超声引导下针刀松解联合肩峰下封闭注射治疗肩峰下撞击综合征的疗效观察  

Clinical Effect of Ultrasound-guided Needle-Knife Loosening Combined with Subacromial Injection in Treatment of Subacromial Impingement Syndrome

作　　者：尚祥 丁双 赵汉卿 耿凯 刘存斌 杨永晖[3] SHANG Xiang;DING Shuang;ZHAO Hanqing;GENG Kai;LIU Cunbin;YANG Yonghui(Graduate School of Anhui University of Chinese Medicine,Anhui Hefei 230012,China;Anhui Hospital Affiliated to Shuguang Hospital of Shanghai University of Traditional Chinese Medicine,Anhui Hefei 230031,China;The Second Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230061,China)

机构地区：[1]安徽中医药大学研究生院,安徽合肥230012 [2]上海中医药大学附属曙光医院安徽医院,安徽合肥230031 [3]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《安徽中医药大学学报》2025年第1期57-61,共5页Journal of Anhui University of Chinese Medicine

基　　金：国家自然科学基金项目(81774436);“十四五”省级中医优势特色专科项目(皖中医药服务秘〔2021〕71号);安徽省名中医及基层名中医工作室建设项目(中发展〔2022〕5号)。

摘　　要：目的观察超声引导下针刀松解联合肩峰下封闭注射治疗肩峰下撞击综合征(subacromial impingement syndrome,SIS)的临床疗效。方法将60例SIS患者按照随机数字表法分为观察组和对照组,每组30例。对照组采用超声引导下肩峰下封闭注射治疗,观察组在对照组治疗基础上再行超声引导下针刀松解治疗,两组患者均每周治疗1次,共治疗4周。采用Constant-Murley评分(Constant-Murley score,CMS)评价肩关节功能,采用肩峰指数(acromion index,AI)评价肩峰与肱骨头的位置关系,采用最短肩肱间距(acromion humeral distance,AHD)评价肩峰下间隙大小,基于CMS评分判定临床疗效。结果在提高CMS各维度评分、CMS总分、肩关节外展60°时AHD,以及降低AI方面,观察组显著优于对照组(P<0.05);观察组临床疗效显著优于对照组(P<0.05)。结论超声引导下针刀松解联合肩峰下封闭注射能够显著减轻SIS患者的疼痛,改善肩关节活动度,其疗效优于单纯肩峰下封闭注射治疗。Objective To investigate the clinical effect of ultrasound-guided needle-knife loosening combined with subacromial injection in the treatment of subacromial impingement syndrome(SIS).Methods A total of 60 patients with SIS were randomly divided into observation group and control group using a random number table,with 30 patients in each group.The patients in the control group received ultrasound-guided subacromial injection,while those in the observation group underwent ultrasound-guided needle-knife loosening in addition to the treatment in the control group,once a week for 4 weeks.Constant-Murley score(CMS)was used to evaluate shoulder joint function;acromion index(AI)was used to evaluate the positional relationship between the acromion and humeral head;acromion-humeral distance(AHD)was used to evaluate subacromial space;clinical outcome was assessed based on CMS.Results Compared with the control group,the observation group had significantly greater increases in the scores of each dimension of CMS,total CMS score,and AHD at 60°abduction and a significantly greater reduction in AI(P<0.05).The observation group had a significantly better clinical outcome than the control group(P<0.05).Conclusion Ultrasound-guided needle-knife loosening combined with subacromial injection can significantly alleviate pain and improve the range of motion of shoulder joint in patients with SIS,with a better clinical effect than subacromial injection alone.

关 键 词：肩峰下撞击综合征 针刀 肩峰指数 超声引导 最短肩肱间距 

分 类 号：R686[医药卫生—骨科学] R246[医药卫生—外科学]