肌骨超声引导下针刀联合郑氏手法治疗粘连期肩周炎的临床疗效观察  

Observation on the clinical efficacy of acupotomy under the guidance of musculoskeletal ultrasound combined with Zheng's manipulation in the treatment of frozen shoulder at the adhesion stage

作　　者：王标[1] 唐浩琛[1] 胡锐 刘太[1] 罗小兵[1] WANG Biao;TANG Hao-chen;HU Rui;LIU Tai;LUO Xiao-bing(Sichuan Province Orthopedic Hospital,Chengdu 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《实用医院临床杂志》2025年第2期130-134,共5页Practical Journal of Clinical Medicine

基　　金：四川省中医药管理局科学技术研究专项课题(编号:2020LC0183)。

摘　　要：目的探讨肌骨超声引导下针刀联合郑氏手法治疗粘连期肩周炎的临床疗效。方法选取2021年1月至2022年8月我院收治的172例肩周炎患者,按照随机数字表法分为传统针刀组和超声引导针刀组各86例,两组患者均行肩周痛点的针刀治疗1次/周,连续2周,超声引导针刀组在肌骨超声引导下定位进针治疗后联合郑氏手法治疗。治疗前、治疗2周以及治疗1个月时测量两组患者的肩关节活动度,采用视觉模拟评分法(VAS)、肩关节功能评分(Constant-Murley)量表对肩关节疼痛及功能改善进行量化评估,并随访6个月。结果两组患者均完成全部治疗及随访,超声引导针刀组有效率98.83%(85/86),明显高于传统针刀组有效率90.70%(78/86)(P<0.05);两组治疗后2周、治疗1月后VAS及Constant-Murley评分以及肩关节活动度改善均优于治疗前,且超声引导针刀组显著优于传统针刀组(P<0.05)。结论采用肌骨超声引导下针刀联合郑氏手法治疗粘连期肩周炎能达到可视化精准进针治疗,避免盲区操作,配合传统郑氏手法松解,有效改善肩关节活动度并减轻疼痛,促进患者肩关节功能恢复,是一种安全有效且精准的针刀综合治疗方法。Objective To explore the clinical effectiveness of musculoskeletal ultrasound-guided acupotomy combined with Zheng’s massage for adhesive periarthritis.Methods A total of 172 patients with shoulder periarthritis in our hospital from January 2021 to August 2022 were selected.The patients were divided into a traditional acupotomy group and an ultrasound-guided acupotomy group according to the random number table method,86 in each group.Both groups received acupotomy at pain points around their shoulders for two weeks,once per week.The ultrasound-guided acupotomy group received musculoskeletal ultrasound-guided acupotomy combined with immediate postoperative Zheng’s massage.The shoulder joint mobility of the two groups of patients was measured before treatment and after 2 weeks and 1 month of treatment.The visual analog scale(VAS)and shoulder joint function score(Constant-Murley)were used to evaluate shoulder joint pain and functional improvement.The patients were followed-up for 6 months.Results Both groups completed the treatment and the follow-up.The total effective rate of the ultrasound-guided acupotomy group was 98.83%(85/86),which was significantly higher than 90.70%(78/87)of the traditional acupotomy(P<0.05).The VAS score,Constant-Murley score and range of motion of shoulder joints of both groups after two weeks and one month of treatment were all better than those before treatment and the ultrasound-guided acupotomy was better than the traditional acupotomy group(P<0.05).Conclusions Using musculoskeletal ultrasound-guided acupotomy combined with Zheng's manipulation to treat frozen shoulder at the adhesion stage can achieve visual and precise acupuncture treatment and avoid blind area operations.The combination with postoperative Zheng’s message effectively improves the range of motion of shoulder joints,reduces the pain and promotes the recovery of shoulder joint function.It is a safe,effective and precise comprehensive acupotomy treatment method.

关 键 词：肌骨超声 肩周炎 针刀 郑氏手法 肩关节功能 

分 类 号：R245-33[医药卫生—针灸推拿学]