补肾蠲痹汤联合针刺治疗冻结肩患者的临床疗效及对其血清转化生长因子-β1、前列腺素E2的影响  

Clinical Curative Effect of Bushen Juanbi Decoction Combined with Acupuncture and Its Influences on Serum Transforming Growth Factor-β1 and Prostaglandin E2 in Patients with Frozen Shoulder

作　　者：周晓东 侯丽娟 张艺凡 王康 刘丽华 董蒙蒙 ZHOU Xiao-dong;HOU Li-juan;ZHANG Yi-fan;WANG Kang;LIU Li-hua;DONG Meng-meng(Shijiazhuang People's Hospital,Shijiazhuang Hebei 050000;The First Affiliated Hospital of Hebei University of Chi-nese Medicine/Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei 050000)

机构地区：[1]石家庄市人民医院,河北石家庄050000 [2]河北中医药大学第一附属医院/河北省中医院,河北石家庄050000

出　　处：《世界中西医结合杂志》2024年第11期2217-2221,2227,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局计划项目(2022483)。

摘　　要：目的探究补肾蠲痹汤联合针刺治疗冻结肩(Frozen shoulder,FS)患者的临床疗效及对其血清转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、前列腺素E_(2)(Prostaglandin E_(2),PGE_(2))的影响。方法选取2021年10月—2023年10月期间石家庄市人民医院收治的120例辨证属寒湿痹阻证FS患者,按随机数字表法分为对照组和试验组,每组各60例。对照组予以口服双氯芬酸钠治疗,试验组予以补肾蠲痹汤联合针刺治疗,两组患者均持续治疗4周。比较两组患者临床疗效,治疗前后中医证候评分、血清炎症指标[转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、前列腺素E_(2)(Prostaglandin E_(2),PGE_(2))、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子α(Tumor necrosis factor-α,TNF-α)]、肩关节恢复情况[疼痛视觉模拟评分(Visual analog scale,VAS)、Constant-Murley肩关节功能评定量表(Constant-Murleyscale,CMS)]、不良反应发生率和复发率的差异。结果治疗后试验组临床总有效率95.00%(57/60)高于对照组80.00%(48/60),差异有统计学意义(P<0.05)。治疗后两组患者各中医证候评分均较治疗前降低,差异有统计学意义(P<0.05);且试验组中医证候评分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者TGF-β1、PGE_(2)、CRP、TNF-α水平均较治疗前降低,差异有统计学意义(P<0.05);且试验组血清炎症指标低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者VAS评分较治疗前降低,CMS各维度评分均较治疗前升高,差异有统计学意义(P<0.05);且试验组VAS评分低于对照组,CMS各维度评分高于对照组,差异有统计学意义(P<0.05)。两组患者不良反应和复发率比较,差异有统计学意义(P<0.05)。结论补肾蠲痹汤联合针刺治疗风寒湿痹证FS患者的效果显著,能有效改善中医证候,降低血清炎症因子水平,促进肩关节功能恢复,提高自理能力,且安全性高,复发率低。Objective To explore the clinical curative effect of Bushen Juanbi Decoction combined with acupuncture and its influences on serum transforming growth factor-β1(TGF-β1)and prostaglandin E_(2)(PGE_(2))in patients with frozen shoulder(FS).Methods According to the random number table method,120 patients with FS(cold-dampness obstruction syndrome)admitted to Shijiazhuang People's Hospital between October 2021 and October 2023 were divided into a control group(60 cases)and an experimental group(60 cases).The control group was treated with oral diclofenac sodium,while the experimental group was treated with Bushen Juanbi Decoction and acupuncture.The two groups were both treated for 4 weeks.The clinical curative effect was compared between the two groups.In addition,comparison was also performed on the traditional Chinese medicine(TCM)syndrome scores,serum inflammatory indexes[TGF-β1,PGE_(2),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)],shoulder joint recovery[visual analog scale(VAS)and Constant-Murley scale(CMS)],incidence of adverse reactions,and recurrence rate.Results After treatment,the total clinical effective rate of the experimental group was higher than that of the control group[95.00%(57/60)vs 80.00%(48/60),P<0.05].After treatment,TCM syndrome scores were decreased in both groups(P<0.05),which were lower in the experimental group than in the control group(P<0.05).After treatment,the levels of TGF-β1,PGE_(2),CRP,and TNF-αwere decreased in both groups(P<0.05),which were lower in the experimental group than in the control group(P<0.05).After treatment,the VAS scores were decreased in both groups(P<0.05),which were lower in the experimental group than in the control group(P<0.05).Additionally,the CMS scores were increased after treatment(P<0.05),which were higher in the experimental group than in the control group(P<0.05).There were significant differences in the incidence of adverse reactions and the recurrence rate between the two groups(P<0.05).Conclusion The curative effect of Bushen Jua

关 键 词：冻结肩 补肾蠲痹汤 针刺 双氯芬酸钠 血清指标 

分 类 号：R245.31[医药卫生—针灸推拿学] R364.5[医药卫生—中医临床基础]