魏氏伤科“肩六步”手法结合导引治疗冻结肩的临床研究  

Clinical Study of Combining“Six-Step Shoulder Manipulation”of Wei's Traumatology with Daoyin Exercise to Treat Frozen Shoulders

作　　者：李辉 刘涛[2] 胡大佑[2] LI Hui;LIU Tao;HU Dayou(Jing'an District Zhabei Central Hospital,Shanghai 200070,China;Ruijing Hospital Affiliated to Shanghai Jiao Tong Univercity School of Medicine,Shanghai 200025,China)

机构地区：[1]上海市静安区闸北中心医院,上海200070 [2]上海交通大学医学院附属瑞金医院

出　　处：《中国中医骨伤科杂志》2024年第8期7-12,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：2021年上海市静安区医学科研课题(中医2021ZY03)。

摘　　要：目的:观察魏氏伤科“肩六步”手法结合导引治疗冻结肩的临床疗效。方法:选取冻结肩患者120例,随机分成三组,即手法结合导引组(结合组)、手法组、导引组,每组各40例。比较三组患者治疗前、治疗后第4周和第8周疼痛视觉模拟量表(VAS)评分、Constant-Murley肩关节功能量表(CMS)评分、肩关节活动度(ROM)变化,评价三组患者治疗后总体疗效。结果:110例患者完成全部治疗及随访。治疗前三组患者疼痛VAS评分、CMS评分及肩关节活动度差异无统计学意义(P>0.05)。治疗后第4周,疼痛VAS评分结合组与手法组比较差异无统计学意义(P>0.05),结合组VAS评分显著小于导引组,差异有统计学意义(P<0.05);CMS评分结合组显著大于手法组和导引组,差异有统计学意义(P<0.05)。肩关节活动度比较:前屈、后伸、外展、外旋活动结合组与手法组差异无统计学意义(P>0.05);结合组显著大于导引组,差异有统计学意义(P<0.05);内收、内旋结合组与手法组和导引组差异无统计学意义(P>0.05)。治疗后第8周,结合组疼痛VAS评分显著低于手法组和导引组,差异有统计学意义(P<0.001),VAS评分手法组显著低于导引组,差异有统计学意义(P<0.05);CMS评分结合组显著高于手法组和导引组,差异有统计学意义(P<0.05),CMS评分手法组显著高于导引组,差异有统计学意义(P<0.001)。肩关节活动度比较,结合组显著大于手法组及导引组,差异有统计学意义(P<0.001)。三组疗效比较:总体疗效三组差异有统计学意义(P<0.05),两两比较结合组优于手法组和导引组(P<0.05),手法组与导引组比较差异无统计学意义(P>0.05)。结论:魏氏伤科“肩六步”手法结合导引能更快速有效治疗冻结肩,改善肩关节的整体功能。Objective:To observe the clinical efficacy of combining“Six-Step Shoulder Manipulation”of Wei's traumatology with Daoyin exercise on the treatment of stiffened frozen shoulders.Methods:120patients with frozen shoulders were selected and randomly divided into three groups,i.e.the manipulation combined with Daoyin exercise group(combination group),the manipulation group and the Daoyin exercise group.40patients were included in each group in the clinical trial.The visual analogue scale(VAS)pain simulation score,shoulder functional evaluation(Constant-Murley shoulder function scale(CMS))score,range of motion(ROM),and overall efficacy evaluation were used in this study.The VAS pain simulation score and CMS score were compared among the three groups at pre-treatment and at 4and 8weeks post-treatment.The overall efficacy was evaluated at 8 weeks posttreatment.Results:110patients completed all treatment and follow-up.Prior to treatment initiation,the three groups displayed no significant differences in pain VAS scores,shoulder joint function(as measured by CMS),or range of shoulder joint motion(P>0.05).At 4weeks after treatment,there was no significant difference in pain VAS scores between the combination group and the manipulation group(P>0.05),and the VAS scores of combination group was significantly smaller than those of the Daoyin exercise group(P<0.05).Significant improvements were noted across all groups in terms of shoulder joint function.Notably,the combination group experienced superior outcomes compared to both the manipulation and Daoyin exercise groups(P<0.05).Regarding range of motion,no significant disparity was found between the combination and manipulation groups in flexion,extension,abduction,and external rotation(P>0.05).However,the combination group exhibited significantly greater enhancements than the Daoyin exercise group in these same movements(P<0.05).Adduction and internal rotation did not show any significant difference when the combination group was compared with the manipulation and Daoyin

关 键 词：冻结肩 魏氏伤科 手法 导引 

分 类 号：R684.3[医药卫生—骨科学]