冈上肌腱损伤疼痛及影响因素与肩部经络循行相关性研究  

Study on the Correlation between Pain of Supraspinatus Tendon Injury and Its Influencing Factors and Meridian Circulation of Shoulder

作　　者：耿启砥 蒋永东 高世华 陈亮 吴宇峰 GENG Qidi;JIANG Yongdong;GAO Shihua;CHEN Liang;WU Yufeng(Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine,Zhongshan 528400,Guangdong,China)

机构地区：[1]广州中医药大学附属中山中医院,广东中山528400

出　　处：《辽宁中医药大学学报》2025年第2期166-175,共10页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：广东省基础与应用基础研究基金企业联合基金项目(2021A1515220133)。

摘　　要：目的 通过观察冈上肌腱损伤患者的疼痛部位,基于“以痛为腧”理论对冈上肌腱损伤进行经络分型,对不同肩部经络分型下的冈上肌腱损伤疼痛的相关因素进行统计学分析,为冈上肌腱损伤患者的治疗提供参考。方法 研究采用前瞻性试验方案,选择2023年1月—2023年12月在广州中医药大学附属中山中医院关节科住院符合纳入标准的120例冈上肌腱损伤患者。对纳入的冈上肌腱患者的性别、年龄、职业、外伤史、病史长短、患侧、撕裂程度、Patte分级、有无滑膜增生、Ellman分型、疼痛特征(疼痛性质、疼痛时间、疼痛部位、疼痛程度等)、穴位压痛、中医证型等信息进行调查,基于“以痛为腧”理论,根据疼痛部位(压痛点、穴位压痛)来判定患者冈上肌腱损伤经络分型,并根据患者症状、体征、舌脉等来判定患者冈上肌腱损伤的中医证型,统计分析结果,得出结论。数据录入、分析、处理使用Excel2016和SPSS 26.0软件。结果 单因素分析:性别、年龄、中医证型可能与手太阴肺经型冈上肌腱损伤存在相关性(P<0.2);性别、是否合并糖尿病、撕裂程度、疼痛昼夜变化、疼痛诱发因素与手太阳大肠经型冈上肌腱损伤存在显著相关性(P<0.05);中医证型与手少阳三焦经型冈上肌腱损伤存在显著相关性(P<0.05);疼痛性质、疼痛昼夜变化与手太阳小肠经型冈上肌腱损伤存在显著相关性(P<0.05)。多因素分析:性别(男)、有合并糖尿病、活动和劳累与手阳明大肠经型冈上肌腱损伤相关(P<0.05);中医证型和疼痛昼夜变化与手少阳三焦经型冈上肌腱损伤相关(P<0.05);疼痛性质与手太阳小肠经型冈上肌腱损伤相关(P<0.05)。而年龄、职业、外伤史、病程、有无回缩、损伤分型、有无滑膜增生等因素对不同经络分型下冈上肌腱损伤的疼痛影响不明显。结论 不同经络分型下的冈上肌腱损伤的疼痛与性�Objective By collecting the general data and pain information of supraspinatus tendon injury,the pain sites(tender points and acupoints)of the patients with supraspinatus tendon injury were summarized,and the meridian classification of supraspinatus tendon injury was determined based on the theory of“pain-point needling”.Correlation analysis was made between supraspinatus tendon injury under different classification types and the included factors to determine the relevant factors affecting the pain of supraspinatus tendon injury.To provide the basis for clinical treatment of supraspinatus tendon injury.Methods A prospective trial scheme was used to select 120 patients with supraspinatus tendon injury who met the inclusion criteria in the department of arthrosis,Zhongshan hospital of traditional Chinese medicine affiliated to Guangzhou university of Chinese medicine from January 2023 to December 2023.Gender,age,occupation,trauma history,length of medical history,affected side,tearing degree,Patte grade,presence or non-synovial hyperplasia,Ellman classification,pain characteristics(pain nature,pain time,pain location,pain degree,etc.),acupoint pressure,TCM syndrome type and other information of supraspinatus tendon patients were investigated.Based on“pain-point needling”and according to the pain site(tenderness point,acupoint tenderness)to determine the meridian of the shoulder,do correlation analysis around the shoulder meridian,statistical results,the conclusion is that data entry,analysis,processing using Excel2016 and SPSS 26.0 software.Results Univariate analysis:Gender,age,TCM syndrome type may be correlated with supraspinatus tendon injury of hand Taiyin lung meridian type(P<0.2);There were significant correlations between gender,diabetes mellitus,tearing degree,diurnal variation of pain,pain inducing factors and supraspinatus tendon injury of hand Taiyang large intestine meridian type(P<0.05).There was significant correlation between TCM syndrome type and supraspinatus tendon injury of hand Shaoyang

关 键 词：冈上肌腱损伤 疼痛 经络循行 以痛为腧 

分 类 号：R224[医药卫生—中医基础理论]