麻醉下手法松解术联合综合康复治疗对冻结肩患者疼痛及肩关节活动度的影响  

Effect of Manipulation under Anesthesia Combined with Comprehensive Rehabilitation Therapy on Pain and Shoulder Mobility in Patients with Frozen Shoulder

作　　者：贾柯 李勃彤 刘海洋 石艳霞 于鑫 闵建华 张涛 宋国栋 JIA Ke;LI Botong;LIU Haiyang;SHI Yanxia;YU Xin;MIN Jianhua;ZHANG Tao;SONG Guodong(Ningxia Hospital of Integrated Traditional Chinese and Western Medicine,Yinchuan,Ningxia 750021;Yinchuan Hospital of Traditional Chinese Medicine Affiliated to Ningxia Medical University,Yinchuan,Ningxia 750001)

机构地区：[1]宁夏回族自治区中西医结合医院,宁夏银川750021 [2]宁夏医科大学附属银川市中医医院,宁夏银川750000

出　　处：《中医康复》2025年第3期30-34,40,共6页Traditional Chinese Medicine Rehabilitation

基　　金：国家自然科学基金(2019YYZ10);宁夏卫生健康系统科研课题(2024-NWQP-B040);银川市科技创新重点专项(2021-SF-002)。

摘　　要：目的:探讨麻醉下手法松解术联合综合康复治疗对冻结肩疼痛程度及活动度的影响。方法:选取宁夏中西医结合医院于2019年4月~2022年8月收治的冻结肩患者96例,随机分为试验组和对照组各48例。对照组给予综合康复治疗,试验组给予麻醉下手法松解术联合综合康复治疗,分别于治疗前和治疗2周、4周、12周后比较两组患者血清疼痛因子(PGE2、缓激肽、5-HT)水平,以及肩关节功能评分、Constant-Murley评分、VAS评分。结果:治疗2周、4周、12周后,两组PGE2、缓激肽、5-HT水平及VAS评分均下降,内旋、外旋、患侧反手摸背、患手摸耳及Constant-Murley评分均上升(P<0.05),且试验组治疗2周、4周、12周后PGE2、缓激肽、5-HT水平及VAS评分较对照组低,肩功能评分、Constant-Murley评分较对照组高(P<0.05)。结论:麻醉下手法松解术联合综合康复治疗冻结肩疗效显著,可有效降低疼痛因子的表达,明显改善了冻结肩患者肩关节疼痛程度和关节活动度,提高近期、中期治疗效果。Objective:To investigate the effect of manipulation under anesthesia combined with comprehensive rehabilitation therapy on pain and shoulder mobility in patients with frozen shoulder.Methods:A total of 96 patients with frozen shoulder admitted to the hospital from April 2019 to August 2022 were selected and randomly divided into experimental group(n=48)and control group(n=48),the control group was given comprehensive rehabilitation treatment,and the experimental group was given manipulation under anesthesia combined with comprehensive rehabilitation treatment.The levels of serum pain factors(PGE2,bradykinin,5-HT),shoulder joint function score,Constant-Murley score,and visual analogue scale(VAS)score were compared between the two groups before treatment and 2,4,and 12 weeks after treatment.Results:After 2 week,4 weeks and 12 weeks of treatment,the levels of PGE2,bradykinin,5-HT and VAS scores in the two groups decreased,while the scores of internal rotation,external rotation,back touching of the affected hand,ear touching of the affected hand and Constant-Murley scores increased(P<0.05).After 2,4 and 12 weeks of treatment,the levels of PGE2,bradykinin and 5-HT and VAS score in the experimental group were lower than those in the control group,and the shoulder function score and Constant-Murley score were higher than those in the control group(P<0.05).Conclusions:Manipulation under anesthesia combined with comprehensive rehabilitation is effective in the treatment of frozen shoulder,which can effectively reduce the expression of pain factors,significantly improve the degree of shoulder pain and joint mobility of patients with frozen shoulder,and improve the short-term and medium-term treatment effect.

关 键 词：冻结肩、粘连性肩关节囊炎、肩周炎 手法松解 麻醉 综合康复治疗 肩关节活动度 疼痛 PGE2 缓激肽 5-HT 

分 类 号：R684.3[医药卫生—骨科学]