中能量冲击波刺激“肩三针”穴位治疗肩袖损伤及镇痛时效观察  

Therapeutic Effect and Immediate and long-term Analgesia of Rotator Cuff Injury by Stimulation of “Shoulder Three Needles” with Medium Energy Shock Wave

作　　者：马晴 张亮[2] 邵妍[3] 赵曦彤 吕文正 王鹏琴[3] MA Qing;ZHANG Liang;SHAO Yan;ZHAO Xitong;LYU Wenzheng;WANG Pengqin(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Liaoning Provincial People's Hospital,Shenyang 110000,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China;China Medical University,Shenyang 110122,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁省人民医院,辽宁沈阳110000 [3]辽宁中医药大学附属医院,辽宁沈阳110032 [4]中国医科大学,辽宁沈阳110122

出　　处：《辽宁中医杂志》2022年第2期170-173,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局中医学术流派传承工作室建设项目(LPGZS2012-09);辽宁省专科能力建设项目(LNZYXZK201911);辽宁省自然基金(2019-MS-229)

摘　　要：目的观察中能量发散式体外冲击波刺激“肩三针”穴位配合常规康复训练应用于肩袖肌腱损伤的临床疗效以及不同时间点止痛效应。方法选取44例肩袖肌腱损伤诊断明确的患者,采用随机数字表法分为冲击波组和对照组各22例。两组均采用中频电疗法、超短波疗法、中药蒸汽熏蒸及彭氏眼针上焦区埋针后关节松动术,试验组增加中能量发散式体外冲击波刺激肩髃穴、肩贞穴、肩髎穴,选择DLФ15 mm探头,设置频率11 Hz,强度2.0~3.2 bar,每穴治疗800~1000 r根据患者耐受能力调整,治疗结束后局部冷疗,避免不良反应。分别于治疗前、首次治疗后、治疗后2周评定,采用疼痛视觉模拟评分(VAS)、Constant-Murley评分(CMS)、日常生活活动能力Barthel指数(BI)评价。结果治疗前两组VAS、CMS、BI评分差异无统计学意义(P>0.05)。与治疗前比较,两组首次治疗后、治疗2周后VAS评分均明显降低,CMS各项评分和BI评分均提高,差异具有统计学意义(P<0.05)。与首次治疗后比较,治疗2周后VAS评分均明显降低,CMS各项评分和BI评分均提高,差异具有统计学意义(P<0.05)。与对照组治疗后同一时间点比较,冲击波组VAS评分明显更低,CMS各项评分和BI评分均明显更高,差异具有统计学意义(P<0.05)。治疗2周后,冲击波组和对照组疼痛消失率分别为22.7%、13.6%。结论肩袖肌腱损伤患者在常规康复治疗基础上,采用中能量体外冲击波刺激“肩三针”穴位治疗效果显著,镇痛即刻效应明显,改善肩关节功能及日常生活能力累积效应显著。Objective The clinical effect of energy divergent extracorporeal shock wave stimulation of“shoulder three needles”combined with routine rehabilitation training on rotator cuff tendon injury and the analgesic effect at different time points were observed.Methods Forty-four patients with rotator cuff tendon injury with definite diagnosis were selected.By random number table method,22 patients were divided into shock wave group and control group.Two groups both used medium frequency electrotherapy and ultrashort wave therapy,traditional Chinese medicine steam fumigation and joint loosening after embedding needle in the upper focal area of PENG′s eye needle.The experimental group added energy extracorporeal shock wave stimulation at Jianyu(LI15),Jianzhen(SI9)and Jianliao(SJ14).DLФ15 mm probe was selected,setting up 11 Hz frequency,intensity of 2.0-3.2 bar,800-1000 r according to patients′every hole tolerance.The local cold therapy was used after treatment to avoid adverse reaction.Visual analogue scale(VAS),Constant-Murley score(CMS)and Barthel index(BI)were used to evaluate the pain before treatment,after the first treatment and 2 weeks after treatment.Results There were no significant differences in VAS,CMS or BI scores between the two groups before treatment(P>0.05).Compared with those before treatment,VAS scores were significantly decreased after the first treatment and 2 weeks after treatment,while CMS scores and BI scores were increased in both groups with statistical significance(P<0.05).After 2 weeks of treatment,VAS scores were significantly decreased,while CMS scores and BI scores were increased with statistical significance(P<0.05).Compared with those of the control group at the same time after treatment,the VAS score in the shock wave group was significantly lower,and the CMS scores and BI scores were significantly higher with statistical significance(P<0.05).The total effective rates were 72.7%and 81.8%in the shock wave group after the first treatment and 2 weeks after treatment,and 59.1%and 68.

关 键 词：肩袖损伤 冲击波 肩三针 康复 中西医结合 

分 类 号：R246.9[医药卫生—针灸推拿学]