目的: 评估激痛点刺络拔罐疗法在治疗中风后肩痛中的临床疗效。方法: 纳入102例中风后肩痛患者,随机分为观察组和对照组。观察组在基础治疗和常规针刺的基础上,实施激痛点刺络拔罐疗法;对照组则仅接受基础治疗和常规针刺,两组均治疗2周（10次）。于治疗前、治疗1周、治疗结束时、随访1个月评估其疼痛视觉模拟评分（visual analogue scale,VAS）、上肢功能评定量表（Fugl-Meyer assessment,FMA）、改良Barthel指数量表（modified barthel index,MBI）、汉密尔顿焦虑量表（Hamilton anxiety scale,HAMA）、匹兹堡睡眠质量指数量表（Pittsburgh sleep quality index,PSQI）及记录其非甾体类止痛药（non-steroidal anti-inflammatory drug,NSAIDs）使用频次。结果: 观察组的总有效率高于对照组。重复测量方差分析显示,时间因素对各项指标均有显著影响,两组患者的VAS、HAMA、PSQI评分及非甾体类止痛药使用频次均随治疗进展显著下降,而FMA与MBI评分则显著上升。组间比较进一步表明,观察组在多个维度改善更为显著：在疼痛控制（VAS）与睡眠质量（PSQI）方面,观察组自治疗结束起至随访期评分均显著低于对照组;在运动功能（FMA）与日常生活能力（MBI）方面,观察组评分在治疗结束时及随访期均显著高于对照组;在焦虑情绪（HAMA）方面,两组在治疗期间差异无统计学意义,但在随访期观察组评分显著更低;在药物使用频次方面,观察组在治疗一周时使用频次已显著低于对照组,但在治疗结束后及随访期间两组差异无统计学意义。结论: 针刺治疗可有效缓解中风后肩痛患者的疼痛症状,促进上肢运动功能与日常生活能力恢复,并在改善焦虑情绪、睡眠质量及减少止痛药使用方面具有积极作用。在常规针刺基础上联合激痛点刺络拔罐,可进一步加快疼痛缓解与早期药物减量,增强运动功能与日常生活能力的恢复程度,并在维持长期情绪稳定与睡眠改善方面表现更优,整体疗效显著优于单纯常规针刺,具备临床推广应用价值。

Objective To evaluate the clinical efficacy of trigger point blood-letting cupping therapy in the treatment of post-stroke shoulder pain. Methods A total of 102 patients with post-stroke shoulder pain were enrolled and randomly divided into an observation group and a control group. The observation group received trigger point blood-letting cupping therapy on the basis of basic treatment and routine acupuncture, while the control group only received basic treatment and routine acupuncture. Both groups were treated for 2 weeks (10 times). The visual analogue scale (VAS) for pain, the Fugl-Meyer assessment (FMA) scale for upper limb function, the modified barthel index (MBI), the Hamilton anxiety scale (HAMA), the Pittsburgh sleep quality index (PSQI) were evaluated before treatment, after 1-week treatment, after treatment, and 1-month follow-up, and the frequency of non-steroidal anti-inflammatory drug (NSAIDs) use was recorded. Results The total effective rate was higher in the observation group than in the control group. Repeated measures ANOVA revealed that the time factor had a significant influence on all outcome measures: VAS, HAMA, and PSQI scores, as well as the frequency of non-steroidal analgesic use, decreased significantly over the course of treatment in both groups, while FMA and MBI scores increased significantly. Intergroup comparisons further demonstrated superior improvement in the observation group across multiple dimensions: For pain control (VAS) and sleep quality (PSQI), the observation group showed significantly lower scores from the end of treatment through the follow-up period. Regarding motor function (FMA) and activities of daily living (MBI), the observation group had significantly higher scores at the end of treatment and at follow-up. For anxiety (HAMA), no statistically significant difference was found between the groups during the treatment period, but the observation group's scores were significantly lower at follow-up. Concerning the frequency of analgesic use, it was already significantly lower in the observation group at one week of treatment, but no significant difference was observed between the groups post-treatment and at follow-up. Conclusion Acupuncture treatment can effectively alleviate pain, improve upper limb motor function and activities of daily living, and also has positive effects on reducing anxiety, improving sleep quality, and decreasing the reliance on non-steroidal analgesics in patients with post-stroke shoulder pain. The addition of trigger point bloodletting and cupping to conventional acupuncture therapy can further accelerate pain relief and early analgesic reduction, enhance the recovery of motor function and daily living abilities, and provide superior long-term stability in mood and sleep improvement. The overall therapeutic effect of the combined protocol is significantly superior to conventional acupuncture alone, demonstrating value for clinical application and promotion.