桂枝芍药知母汤联合火针针刺激痛点及“肩三针”治疗风寒湿痹型肩关节周围炎的临床疗效  

Clinical Efficacy of Guizhi Shaoyao Zhimutang Combined with Fire Needling in Treatment of Periarthritis of Shoulder with Wind-cold-dampness Impediment Syndrome by Stimulating Pain Points and"Shoulder Three Acupoints"

作　　者：桂树虹[1] 蔡燕[1] 秦庆广 赵灿[1] 宋曼萍 GUI Shuhong;CAI Yan;QIN Qingguang;ZHAO Can;SONG Manping(Hainan General Hospital(Hainan Affiliated Hospital of Hainan Medical College),Haikou 570311,China)

机构地区：[1]海南省人民医院(海南医学院附属海南医院),海口570311

出　　处：《中国实验方剂学杂志》2023年第17期150-156,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：海南省卫生健康行业科研项目(20A200033)。

摘　　要：目的:探讨桂枝芍药知母汤联合火针针刺激痛点及“肩三针”治疗风寒湿痹型肩关节周围炎的临床疗效及安全性。方法:选择2020年8月至2022年8月海南省人民医院收治的120例风寒湿痹型肩关节周围炎患者,按照随机数字表法分为两组。对照组(60例)给予桂枝芍药知母汤治疗治疗2周,观察组(60例)桂枝芍药知母汤联合火针针刺激痛点及“肩三针”治疗2周。比较两组患者临床疗效、不良反应及治疗前后肩关节疼痛程度、肩关节功能、血清降钙素基因相关肽(CGRP)、环氧合酶-2(COX-2)、白细胞介素(IL)-2、IL-17水平差异。结果:观察组患者治疗总有效率为88.33%(53/60),对照组患者总有效率为68.33%(41/60),观察组患者总有效率高于对照组,差异具有统计学意义(χ^(2)=7.070,P<0.01)。与本组治疗前比较,两组患者治疗后疼痛分级指数(PRI)、视觉模拟评分法(VAS)、现时疼痛强度(PPI)、简化McGill疼痛问卷(SF-MPQ)总分,血清CGRP、COX-2、IL-2、IL-17水平较治疗前均显著降低(P<0.01),疼痛程度、日常生活能力、关节活动度、肌力、Constant-Murley总分较治疗前均显著增高(P<0.01)。与对照组治疗后比较,观察组患者治疗后PRI、VAS、PPI、SF-MPQ总分,血清CGRP、COX-2、IL-2、IL-17水平均显著低于对照组(P<0.01),疼痛程度、日常生活能力、关节活动度、肌力、Constant-Murley总分均显著高于对照组(P<0.01)。两组不良反应发生率比较差异无统计学意义。结论:桂枝芍药知母汤联合火针针刺激痛点和“肩三针”治疗风寒湿痹型肩关节周围炎可更有效地降低血清炎症因子和疼痛介质水平,缓解患者疼痛程度,改善患者肩关节功能。Objective:To investigate the clinical efficacy of Guizhi Shaoyao Zhimutang(GZSYZM)combined with fire needling in the treatment of periarthritis of shoulder with wind-cold-dampness impediment syndrome by stimulating pain points and"shoulder three acupoints".Method:A total of 120 patients with periarthritis of shoulder with wind-cold-dampness impediment syndrome,admitted to Hainan General Hospital from August 2020 to August 2022,were randomly divided into two groups using a random number table.The control group(60 cases)received treatment with GZSYZM for two weeks,while the observation group(60 cases)received treatment with GZSYZM combined with fire needling at pain points and"shoulder three acupoints"for two weeks.The clinical efficacy,adverse reactions,shoulder pain intensity,shoulder joint function,and levels of calcitonin gene-related peptide(CGRP),cyclooxygenase-2(COX-2),interleukin(IL)-2,and IL-17 before and after treatment were compared between the two groups.Result:The total effective rate in the observation group was 88.33%(53/60),significantly higher than 68.33%(41/60)of the control group(χ^(2)=7.070,P<0.01).Compared with the results before treatment,both groups showed significant reductions in pain rating index(PRI),visual analog scale(VAS)scores,present pain intensity(PPI),and Simplified McGill Pain Questionnaire(SF-MPQ)total scores,as well as serum levels of CGRP,COX-2,IL-2,and IL-17 after treatment(P<0.01),and improved pain intensity,daily life abilities,joint mobility,muscle strength,and Constant-Murley score(P<0.01).Compared with the control group after treatment,the observation group showed significantly reduced PRI,VAS score,PPI,SF-MPQ total score,as well as serum levels of CGRP,COX-2,IL-2,and IL-17(P<0.01),and increased pain intensity,daily life abilities,joint mobility,muscle strength,and Constant-Murley score(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:GZSYZM combined with fire needling at pain points and"shoulder three ac

关 键 词：肩关节周围炎 桂枝芍药知母汤 火针 激痛点 风寒湿痹 

分 类 号：R2-0[医药卫生—中医学] R22R285.5R2-031R259R684.3R255.6