三通序贯法治疗风寒湿型肩关节周围炎  

Clinical Observation of YU Boliang's"Three-way Sequential Therapy"in Treatment of Scapulohumeral Periarthritis of Wind-Cold-Damp Type

作　　者：林海波 林汉瑜 黄可心 余伯亮 LIN Haibo;LIN Hanyu;HUANG Kexin;YU Boliang(Jiangmen Wuyi Hospital of Traditional Chinese Medicine,Jiangmen Guangdong China 529000;Guangzhou University of TCM,Guangzhou Guangdong China 510006;Hunan University of TCM,Changsha Hunan China 410228)

机构地区：[1]江门市五邑中医院,广东江门529000 [2]广州中医药大学,广东广州510006 [3]湖南中医药大学,湖南长沙410228

出　　处：《中医学报》2020年第6期1341-1345,共5页Acta Chinese Medicine

基　　金：余伯亮全国名老中医药专家传承工作室建设项目{国中医药人教函〔2018〕134号}。

摘　　要：目的:探讨三通序贯法治疗风寒湿型肩关节周围炎的临床疗效。方法:120例风寒湿型肩关节周围炎患者采用随机数字表法分成三通组、手法组、浅刺组和封包组,每组30例。三通组采用三通序贯(理筋手法-多针浅刺-酒醋封包)治疗,手法组单用理筋手法,浅刺组单用多针浅刺,封包组单用酒醋封包,均每日治疗1次,每周治疗6 d,共治疗2周。对4组治疗前后及治疗后1个月肩部的疼痛度、活动范围、日常生活活动能力进行评分。结果:治疗后,4组肩关节疼痛、肩关节活动范围、日常生活活动能力、肩部形态评分均较前提高,差异均有统计学意义(P<0.05),其中三通组有效率为90.00%(27/30),手法组为73.33%(22/30),浅刺组为82.76%(25/29),封包组为57.14%(18/28),4组比较,差异有统计学意义(P<0.05)。4组治疗后与随访评分比较,差异均无统计学意义(P>0.05)。结论:理筋手法、多针浅刺、酒醋封包及三通序贯4种疗法治疗风寒湿型肩关节周围炎均有疗效,均可以明显缓解患者肩部疼痛,增加患者肩关节活动范围,改善患者肩部日常生活活动能力及局部形态,随访效果稳定,未见明显反弹。其中三通序贯法临床疗效明显优于其余三法。Objective:To explore the clinical effect of the"Three-way Sequential Therapy"in treatment of shoulder periarthritis of wind-cold-damp type.Methods:120 patients with rheumatic cold and shoulder periarthritis were divided into three groups,manual group,shallow puncture group and packet group by random number table method,with 30 cases in each group.The three-way group was treated with three-way sequential(reinforcing tendons-multi-needle shallow puncture-wine vinegar sealing)treatment.The manipulation group used only the tendon manipulation,the shallow puncture group used multi-needle shallow puncture,and the packet group used wine vinegar alone.They were treated once a day,6 days a week and the total process lasted for 2 weeks.Before and after treatment and 1 month after treatment,the shoulder pain,range of activities,and activities of daily living were scored.Results:After the treatment,the shoulder pain,the range of motion of the shoulder joint,the activities of daily living,and the shoulder morphology scores of the 4 groups were all improved compared with the previous ones,and the differences were statistically significant(P<0.05).The effective rate of the three-way group was 90%,73.33%in the manipulation group,82.76%in the shallow puncture group,and 57.14%in the packet group.The difference between the four groups was statistically significant(P<0.05).There was no statistically significant difference between the 4 groups after treatment and follow-up scores(P>0.05).Conclusion:Reinforcing muscle manipulation,multi-needle shallow puncture,wine vinegar sealing and three-way sequential therapy are all effective in the treatment of rheumatic cold and wet shoulder periarthritis.They can alleviate shoulder pain and increase the range of shoulder joint movement,improve the patient's shoulder activities of daily life and local morphology,follow-up effect is stable,no significant rebound.Among them,the three-pass sequential clinical effect is obviously better than the other three methods.

关 键 词：肩关节周围炎 三通序贯法 风寒湿证 理筋手法 多针浅刺 酒醋封包 

分 类 号：R245.84[医药卫生—针灸推拿学]