盂肱关节糖皮质激素注射与功能锻炼治疗肩周炎疗效分析  

Comparative study of corticosteroid injection and home exercise in treatment of adhesive capsulitis

作　　者：黄德刚[1] 董利军[1] 宣华兵[1] 贺华正[1] 

机构地区：[1]皖南医学院附属弋矶山医院关节外科

出　　处：《中国临床药理学与治疗学》2013年第1期62-65,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:通过对盂肱关节腔激素注射与单纯功能锻炼两种常用的肩周炎的治疗方法,评价两者的临床疗效。方法:选择本院门诊治疗的肩周炎患者42人,按门诊先后顺序交替列入两组:盂肱关节激素注射组(A组)及功能锻炼组(B组)。A组患者行盂肱关节内注射,注射药物为:得保7mg(二丙酸倍他米松5mg+倍他米松磷酸二钠2mg)+2%利多卡因2mL+注射用生理盐水2mL,两周后重复一次,辅以功能锻炼。注射点为喙突外上缘,所有注射均在超声引导下完成。B组单纯功能锻炼。分别于治疗前(0周),治疗后6周,3月记录SPADI评分,评分结果以DAS1.0作统计分析。结果:单纯的功能锻炼(B组)在治疗后6周和3月,SPADI总体评分、疼痛评分、功能评分均较基线水平有了一定的改善,但改善的程度有限。而激素关节内注射辅以功能锻炼患者(A组)SPADI总体评分、疼痛评分、功能评分均较基线水平明显改善,6周、3月和单纯功能锻炼相比,亦有明显差异,均数差值均大于10,疗效明显优于单纯功能锻炼。结论:盂肱关节的激素注射治疗,在中短期内可迅速缓解疼痛症状,辅以功能锻炼,能更有效地改善功能。AIM. To assess whether intraarticular corticosteroids improves the outcome of a comprehensive exercise programme in patients with adhesive capsulitis. METHODS： The patients were randomly assigned into two groups： Group A patients were given intraarticular corticosteroid （1 mL, 7 mg compound betamethasone injection＋2% lidocaine＋2 mL NS）, repeated it again two weeks later, followed by a comprehensive home exercise programme. Group B patients were given guide about comprehensive home exercise programme. All injections were done under ultrasound guiding. Record the SPADI scores at 0 weeks,6 weeks and 3 months. Data analysis was performed using VAS 1.0. RESULTS=The scores of Shoulder Pain and Disability Index were statistically different between the two groups at 6 weeks and 3 months, with the better scores in Group A, the difference of the mean between two groups were more than 10 scores. CONCLUSION. Intraarticular corticosteroids have the additive effect of providing rapid pain relief, intraarticular corticosteroid therapy could be advised concomitantly with exercise.

关 键 词：肩周炎 关节内注射 功能锻炼 

分 类 号：R274.39[医药卫生—中医骨伤科学]