肩部松解推拿术联合雷火灸治疗肩关节周围炎风寒湿痹证疗效及对肩关节活动度、血清炎症相关因子的影响  

Curative effect of shoulder release massage combined with thunder-fire moxibustion for periarthritis of shoulder of wind cold wetness syndrome and how it impacts on shoulder mobility and serum inflammation-related factors

作　　者：常红 赵燕 王绛辉 常英[3] 吴靖 王聪 杨昱 CHANG Hong;ZHAO Yan;WANG Jianghui;CHANG Ying;WU Jing;WANG Cong;YANG Yu(Department of Acupuncture and Moxibustion,Affiliated Hospital of Hebei Academy of Traditional Chinese Medicine,Shijiazhuang,Hebei 050031;Department of Surgery,Affiliated Hospital of Hebei Academy of Traditional Chinese Medicine,Shijiazhuang,Hebei 050031;Department of Acupuncture,The Third Hospital of Hebei Medical University,Shijiazhuang,Hebei 050011)

机构地区：[1]河北省中医药科学院附属医院针灸科,河北石家庄050031 [2]河北省中医药科学院附属医院外科,河北石家庄050031 [3]河北医科大学第三医院针灸科,河北石家庄050011

出　　处：《河北中医》2022年第7期1159-1163,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2016年度科研计划项目(中医药类科研课题)(编号:2016019)。

摘　　要：目的观察肩部松解推拿术联合雷火灸治疗肩关节周围炎(以下简称肩周炎)风寒湿痹证的疗效及对肩关节活动度、血清炎症相关因子的影响。方法将100例风寒湿痹型肩周炎患者按照随机数字表法分为2组,每组各50例。治疗组予肩部松解推拿术联合雷火灸治疗,对照组予电针疗法,均治疗2周后比较2组临床疗效。比较2组治疗前后主要中医症状评分、肩关节活动度、日本骨科协会(JOA)肩关节疾患治疗成绩判定标准中疼痛评分(以下简称JOA疼痛评分)、疼痛视觉模拟评分(VAS)及肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、C反应蛋白(CRP)、一氧化氮(NO)水平变化。结果治疗组总有效率90.00%(45/50),对照组总有效率76.00%(38/50),治疗组临床疗效优于对照组(P<0.05)。治疗后,2组主要中医症状肩关节疼痛、肩关节屈伸不利、肢冷重着恶风评分和疼痛VAS均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后,2组肩关节活动(前屈、后伸、内收、外展和外旋)度均较本组治疗前增加(P<0.05),且治疗组均大于对照组(P<0.05)。治疗后,2组JOA疼痛评分均较本组治疗前升高(P<0.05),且治疗组高于对照组(P<0.05)。治疗后,2组TNF-α、IL-6、CRP、NO水平均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。结论肩部松解推拿术联合雷火灸可有效缓解风寒湿痹型肩周炎患者的症状,改善肩关节活动度,降低炎症相关因子水平,抑制炎性反应,减轻患者肩部疼痛不适,提高临床疗效。Objective To observe the curative effect of shoulder release massage combined with thunder-fire moxibustion for periarthritis of shoulder(PAS)of wind cold wetness syndrome and how it impacts on shoulder mobility and serum inflammation-related factors.Methods Totally 100 PAS patients(wind cold wetness syndrome)were randomly assigned into the treatment group(n=50)and the control group(n=50).The treatment group was treated with shoulder release massage combined with thunder-fire moxibustion,and the control group with electroacupuncture(EA).Treated for 2 weeks,the key observation was traditional Chinese medicine(TCM)symptom scores,shoulder mobility,japaneseorthopaedic association(JOA)score for shoulder pain,visual analogue scale(VAS)for pain,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),nitric oxide(NO);the curative effect was assessed.Results The overall effective rate in the treatment group was better than that in the control group(90.00%[45/50],vs 76.00%[38/50],(P<0.05),respectively).After treatment,TCM symptom(shoulder pain,shoulder flexion and extension adverse,cold limbs and fear of wind)scores,VAS scores in groups were decreased(P<0.05),which were decreased in the treatment group in comparison with the control group(P<0.05);shoulder mobility(anteflexion,posterior extension,adduction,abduction,external rotation)in groups was increased(P<0.05),the treatment group was more prevalent(P<0.05);JOA scores in groups were increased(P<0.05),which were increased(P<0.05)in the treatment group relevant to the control group;TNF-α,IL-6,CRP,NO in groups were decreased(P<0.05),the reduction in the treatment group was more common(P<0.05).Conclusion For PAS patients(wind cold wetness syndrome),shoulder release massage combined with thunder-fire moxibustion is effectively capable of relieving symptoms,improving shoulder mobility,reducing the level of inflammation-related factors,inhibiting the inflammatory response,relieving the pain and discomfort of the shoulder,and improving the clinical efficac

关 键 词：肩凝症 针灸疗法 推拿 风寒湿痹 炎症 

分 类 号：R684.305[医药卫生—骨科学] R244.1[医药卫生—外科学]