四法合用治疗肩周炎冻结期的疗效及对肩周临床症状、关节功能的影响  

Curative Effect of Applying Combined Four Treatment Methods in the Treatment of Patients with Frozen Period of Shoulder Periarthritis and Its Influences on Scapulohumeral Clinical Symptoms and Joint Function

作　　者：黄金良 宁兴连 燕军 饶海冰 万超 周璇 赵美 梁宁燕 HUANG Jinliang;NING Xinglian;YAN Jun(Shenzhen Municipal Integrated Traditional Chinese and Western Medicine Hospital,Shenzhen Guangdong 518104,China)

机构地区：[1]深圳市中西医结合医院,广东深圳518104

出　　处：《四川中医》2022年第8期135-138,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：深圳市宝安区科技创新局资助项目(编号:2020JD566)

摘　　要：目的:探究四法合用治疗肩周炎冻结期患者的疗效及对肩周临床症状、关节功能的影响。方法:选择2020年1月~2021年12月来我院就诊的肩周炎冻结期患者96例,按照随机数表法,分成观察组和对照组各48例。对照组采用针刀松解术+微量封闭术治疗,观察组采用四法合用(针刀松解术+微量封闭术+穴位放血+龙氏正脊手法)治疗。比较两组治疗后的临床疗效,比较两组治疗前后肩关节功能评分、炎性因子水平[肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]、肩峰下滑囊、结节间沟积液厚度及肩部肌腱厚度。结果:治疗后,观察组的总有效率为95.83%,高于对照组77.08%(P<0.05);治疗后,观察组疼痛、日常生活活动、肩关节活动度、肌力评分分别为(13.25±1.48)分、(17.69±1.73)分、(35.44±2.35)分、(23.21±1.19)分,均高于对照组(9.53±1.89)分、(14.25±2.32)分、(28.16±3.23)分、(20.45±1.22)分(P<0.05);治疗后,观察组的肩峰下滑囊、结节间沟积液厚度以及冈上肌腱、冈下肌腱、肌筋膜、关节囊下壁厚度分别为(0.53±0.09)mm、(0.13±0.03)mm、(4.91±0.65)mm、(4.63±0.42)mm、(0.64±0.18)mm、(2.11±0.52)mm,均低于对照组(0.67±0.11)mm、(0.26±0.04)mm、(5.08±0.71)mm、(4.76±0.39)mm、(0.75±0.17)mm、(2.37±0.63)mm、(P<0.05);治疗后观察组IL-6、IL-10、TNF-α水平分别为(30.07±6.18)ng/L、(6.19±1.56)ng/L、(15.43±3.04)ng/L,低于对照组(38.51±6.71)ng/L、(9.23±2.14)ng/L、(19.54±2.08)ng/L、(P<0.05)。结论:四法合用治疗肩周炎冻结期患者的疗效好,能有效改善其临床症状,提高其肩关节功能,减轻组织水肿及炎症因子水平,值得临床推广。Objective:To explore the curative effect of applying combined four treatment methods in the treatment of patients with frozen period of shoulder periarthritis and its influences on scapulohumeral clinical symptoms and joint function.Methods:A total of 96 patients with frozen period of shoulder periarthritis treated in the hospital were enrolled between January 2020 and December 2021.According to random number table method,they were divided into an observation group and a controlled group,48 cases in each group.The controlled group was treated with acupotomelysis and micro-occlusion therapy,while the observation group was treated with combined four treatment methods(acupotomelysis,micro-occlusion therapy,acupoint bloodletting,LONG’s chiropractic manipulation).The clinical curative effect after treatment,scores of shoulder function,levels of inflammatory factors[tumor necrosis factorα(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10)],subacromial bursa,thickness of intertuberous sulcus effusion and shoulder tendon before and after treatment were compared between the two groups.Results:After treatment,the total response rate in the observation group was higher than that in the controlled group(95.83%vs 77.08%)(P<0.05).After treatment,scores of pain,activities of daily living,shoulder range of motion and muscle strength in the observation group were(13.25±1.48)points,(17.69±1.73)points,(35.44±2.35)points and(23.21±1.19)points,higher than those in the controlled group[(9.53±1.89)points,(14.25±2.32)points,(28.16±3.23)points,(20.45±1.22)points](P<0.05).After treatment,thickness values of subacromial bursa,intertuberous sulcus effusion,supraspinatus tendon,infraspinatus tendon,myofascia and inferior articular capsule wall in the observation group were(0.53±0.09)mm,(0.13±0.03)mm,(4.91±0.65)mm,(4.63±0.42)mm,(0.64±0.18)mm and(2.11±0.52)mm,thinner than those in the controlled group[(0.67±0.11)mm,(0.26±0.04)mm,(5.08±0.71)mm,(4.76±0.39)mm,(0.75±0.17)mm,(2.37±0.63)mm](P<0.05).After treatment,levels of IL-

关 键 词：针刀松解术 穴位放血 微量封闭术 龙氏正脊手法 肩周炎冻结期 关节功能 

分 类 号：R274.9[医药卫生—中西医结合]