体外冲击波疗法联合关节腔内注射透明质酸钠治疗顽固性肩周炎的疗效观察  

Efficacy of extracorporeal shock wave therapy combined with intra-articular injection of sodium hyaluronate on the treatment of patients with refractory scapulohumeral periarthritis

作　　者：武干生 Wu Gansheng(Department of Painology,Huiji District People's Hospital,Zhengzhou City,Henan Province 450044,China)

机构地区：[1]郑州市惠济区人民医院疼痛科,郑州市450044

出　　处：《中华疼痛学杂志》2023年第1期82-86,共5页Chinese Journal Of Painology

摘　　要：目的研究体外冲击波疗法联合关节腔内注射透明质酸钠治疗顽固性肩周炎的临床效果。方法采用前瞻性随机对照试验, 收集郑州市惠济区人民医院疼痛科2019年1月至2020年8月收治的顽固性肩周炎患者99例, 按照随机数字表法分为体外冲击波联合治疗组(n=49)和透明质酸钠治疗组(n=50)。透明质酸钠治疗组采用关节腔内注射透明质酸钠治疗;体外冲击波联合治疗组在透明质酸钠治疗基础上采用体外冲击波治疗, 共治疗4次。记录两组患者治疗前, 治疗后3及6个月时肩关节功能评分(CMS)和疼痛视觉模拟评分(VAS), 以及治疗期间不良反应。结果体外冲击波联合治疗组治疗后3、6个月时CMS评分分别为(71.7±10.8)分和(92.9±8.7)分, 均较治疗前(50.0±8.3)分升高(P均<0.05)。透明质酸钠治疗组治疗后3、6个月时CMS评分分别为(60.7±8.0)分和(79.5±9.1)分, 均较治疗前的(49.0±7.8)升高(P均<0.05)。两组治疗后3、6个月时VAS评分均较治疗前降低, 差异均有统计学意义(P均<0.05), 体外冲击波联合治疗组降低更明显。透明质酸钠治疗组不良反应发生率低于体外冲击波联合治疗组, 但差异无统计学意义(P>0.05)。结论关节腔内注射透明质酸钠与联合体外冲击波治疗顽固性肩周炎两种方法均可有效缓解顽固性肩周炎患者疼痛感, 有利于肩关节功能恢复, 近期疗效满意, 但联合治疗效果更好。Objective To study the clinical effect of extracorporeal shock wave combined with intra-articular injection of sodium hyaluronate on the treatment of patients with refractory scapulohumeral periarthritis.Methods A prospective randomized controlled trial was conducted in 99 patients with refractory scapulohumeral periarthritis in the Department of Painology,Huiji District People's Hospital of Zhengzhou,from January 2019 to August 2020.According to the random number table method,the patients were divided into the extracorporeal shock wave combined sodium hyaluronate treatment group(combined group,n=49)and sodium hyaluronate treatment group(n=50).The sodium hyaluronate was intra-articularly injected in sodium hyaluronate treatment group,while the sodium hyaluronate injection combined extracorporeal shock wave in combined group,4 times for the two groups.The Constant-Murley score(CMS)of shoulder joint function,visual analogue scale(VAS)before,3 months and 6 months after the treatment and adverse reactions during treatment were recorded.Results The CMS was better after the treatment at 3 months and 6 months than that before the treatment in combined group(71.7±10.8)and(92.9±8.7)comparing(50.0±8.3)(all P<0.05),and in the sodium hyaluronate group(79.5±9.1)and(60.7±8.0)comparing(49.0±7.8)(all P<0.05).The VAS decreased at 3 months and 6 months after the treatment in both groups than that before the treatment(all P<0.05)and VAS decreased more obviously in the combined group.The incidence of adverse reactions was lower in sodium hyaluronate treatment group than that in combined group,but without statistically significant difference(P>0.05).Conclusion Intra-articular injection of sodium hyaluronate,and combined extracorporeal shock wave are both effective in the treatment of refractory scapulohumeral periarthritis,but the combined treatment is better.

关 键 词：肩关节 关节周围炎 注射 关节腔 透明质酸钠 体外冲击波 

分 类 号：R686[医药卫生—骨科学]