中医手法松解结合关节镜治疗冻结肩临床观察  

Clinical Observation of Traditional Chinese Medicine Manipulation of Lysis Combined with Arthroscopy for Frozen Shoulder

作　　者：叶恒力 江克罗 汤海军[1] YE Hengli;JIANG Keluo;TANG Haijun

机构地区：[1]温岭市台州骨伤医院骨关节科,浙江温岭317500

出　　处：《新中医》2018年第8期173-176,共4页New Chinese Medicine

基　　金：浙江省温岭市科技计划项目(2017C31114)

摘　　要：目的:观察中医手法松解结合关节镜、单纯关节镜和中医手法松解治疗冻结肩的临床疗效,探究合理有效的治疗方法。方法:选择13 5例冻结肩患者作为研究对象,按照随机数字表法分为中医组、关节镜组和结合组,每组4 5例。中医组采用中医手法松解治疗,关节镜组采用关节镜下松解治疗,结合组采用中医手法松解结合关节镜治疗。比较3组临床治疗效果,关节功能、疼痛、活动度改善情况以及关节不稳、再次僵硬等发生情况。结果:结合组有效率为9 1.11%,显著高于中医组68.89%和关节镜组7 3.3 3%,差异均有统计学意义(P<0.05)。中医组和关节镜组有效率比较无统计学差异(P>0.05)。治疗前,3组C onstant评分、VAS评分、外展角度、前屈角度比较无差异(P>0.05)。治疗后,3组C onstant评分升高,VAS评分降低,外展、前屈角度提高,差异均有统计学意义(P<0.05)。结合组VAS评分明显低于中医组(P<0.05)。结合组外展、前屈角度均明显高于中医组和关节镜组(P<0.05)。结合组关节不稳定发生率明显低于关节镜组(P<0.05),关节再次僵硬发生率明显低于中医组(P<0.05)。结论:中医手法松解结合关节镜治疗原发性冻结肩具有良好效果,较单纯的中医手法治疗能够更好的缓解疼痛,降低关节僵硬的发生率,较单纯关节镜治疗能够降低关节不稳发生率。Objective： To observe the clinical effect of traditional Chinese medicine manipulation of lysis combined with arthroscopy,simple arthroscopy and traditional Chinese medicine manipulation of lysis for frozen shoulder,and discuss the justified and effective treatment. Methods：Selected 135 cases of patients with frozen shoulder as study subjects,and divided them into the Chinese medicine group, the arthroscopy group and the combination group, 45 cases in each group. The Chinese medicine group received traditional Chinese medicine manipulation of lysis,the arthroscopy group received lysis under arthroscope,and the combination group received traditional Chinese medicine manipulation of lysis combined with arthroscopy for treatment. Compared the clinical effect,improvements of joint function, pain and range of motion, and the recurrence of ankylosis in the three groups. Results： The total effective rate was 91.11% in the combination group,significantly higher than 68.89% in the Chinese medicine group and 73.33% in the arthroscopy group respectively, differences being significant（P〈0.05）. There was no significant difference being found in the comparison of the total effective rate between the Chinese medicine group and the arthroscopy group（P〉0.05）. Before treatment,there were no significant differences being found in the comparison of Constant scores, visual analogue scale（VAS） scores, the abduction angle and anteflexion angle among the three groups（P〉0.05）. After treatment, Constant scores were increased in the three groups,VAS scores were decreased,and the abduction angle and anteflexion angle were increased,differences being significant（P〈0.05）. The VAS scores in the combination group were significantly lower than those in the Chinese medicine group（P〈0.05）. The abduction angle and anteflexion angle in the combination group were significantly higher than those in the Chinese medicine group and the arthroscopy group（P〈0.05）. The incidence of joint instability in the combi

关 键 词：冻结肩 中医手法松解 关节镜 视觉模拟评分(VAS) Constant-Murley肩关节功能评分 

分 类 号：R684.3[医药卫生—骨科学]