电针结合Mulligan动态关节松动手法对肩周炎的临床效果及炎症因子TNF-α、IL-6的影响  

Effect of Electro-Acupuncture Combined with Mulligan Dynamic Joint Loosening Manipulation on TNF-a and IL-6 in Treating Scapulohumeral Periarthritis

作　　者：高俊虎[1] 王博[1] 左冬冬[2] GAO Junhu;WANG Bo;ZUO Dongdong(Heilongjiang University of Chinese Medicine, Harbin 150040, China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《针灸临床杂志》2020年第6期42-46,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：黑龙江省卫生计生委科研课题,编号:2018583;黑龙江省中医药科研项目,编号:2018-006。

摘　　要：目的:观察电针结合Mulligan动态关节松动手法治疗肩周炎的临床效果,并探讨其可能的作用机制。方法:选取有肩关节痛、活动受限病史3个月以上的肩周炎患者80例,采用随机数字表将患者分为电针加手法组和手法组,每组各40例。电针加手法组采用电针加Mulligan动态关节松动手法进行治疗,手法组只采用Mulligan动态关节松动手法进行治疗,两组均每日治疗1次,连续治疗2周。2周后观察对比两组患者的临床疗效,肩关节功能评分,肩关节主动活动角度和炎症因子TNF-α、IL-6的变化情况。结果:治疗2周后,电针加手法组总有效率为92.31%(36/39);手法组总有效率80.00%(32/40),两组比较差异有统计学意义(P<0.05)。治疗前电针加手法组肩关节主动活动角度和肩关节功能评分与手法组比较,差异无统计学意义,治疗后两组患者的肩关节主动活动角度和肩关节功能评分均较治疗前有改善(P<0.05),但电针加手法组更优(P<0.05)。治疗前电针加手法组炎症因子水平与手法组比较,差异无统计学意义,治疗后两组患者的TNF-α、IL-6水平均较治疗前有改善(P<0.05),但电针加手法组更优(P<0.05)。结论:电针结合Mulligan动态关节松动手法治疗肩周炎的临床疗效肯定,能明显改善临床的症状和体征,其可能的作用机制是降低炎症因子水平。Objective:To observe the clinical effect of electro-acupuncture combined with Mulligan dynamic joint loosening manipulation in the treatment of scapulohumeral periarthritis and to explore its possible mechanism.Methods:80 patients met the inclusion criteria were randomly divided into the study group and the control group,with 40 cases in each group.The control group was treated with Mlligan dynamic joint loosening manipulation;on which basis,the study group was also treated with electro-acupuncture.Both groups were treated once a day for two weeks.Clinical efficacy,shoulder function scores,active shoulder movement angle and changes of inflammatory factors of TNF-a and IL-6 were observed and compared between the two groups after the treatment.Results:After two weeks of treatment,the total effective rate of the study group was 92.31%(36/39),which was significantly higher than 80.00%(32/40)of the control group(P<0.05).In terms of active shoulder movement angle,there were no statistical difference between the two groups before the treatment;after the treatment,it was improved in both groups(P<0.05);the improvement in the study group was more significant(P<0.05).In terms of the levels of TNF-a and IL-6,there were no statistical differences between the two groups before the treatment;after the treatment,the levels of inflammatory factors were improved in both groups(P<0.05);the improvements in the study group were more significant(P<0.05).Conclusion:Electro-acupuncture combined with Mulligan's dynamic joint loosening manipulation has a definite clinical effect on scapulohumeral periarthritis,which can significantly improve clinical symptoms and signs,and its possible mechanism is to reduce the levels of inflammatory factors.

关 键 词：电针 Mulligan动态关节松动手法 肩周炎 

分 类 号：R246.2[医药卫生—针灸推拿学]