魏氏验方联合双氯芬酸钠治疗冻结期肩周炎的效果及免疫-炎症机制  

Effect and Immune-inflammatory Mechanism of Wei's Proved Recipes Combined with Diclofenac Sodium in the Treatment of Frozen Periarthritis of Shoulder

作　　者：刘涛[1] 薛彬[1] 奚小冰[1] 张昊[1] LIU Tao;XUE Bin;XI Xiaobing;ZHANG Hao(Department of Orthopedics and Traumatology,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院伤科,上海200025

出　　处：《临床误诊误治》2023年第10期143-148,共6页Clinical Misdiagnosis & Mistherapy

基　　金：上海市临床重点专科建设项目(shslczdzk04802)。

摘　　要：目的探讨魏氏验方联合双氯芬酸钠治疗冻结期肩周炎的效果及免疫-炎症机制。方法选取2020年1月—2022年6月收治的120例冻结期肩周炎为研究对象,随机数字表法分为对照组和研究组,每组60例。对照组采取双氯芬酸钠治疗,研究组采取魏氏验方(伸筋活血汤+痹通洗方)联合双氯芬酸钠治疗,连续治疗3个月。观察对比2组中医疗效、中医证候积分、免疫-炎症相关指标[粒细胞-巨噬细胞集落刺激因子(GM-CSF)、白细胞介素-10(IL-10)、IL-6、肿瘤坏死因子-α(TNF-α)]、疼痛因子[前列腺素E_(2)(PGE_(2))、β内啡肽(β-EP)]、肩关节功能相关指标及不良反应发生情况。结果治疗3个月后,研究组治疗总有效率90.00%(54/60)高于对照组75.00%(45/60)(P<0.05)。治疗1、3个月后,2组关节疼痛、肿胀、沉重、畏寒积分以及血清GM-CSF、IL-10、IL-6、TNF-α、PGE_(2)水平均低于治疗前,且研究组低于对照组(P<0.05)。治疗1、3个月后,2组肩关节被动及主动状态前屈和外展活动度、MMT评分、Constant-Murley评分、血清β-EP水平均高于治疗前,且研究组高于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论魏氏验方联合双氯芬酸钠能减轻冻结期肩周炎患者炎症反应,缓解疼痛,改善临床症状及肩关节功能,且效果确切、安全性高。Objective To explore the effect and immune-inflammatory mechanism of Wei's proved recipes combined with Diclofenac Sodium in the treatment of frozen periarthritis of shoulder.Methods A total of 120 patients with frozen periarthritis of shoulder treated from January 2020 to June 2022 were selected as the research subjects,and were divided into control group and research group by random number table method,with 60 cases in each group.The control group was treated with Diclofenac Sodium,and the research group was treated with Wei's proved recipes(Shenjin Huoxue Decoction+Bitong lotion)combined with Diclofenac Sodium for three months.The TCM efficacy,TCM syndrome scores,immune-inflammation related indexes[granulocyte-macrophage colony-stimulating factor(GM-CSF),interleukin-10(IL-10),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],pain factors[prostaglandin E_(2)(PGE_(2)),β-endorphin(β-EP)]and shoulder function-related indexes and occurrence of adverse reactions of the two groups were observed and compared.Results At 3 months after treatment,the total effective rate of the research group was 90.00%(54/60),which was higher than that of the control group[75.00%(45/60)](P<0.05).At 1 and 3 months after treatment,joint pain,swelling,heaviness,chills scores and serum levels of GM-CSF,IL-10,IL-6,TNF-αand PGE_(2) in the two groups were lower than those before treatment,and lower in the research group than in the control group(P<0.05).At 1 and 3 months after treatment,passive and active shoulder flexion and abduction motion,MMT score,Constant-Murley score and serumβ-EP level in the two groups were higher than those before treatment,and higher in the research group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Combined with Diclofenac Sodium,Wei's proved recipes can relieve inflammation,relieve pain,improve clinical symptoms and shoulder joint function in patients with frozen periarthritis of shoulder,with accurate

关 键 词：肩周炎 魏氏验方 双氯芬酸钠 证候 粒细胞-巨噬细胞集落刺激因子 白细胞介素-10 前列腺素E_(2) Β内啡肽 

分 类 号：R684.3[医药卫生—骨科学]