分期论治肩周炎的随机对照研究  

Staging Treatment on Scapulohumeral Periarthritis: A Randomized Controlled Study

作　　者：杨勇[1] 刘宜军[1] 谈芳芳[1] 王权亮[2] 王雷生[2] 孙飞[1] 周友龙[3] YANG Yong;LIU Yi-jun;TAN Fang-fang;WANG Quan-liang;WANG Lei-sheng;SUN Fei;ZHOU You-long(The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou Henan 450008;Affiliated Hospital of Henan Academy of Traditional Chinese Medicine,Zhengzhou Henan 450003;Henan University of Traditional Chinese Medicine,Zhengzhou Henan 450008)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008 [2]河南省中医药研究院附属医院,河南郑州450003 [3]河南中医药大学,河南郑州450008

出　　处：《世界中西医结合杂志》2020年第10期1885-1889,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河南省中医药研究专项课题(2019ZYZD07);河南省中医药科学研究专项课题(2016ZY2071)。

摘　　要：目的探讨不同针刺方法治疗肩周炎的临床疗效。方法 180例肩周炎患者依临床症状和影像学检查分为疼痛期、僵硬期和恢复期,每期60例,随机分为分期治疗组与温针组,每组30例。分期治疗组:疼痛期采用银质针治疗,僵硬期采用小针刀治疗,恢复期采用结筋病灶点温针灸法治疗;温针组:3期均采用固定穴位温针法治疗,穴取肩髃、肩髎、肩贞、肩前、阿是穴,并随证加减穴位。结果两组治疗后总有效率比较差异无统计学意义(P>0.05),但分期治疗组临床控制率,临床控制率与显效率之和明显高于温针组(P<0.01)。随着疾病的逐渐进展,分期治疗组的临床疗效明显优于温针组,但到恢复期两组临床疗效相当。两组治疗后肩关节病情积分较本组治疗前明显升高(P<0.001),分期治疗组较温针组积分升高更明显(P<0.01)。结论分期治疗肩周炎更具有针对性,能较明显地提高针刺对肩周炎的临床疗效,"因症施术"是治疗肩周炎的一种策略。Objective To explore the clinical effect of different acupuncture methods in different stages of scapulohumeral periarthritis.Methods 180 patients with scapulohumeral periarthritis were divided into pain stage,stiffness stage and recovery stage according to their clinical symptoms and imaging examination.60 patients were effective in each stage.They were randomly divided into staged treatment group and warm needle group with 30 cases in each.Stage treatment group: silver needle treatment in pain stage,small needle knife treatment in stiffness stage,warm needle moxibustion treatment in recovery stage;Warming needling group: Three stages were treated with fixed point warming needling method.Acupoints were selected at Jianyu Jianliao Jianzhen Jianqian and Ashi point,and acupoints were added or subtracted with the syndrome.Results There was no statistically significant difference in the total effective rate between the two groups after treatment(P>0.05),but the clinical control rate,clinical control rate and significant rate of the staged treatment group were significantly higher than the warm acupuncture group(P<0.01).With the gradual progress of the disease,the clinical efficacy of the staged treatment group is significantly better than that of the warm acupuncture group,but the clinical efficacy of the two groups is equivalent in the recovery period.The score of shoulder joint disease after treatment in the two groups was significantly higher than that before the treatment(P<0.001),and the score in the staging treatment group was higher than that in the warm acupuncture group(P<0.01).Conclusion Stage treatment of scapulohumeral periarthritis is more targeted,and can significantly improve the clinical efficacy of acupuncture on scapulohumeral periarthritis,"Symptom treatment"is a strategic application of treatment of scapulohumeral periarthritis.

关 键 词：肩周炎 因症施术 随机对照研究 分期论治 

分 类 号：R686[医药卫生—骨科学]