及贵州中医药大学第二附属医院诊治的64例老年CPSP患者，随机将患者分为治疗组(n=32)和对照组(n=32)。对照组予卒中后二级预防及常规康复治疗，治疗组在对照组的基础上予经皮神经电刺激联合刺络放血疗法治疗，2组患者均治疗4周。采用简式Mc Gill疼痛问卷(MPQ)、匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)评估2组患者疼痛疗效，同时比较2组患者血清IL-1β水平。结果 治疗4周后，2组患者MPQ评分、 PSQI评分、 SAS评分及血清IL-1β水平均低于治疗前，且治疗组明显低于对照组；治疗组疼痛疗效优于对照组；差异均具有统计学意义(P<0.05)。结论 经皮神经电刺激联合刺络放血疗法治疗老年卒中后患者中枢性疼痛，在有效缓解患者疼痛与焦虑情绪的同时，亦能改善其睡眠质量。

英文摘要:

      Objective To observe the clinical effects of transcutaneous electrical nerve stimulation(TENS)combined with bloodletting therapy in the treatment of central post-stroke pain(CPSP)in elderly patients.Methods 64 elderly CPSP patients treated in Guizhou Hospital of Beijing Jishuitan Hospital and Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from February 2024 to February 2025 were selected and randomly divided into treatment group(n=32)and control group(n=32).The control group received secondary prevention and conventional rehabilitation treatment after stroke,while the treatment group received additional TENS combined with bloodletting therapy on the basis of the control group's regimen.Both groups were treated for 4 weeks.The patients were evaluated with the short-form McGill pain questionnaire(MPQ),Pittsburgh sleep quality index(PSQI),and self-rating anxiety scale(SAS).Their serum IL-1β levels were monitored.The pain therapeutic effect was compared between the two groups.Results After 4 weeks of treatment,the scores of MPQ,PSQI,SAS and serum IL-1β levels in both groups were significantly lower than those in the same group before treatment,and the treatment group was lower than the control group.The pain therapeutic effect of the treatment group was superior to that of the control group.All differences were statistically significant(P<0.05).Conclusion TENS combined with bloodletting therapy for central pain in elderly CPSP patients can not only effectively relieve their pain and anxiety,but also improve their sleep quality.