关节腔加压灌注联合局部封闭和手法治疗肩周炎的临床研究  

Clinical study on articular cavity enhancing perfusion combined with blocking therapy and manipulation therapy in the treatment of periarthritis humeroscapularis

作　　者：张允[1] 伍光辉[2] 曾喻[1] 廖敏[1] 罗勇[1] 陈世寅[1] 薛亮[1] 

机构地区：[1]四川省医学科学院四川省人民医院,四川成都610072 [2]泸州医学院附属中医医院,四川泸州646000

出　　处：《中医正骨》2014年第9期11-14,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:观察关节腔加压灌注联合局部封闭和手法治疗肩周炎的临床疗效和安全性。方法:将126例肩周炎患者随机分为3组,43例采用关节腔加压灌注+局部封闭+手法治疗(A组),42例采用关节腔加压灌注+手法治疗(B组),41例采用局部封闭+手法治疗(C组)。分别于治疗前及治疗开始后1 d、7 d、14 d、21 d、28 d采用肩关节周围炎疗效评定量表评定疗效,并观察治疗期间3组患者不良事件的发生情况。结果:1疗效评定结果。治疗前后不同时间之间疗效评分的差异有统计学意义,即存在时间效应(F=4 746.830,P=0.000);时间因素和分组因素之间存在交互效应(F=166.330,P=0.000);3组患者疗效评分的组间差异总体上有统计学意义,即存在分组效应(F=1 843.600,P=0.000);除治疗前外,其余各时点3组的疗效评分比较,差异均有统计学意义[(44.13±12.79)分,(46.02±10.38)分,(45.63±11.06)分,F=210.917,P=0.076;(66.39±12.57)分,(59.16±13.26)分,(47.19±10.23)分,F=271.000,P=0.000;(81.12±6.43)分,(69.67±8.25)分,(55.29±9.38)分,F=633.400,P=0.000;(91.37±6.62)分,(76.21±8.36)分,(60.62±9.87)分,F=1 584.000,P=0.000;(95.12±4.28)分,(90.20±7.03)分,(85.65±7.46)分,F=201.000,P=0.000;(95.73±3.96)分,(92.57±5.81)分,(91.15±5.72)分,F=163.000,P=0.000];治疗开始后1 d、7 d、14 d、21 d和28 d,A组的评分均大于B组和C组(P=0.010,P=0.001;P=0.000,P=0.000;P=0.000,P=0.000;P=0.000,P=0.000;P=0.000,P=0.000)。B组和C组患者的评分均于治疗开始后21 d达到痊愈标准,而A组评分在治疗开始后7 d即达到痊愈标准。2安全性评定结果。3组患者治疗期间均未发生药物过敏、晕针、血糖较大幅度波动、医源性骨折、肩关节关节囊破裂等不良事件。结论:关节腔加压灌注联合局部封闭和手法治疗能迅速缓解肩周炎患者的肩部疼痛症状、改善关节功能,与关节腔加压灌注联合手法治疗和局部封闭联合手法治疗相比,起效快、疗效好,而且具有较高的�Objective：To observe the clinical curative effects and safety of articular cavity enhancing perfusion combined with blocking therapy and manipulation therapy in the treatment of periarthritis humeroscapularis（PH）.Methods：One hundred and twenty-six patients with PH were randomly divided into 3 groups.Forty-three cases（group A）were treated with articular cavity enhancing perfusion combined with blocking therapy and manipulation therapy,42 cases（group B）were treated with articular cavity enhancing perfusion combined with manipulation therapy,while 41 cases（group C）were treated with blocking therapy combined with manipulation therapy.The clinical curative effects were evaluated according to the curative effect rating scale for PH before the treatment and at 1 ,7,1 4,21 and 28 days after the treat-ment.Meanwhile,the adverse events occurred in the three groups were observed.Results：There was statistical difference in the efficacy scores between different timepoints（F=4 746.830,P=0.000）,in other words,there was time effect,There was interaction between time factor and grouping factor（F=1 66.330,P=0.000）.There was statistical difference in the efficacy scores between the 3 groups in general, in other words,there was grouping effect（F=1 843.600,P=0.000）.There was statistical difference in the efficacy scores between the 3 groups at pretreatment timepoints（44.1 3 ＋/-1 2.79,46.02 ＋/-1 0.38,45.63 ＋/-1 1 .06 points,F=21 0.91 7,P=0.076;66.39 ＋/-1 2.57,59.1 6＋/-1 3.26,47.1 9＋/-1 0.23 points,F=271 .000,P=0.000;81 .1 2＋/-6.43,69.67＋/-8.25,55.29 ＋/-9.38 points,F=633.400,P=0.000;91 .37＋/-6.62,76.21 ＋/-8.36,60.62 ＋/-9.87 points,F=1 584.000,P=0.000;95.1 2 ＋/-4.28,90.20 ＋/-7.03,85.65 ＋/-7.46 points,F=201 .000,P=0.000;95.73 ＋/-3.96,92.57 ＋/-5.81 ,91 .1 5 ＋/-5.72 points,F=1 63.000,P=0.000）.The efficacy scores of group A were higher than those of group B and group C at posttreatment timepoints（P=0.01 0,P=0.001;P=0.000,P=0.000;P=0.000,P=0.000;P=0.000,P=0.000;P=0.0

关 键 词：肩凝症 封闭疗法 加压灌注 肌肉骨骼手法 治疗 临床研究性 

分 类 号：R274.9[医药卫生—中西医结合]