针刀松解疗法联合类固醇注射治疗冻结肩的临床效果  

Clinical effect of needle-knife release therapy combined with steroid injection on frozen shoulder

作　　者：张朝鸣[1,2] 侯军杰[1,2] 傅楚滢 王海杰 刘艳[1,2] ZHANG Chaoming;HOU Junjie;FU Chuying;WANG Haijie;LIU Yan(The Eighth Clinical Medical College,Guangzhou University of Chinese Medicine,Guangdong Province,Foshan 528000,China;Department of Orthopedics,Foshan Hospital of Traditional Chinese Medicine,Guangdong Province,Foshan 528000,China;Department of Ultrasound,Foshan Hospital of Traditional Chinese Medicine,Guangdong Province,Foshan 528000,China)

机构地区：[1]广州中医药大学第八临床医学院,广东佛山528000 [2]广东省佛山市中医院骨伤科,广东佛山528000 [3]广东省佛山市中医院超声科,广东佛山528000

出　　处：《中国当代医药》2025年第7期65-70,共6页China Modern Medicine

基　　金：全国名老中医药专家传承工作室钟广玲名医工作室(国中医药人教函〔2018〕134号);广东省佛山市卫生健康局医学科研课题(20220446)。

摘　　要：目的探讨针刀关节外松解术联合肩关节内类固醇注射治疗冻结肩的临床效果,以期为冻结肩的治疗提供一种有效的综合治疗方案。方法选取2022年1月至2023年6月佛山市中医院收治的62例冻结肩患者作为研究对象,按照随机数字法分为观察组(31例)和对照组(31例)。观察组采用针刀松解术联合肩关节内类固醇注射治疗,对照组仅接受肩关节内类固醇注射治疗。治疗后,两组患者均接受相同的康复锻炼方案。采用视觉模拟评分法(VAS)和Constant-Murley肩关节评分评价患者的疼痛和功能活动,同时使用超声影像检查评估肩关节组织结构的变化。结果两组患者治疗后3、12周的VAS评分均低于本组治疗前,差异有统计学意义(P<0.05);观察组治疗后3周VAS评分低于对照组,差异有统计学意义(P<0.05);两组患者治疗后12周VAS评分比较,差异无统计学意义(P>0.05)。两组患者治疗后3、12周的Constant-Murley评分均高于本组治疗前,差异有统计学意义(P<0.05);观察组治疗后3周Constant-Murley评分高于对照组,差异有统计学意义(P<0.05);两组患者治疗后12周Constant-Murley评分比较,差异无统计学意义(P>0.05)。两组患者治疗后12周的喙肱韧带(CHL)最大厚度及后方盂肱关节囊(PGJC)最大厚度均小于本组治疗前,差异有统计学意义(P<0.05);两组患者治疗后12周CHL最大厚度及PGJC最大厚度比较,差异无统计学意义(P>0.05)。结论针刀关节外松解术联合肩关节内类固醇注射治疗冻结肩能更快缓解疼痛并改善关节功能,是一种有效的综合治疗方案。Objective To investigate the clinical effect of needle-knife external articular release combined with intra-articular steroid injection in the treatment of frozen shoulder,in order to provide an effective comprehensive treatment plan for the treatment of frozen shoulder.Methods A total of 62 patients with frozen shoulder treated in Foshan Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were selected as the study objects and they were divided into observation group(31 cases)and control group(31 cases)according to random number method.The observation group was treated with needle-knife and intra-articular steroid injection,while the control group was treated with intra-articular steroid injection only.After treatment,both groups received the same rehabilitation exercise regimen.Visual analogue scale(VAS)and Constant-Murley shoulder joint score were used to evaluate the pain and functional activities of patients,while ultrasound imaging was used to evaluate the structural changes of shoulder joints.Results The VAS scores of 3 and 12 weeks after treatment in two groups were lower than those before treatment,the differences were statistically significant(P<0.05).The VAS score of the observation group was lower than that of the control group at 3 weeks after treatment,and the difference was statistically significant(P<0.05).There was no significant difference in VAS scores at 12 weeks after treatment between the two groups(P>0.05).The Constant-Murley scores of two groups at 3 and 12 weeks after treatment were higher than those before treatment,with statistical significances(P<0.05).The Constant-Murley score of the observation group was higher than that of the control group at 3 weeks after treatment,and the difference was statistically significant(P<0.05).There was no significant difference in Constant-Murley scores between the two groups at 12 weeks after treatment(P>0.05).The maximum thickness of coracohumeral ligament(CHL)and posterior glenohumeral joint capsule(PGJC)at 12 weeks after treatme

关 键 词：冻结肩 针刀松解术 类固醇注射 临床效果 

分 类 号：R684[医药卫生—骨科学]