低剂量类固醇激素联合玻璃酸钠治疗粘连性肩关节囊炎的临床效果  

Clinical effect of low-dose steroid hormone combined with sodium hyaluronate in the treatment of adhesive capsulitis of shoulder joint

作　　者：马小松[1] 李朋斌[1] 西立峰[1] MA Xiaosong;LI Pengbin;XI Lifeng(Orthopaedics Department,Yellow River Sanmenxia Hospital,Sanmenxia 472000,China)

机构地区：[1]黄河三门峡医院骨科,河南三门峡472000

出　　处：《临床医学研究与实践》2024年第21期66-69,共4页Clinical Research and Practice

摘　　要：目的比较低剂量类固醇激素、高剂量类固醇激素及低剂量类固醇激素联合玻璃酸钠治疗粘连性肩关节囊炎的效果。方法选取2020年12月至2021年12月我科收治的60例粘连性肩关节囊炎患者为研究对象,采用随机数字表法将其分为低剂量组、高剂量组和联合组,各20例。低剂量组给予关节腔内注射0.5 mL复方倍他米松注射液,高剂量组给予关节腔内注射1 mL复方倍他米松注射液,联合组给予关节腔内注射0.5 mL复方倍他米松注射液联合2.5 mL玻璃酸钠。比较三组的治疗效果。结果治疗后2、4、8、16周,三组的视觉模拟评分法(VAS)、肩关节疼痛与功能障碍指数(SPADI)评分低于治疗前(P<0.05);治疗后2、4、8、16周,联合组的VAS、SPADI评分低于低剂量组(P<0.05);治疗后2、4、8、16周,联合组和高剂量组的VAS、SPADI评分无明显差异(P>0.05)。治疗后2、4、8、16周,三组的肩关节外展活动度及肩关节外旋活动度大于治疗前(P<0.05);治疗后2、4、8、16周,三组的肩关节外展活动度及肩关节外旋活动度无明显差异(P>0.05)。结论低剂量类固醇激素联合玻璃酸钠可以缓解粘连性肩关节囊炎患者的疼痛,改善关节功能,其效果与高剂量类固醇激素相当,优于低剂量类固醇激素。Objective To compare the effects of low-dose steroid hormone,high-dose steroid hormone and low-dose steroid hormone combined with sodium hyaluronate in the treatment of adhesive capsulitis of shoulder joint.Methods A total of 60 patients with adhesive capsulitis of shoulder joint admitted in our department from December 2020 to December 2021 were selected as the research objects.The patients were divided into low-dose group,high-dose group and combined group by random number table method,with 20 cases in each group.The low-dose group was given intra-articular injection of 0.5 mL compound betamethasone injection,the high-dose group was given intra-articular injection of 1 mL compound betamethasone injection,and the combined group was given intra-articular injection of 0.5 mL compound betamethasone injection combined with 2.5 mL sodium hyaluronate.The therapeutic effects of the three groups were compared.Results At 2,4,8 and 16 weeks after treatment,the scores of Visual Analogue Scale(VAS)and Shoulder Pain and Disability Index(SPADI)in the three groups were lower than those before treatment(P<0.05);at 2,4,8 and 16 weeks after treatment,the VAS and SPADI scores of the combined group were lower than those of the low-dose group(P<0.05);at 2,4,8 and 16 weeks after treatment,there were no significant differences in VAS and SPADI scores between the combined group and the high-dose group(P>0.05).At 2,4,8 and 16 weeks after treatment,the shoulder abduction activity and shoulder external rotation activity of the three groups were greater than those before treatment(P<0.05);at 2,4,8 and 16 weeks after treatment,there were no significant differences in shoulder abduction activity and shoulder external rotation activity among the three groups(P>0.05).Conclusion Low-dose steroids hormone combined with sodium hyaluronate can relieve pain and improve joint function in patients with adhesive capsulitis of shoulder joint,the effect is equivalent to high-dose steroids hormone and better than low-dose steroids hormone.

关 键 词：粘连性肩关节囊炎 关节内注射 类固醇 玻璃酸钠 

分 类 号：R684.3[医药卫生—骨科学]