毫火针针刺结筋病灶点联合Mulligan动态关节松动术治疗僵硬期肩周炎的疗效及对血清5-HT、SP的影响  

Curative Effect of Milli-Fire Needling Focal Point of Knot Tendon Combined with Mulligan Dynamic Joint Mobilization on Periarthritis of Shoulder during Stiff Stage and Its Influence to Serum 5-HT and SP

作　　者：王亚楠[1,2] 孙宏 王秀珍[2] 刘凯[2] 梁国英[1,3] 伊思锐[1] 宋莉坤 张金朋 王喜今 WANG Yanan;SUN Hong;WANG Xiuzhen;LIU Kai;LIANG Guoying;YI Sirui;SONG Likun;ZHANG Jinpeng;WANG Xijin(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China;The First Psychiatric Hospital of Harbin,Harbin 150056,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001 [3]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [4]哈尔滨市第一专科医院,黑龙江哈尔滨150056

出　　处：《针灸临床杂志》2023年第9期39-44,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：全国中医临床特色技术传承骨干人才培训项目,编号:国中医药人教函[2019]36号;中国高等教育学会高等教育信息化发展改革实践研究课题,编号:22XX0414;黑龙江省中医药经典普及化专项课题,编号:ZYW2022-028;孙申田青年人才基金,编号:2020KY-13、2021KY-10。

摘　　要：目的:观察毫火针针刺结筋病灶点联合Mulligan动态关节松动术治疗僵硬期肩周炎的临床疗效及对血清5-羟色胺(5-HT)、P物质(SP)的影响。方法:筛选2021年1月—2022年3月于黑龙江中医药大学附属第二医院诊治的僵硬期肩周炎患者64例,按就诊顺序随机分为对照组(32例,脱落2例)和治疗组(32例,脱落1例)。对照组患者给予常规针刺联合Mulligan动态关节松动术治疗,1次/d。治疗组患者给予毫火针针刺结筋病灶点联合Mulligan动态关节松动术治疗,毫火针隔日1次,Mulligan动态关节松动术1次/d,两组患者疗程均为3周。比较两组患者治疗前后及治疗后1个月随访时的疼痛视觉模拟量表(VAS)评分、Constant-Murley(CMS)评分、健康调查量表(SF-36)评分及血清P物质(SP)、5-羟色胺(5-HT)变化情况和临床疗效。结果:治疗前两组患者的VAS、CMS、SF-36评分及血清SP和5-HT水平比较差异无统计学意义(P>0.05);与治疗前比较,治疗后及治疗后1个月随访时两组患者VAS评分降低明显,CMS、SF-36升高明显,血清SP、5-HT水平均显著下降,差异具有统计学意义(P<0.05),且治疗组患者的各项评分改善的程度更大,血清SP、5-HT水平下降更为显著,明显优于对照组,差异具有统计学意义(P<0.05);与治疗后比较,治疗后1个月随访两组患者VAS、CMS、SF-36评分及血清SP和5-HT水平差异均无统计学意义(P>0.05);治疗组总有效率93.55%(29/31),对照组总有效率76.67%(23/30),治疗组明显高于对照组,差异具有统计学意义(P<0.05)。结论:毫火针针刺结筋病灶点联合Mulligan动态关节松动术治疗僵硬期肩周炎能明显减轻肩关节疼痛,改善肩关节功能,并减少疼痛介质的分泌,临床疗效显著。Objective:To observe the clinical efficacy of milli-fire needling focal point of tendon knot combined with Mulligan dynamic joint mobilization in treatment of periarthritis of shoulder during stiff stage and its influence to serum 5-hydroxytryptamine(5-HT)and substance P(SP).Methods:A total of 64 patients with periarthritis of shoulder during stiff stage were randomly divided into the control group(32 cases,2 cases withdrew)and the treatment group(32 cases,1 case withdrew)according to the order of treatment.The control group was treated with conventional acupuncture combined with Mulligan dynamic joint mobilization,once a day;whereas,the treatment group was treated with milli-fire needling focal point of tendon knot combined with Mulligan dynamic joint mobilization,the milli-fire needling was once every other day and Mulligan dynamic joint mobilization was once a day.The treatment course for both groups was 3 weeks.Visual Analogue Scale(VAS)score,Constant-Murley(CMS)score,Health Survey Scale(SF-36)score,serum SP and 5-HT were compared among before the treatment,after the treatment and during one-month follow-up in the two groups.Clinical efficacy was compared between the two groups.Results:There were no statistical differences in the scores of VAS,CMS and SF-36,as well as in serum levels of SP and 5-HT between the two groups before the treatment(P>0.05);compared with those before the treatment,the score of VAS was decreased significantly,the scores of CMS and SF-36 were increased significantly,and the serum levels of SP and 5-HT were decreased significantly after the treatment and during the one-month follow-up(P<0.05);of which the improvements were more significant in the treatment group than those in the control group(P<0.05).There were no statistical differences in the scores of VAS,CMS and SF-36,as well as in the serum levels of SP and 5-HT between after the treatment and during one-month follow-up in the two groups(P>0.05).The total effective rate was 93.55%(29/31)in the treatment group,which was significant

关 键 词：肩周炎 毫火针 结筋病灶点 动态关节松动术 僵硬期 

分 类 号：R246.2[医药卫生—针灸推拿学]