身痛逐瘀汤加味辅以推拿疗法治疗慢性肩周炎疗效及对缓激肽、白细胞介素-1β变化的研究  

Changes of Bradykinin and Interleukin-1βin Patients with Chronic Frozen Shoulder Treated with Modified Shentong Zhuyu Decoction(身痛逐瘀汤加味)Assisting Tuina Therapy

作　　者：虞隽[1] 蒉文筠 薛纯纯[1] 谷桢[1] 谢磊[1] 黄爱苹[1] 孔舒祎 王开强[1] YU Jun;KUI Wenjun;XUE Chunchun;GU Zhen;XIE Lei;HUANG Aiping;KONG Shuyi;WANG Kaiqiang(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071

出　　处：《中华中医药学刊》2025年第2期88-91,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81804122);上海市科技计划项目(20Y21903100)。

摘　　要：目的研究身痛逐瘀汤加味辅以推拿疗法治疗慢性肩周炎疗效及对患者缓激肽(Bradykinin,BK)、白细胞介素-1β(Interleukin-1β,IL-1β)的变化影响。方法选取2022年5月—2023年4月上海中医药大学附属市中医医院收治的100例慢性肩周炎患者,以随机数字法分为推拿组和身痛逐瘀汤组。推拿组给予推拿疗法治疗,身痛逐瘀汤组在推拿疗法基础上给予身痛逐瘀汤加味治疗,分析两组的临床效果。结果身痛逐瘀汤组总有效率96.00%(48/50)高于推拿组84.00%(42/50),差异有统计学意义(P<0.05)。治疗前,推拿组和身痛逐瘀汤组BK、5-羟色胺(5-Hydroxytryptamine,5-HT)、炎症因子比较,差异无统计学意义(P>0.05)。推拿组和身痛逐瘀汤组BK、白细胞介素-18(Interleukin-18,IL-18)、5-HT、IL-1β、白细胞介素-32(Interleukin-32,IL-32)、粒细胞-巨噬细胞集落刺激因子(Granulocyte macrophage colony stimulating factor,GM-CSF)较前降低(P<0.05),身痛逐瘀汤组较推拿组更低(P<0.05)。治疗前,推拿组和身痛逐瘀汤组McGill疼痛问卷评分、美国肩肘外科医师评分(ASES)评分比较,差异无统计学意义(P>0.05)。推拿组和身痛逐瘀汤组McGill评分较前降低(P<0.05),身痛逐瘀汤组较推拿组更低(P<0.05)。推拿组和身痛逐瘀汤组美国肩肘外科医师评分(American Shoulder and Elbow Surgeons’Form,ASES)较前降低(P<0.05),身痛逐瘀汤组较推拿组更高(P<0.05)。结论身痛逐瘀汤加味辅以推拿疗法治疗慢性肩周炎可降低BK、5-HT及炎症因子的表达,提高生活能力。Objective To study the effect of Modified Shentong Zhuyu Decoction(身痛逐瘀汤加味)assisting Tuina therapy for chronic frozen shoulder on the changes of bradykinin(BK)and interleukin-1β(IL-1β)in patients.Methods One hundred patients with chronic frozen shoulder admitted to the Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from May 2022 to April 2023 were selected,and were divided into the Tuina group and the Modified Shentong Zhuyu Decoction group by the randomized numerical method.The Tuina group was treated with Tuina therapy,and the Modified Shentong Zhuyu Decoction group was treated with Modified Shentong Zhuyu Decoction on the basis of Tuina therapy,and the clinical effects of the two groups were analyzed.Results The total effective rate was 96.00%(clinical cure rate 28.00%+significant effect rate 42.00%+effective rate 26.00%)in the Modified Shentong Zhuyu Decoction group was higher than that(84.00%)(clinical cure rate 18.00%+significant effect rate 36.00%+effective rate 30.00%)in the Tuina group,with a significant difference(P<0.05).Before treatment,there was no difference in bradykinin(BK),5-hydroxytryptamine(5-HT)or inflammatory factors between the Tuina group and the Modified Shentong Zhuyu Decoction group(P>0.05).The levels of BK,interleukin-18(IL-18),5-HT,IL-1β,interleukin-32(IL-32)and granulocyte-macrophage colony-stimulating factor(GM-CSF)were lower in the Tuina and Modified Shentong Zhuyu Decoction groups compared with those before treatment(P<0.05),and they were lower in the Modified Shentong Zhuyu Decoction group compared with those in the Tuina group(P<0.05).Before treatment,there was no difference between the McGill Pain Questionnaire score and American Shoulder and Elbow Surgeons'Score(ASES)in the Tuina group and the Modified Shentong Zhuyu Decoction group(P>0.05).McGill scores were lower in the Tuina and Modified Shentong Zhuyu Decoction groups than those before treatment(P<0.05),and lower in the Modified

关 键 词：身痛逐瘀汤加味 推拿疗法 慢性肩周炎 缓激肽 炎症因子 

分 类 号：R274.39[医药卫生—中医骨伤科学]