中药热熨、针灸联合点揉法治疗老年肩周炎效果及对患者肩关节功能、炎症状态、疼痛递质的影响  

The effect of hot ironing,acupuncture and moxibustion combined with point kneading in the reatment of senile periarthritis of shoulder and its influence on the function of shoulder joint,inflammatory state and pain transmitter

作　　者：张晓燕[1] 张凌娟[1] 张礼璐 张羽[2] ZHANG Xiaoyan;ZHANG Lingjuan;ZHANG Lilu(Department of Geriatrics,Nanjing Brain Hospital,Nanjing 210000)

机构地区：[1]南京脑科医院老年医学科,南京210000 [2]四川省绵阳市中心医院,绵阳621000

出　　处：《陕西中医》2020年第10期1492-1495,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：四川省科技计划重点研发项目(2017SZ0148)。

摘　　要：目的:观察中药热熨、针灸联合点揉法治疗老年肩周炎(风寒痹阻证)的效果,着重探讨其对患者肩关节功能、炎症状态、疼痛递质的影响。方法:将65例老年肩周炎患者按照随机数字表法分为对照组(n=32例)和观察组(n=33例)。对照组患者给予康复运动锻炼,观察组患者在对照组基础上给予中药热熨、针灸联合点揉法进行中医外治协同治疗,治疗4周后对比临床的治疗效果、肩关节功能Constant-Murley评分、生活质量WHOQOL-BREF评分、血清中相关炎症因子、疼痛递质水平。结果:观察组的临床效果更好,总有效率高达93.94%,显著高于对照组的总有效率78.13%(P<0.05);经过治疗后,两组患者的肩关节功能Constant-Murley评分均明显升高,与对照组进行组间比较,观察组患者的疼痛、肩关节活动度、日常生活能力评分升高更明显(P<0.05),但肌力评分的差异无统计学意义(P>0.05);治疗4周后,以观察组WHOQOL-BREF评分显著高于对照组(P<0.05);观察组的血清中炎症相关因子TGF-β1、GM-CSF水平及疼痛递质SP、PGE 2水平均显著低于对照组(P<0.05)。结论:中药热熨、针灸联合点揉法更利于改善老年肩周炎患者的肩关节功能,提高生活质量,通过抑制血清中TGF-β1、GM-CSF、SP、PGE 2表达而发挥的抗炎、镇痛效果更突出。Objective:The effect of hot ironing and acupuncture combined with point rubbing in the treatment of periarthritis of shoulder in the elderly,and focus on its effect on shoulder joint function,inflammatory state and pain transmitters.Methods:65 elderly patients with scapulohumeral periarthritis were divided into control group(n=32 cases)and observation group(n=33 cases).The control group was given rehabilitation exercise,and the observation group was given Chinese medicine hot iron,acupuncture and point rub on the basis of the control group.After 4 weeks of treatment,the clinical effect,shoulder function constant-murley score,quality of life WHOQOL-BREF score,serum inflammatory factors,pain transmitter level were compared.Results:the clinical effect of the observation group was better,the effective rate was 93.94%,significantly higher than 78.13%of the control group(P<0.05).There was no significant difference in scores(P>0.05);the WHOQOL-BREF score of the observation group was significantly higher than that of the control group(P<0.05);the levels of TGF-β1,GM-CSF,SP and PGE 2 in serum of the observation group were significantly lower than that of the control group(P<0.05).Conclusion:the combination of hot ironing,acupuncture and massage is more beneficial to improve the shoulder function and quality of life of the elderly patients with scapulohumeral periarthritis.The anti-inflammatory and analgesic effects of inhibiting the expression of TGF-β1,GM-CSF,SP,PGE 2 in serum are more prominent.

关 键 词：中药热熨 针灸 点揉法 老年 肩周炎 风寒湿痹证 肩关节功能 炎症状态 疼痛递质 

分 类 号：R274.9[医药卫生—中西医结合]