活血通络方治疗急性期肩周炎(气血瘀滞证)的临床观察  

Clinical Study of Huoxue Tongluo Formula in the Treatment of Acute Stage Periarthritis of Shoulder(Syndrome of Qi Stagnation and Blood Stasis)

作　　者：王冠军[1] 单鹏飞 毕俊芳[1] 解纪惠 张意侗 李斌 王韬 张素娟[1] Wang Guanjun;Shan Pengfei;Bi Junfang;Xie Jihui;Zhang Yidong;Li Bin;Wang Tao;Zhang Sujuan(Shijiazhuang Hospital of Traditional Chinese Medicine,Hebei,Shijiazhuang 050051,China)

机构地区：[1]河北省石家庄市中医院,河北石家庄050051 [2]河北北方学院,河北张家口075000

出　　处：《中国中医急症》2025年第4期676-680,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2021247)。

摘　　要：目的观察活血通络方联合体外冲击波治疗急性期肩周炎(气血瘀滞证)的临床疗效。方法将86例患者随机分为对照组与治疗组,两组患者均予以口服塞来昔布胶囊及肩关节功能锻炼,对照组予以体外冲击波治疗,治疗组在对照组基础上予以中药汤剂自拟活血通络方内服治疗,两组均治疗4周,记录并对比两组临床疗效及治疗前后视觉模拟量表(VAS)评分、Constant-Murley肩关节功能评分(CMS)、肩关节活动度(ROM)、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、前列腺素E2(PGE2)、5-羟色胺(5-HT)水平。结果治疗组总有效率为95.24%,高于对照组的88.10%(P<0.05);两组治疗后VAS评分及TNF-α、IL-1β、PGE2、5-HT水平均较治疗前显著降低,且治疗组较对照组降低更明显(P<0.05);两组治疗后Constant-Murley评分、肩关节活动度均较治疗前显著增高,且治疗组较对照组增高更明显(P<0.05)。结论活血通络方联合体外冲击波治疗急性期(气血瘀滞证)肩周炎患者,可有效缓解疼痛,抑制炎症反应,改善肩部肌群肌力,恢复肩关节活动度及功能,提高日常生活能力,临床治疗有效。Objective:To observe the clinical efficacy of Huoxue Tongluo formula combined with extracorporeal shock wave therapy in treating acute stage periarthritis of shoulder with syndrome of qi stagnation and blood stasis.Methods:86 patients were randomly divided into a control group and a treatment group.Both groups received oral celecoxib capsules and shoulder joint functional exercise.The control group received extracorporeal shock wave therapy,while the treatment group additionally received Huoxue Tongluo formula on the basis of the control group for a total of 4 weeks.The Visual Analogue Scale(VAS)scores,Constant-Murley Shoulder Score(CMS),range of motion(ROM)of the shoulder joint,and serum levels of tumor necrosis factor-alpha(TNF-α),interleukin-1β(IL-1β),prostaglandin E2(PGE2),and serotonin(5-HT)were recorded and compared before and after treatment between the two groups.Results:The total effective rate in the treatment group was 95.24%,which was significantly higher than 88.10%in the control group(P<0.05).After treatment,the VAS scores and serum levels of TNF-α,IL-1β,PGE2,and 5-HT decreased significantly in both groups,with more significant reductions observed in the treatment group compared with the control group(P<0.05).The CMS scores and ROM of the shoulder joint increased significantly in both groups after treatment,with more significant improvements observed in the treatment group compared with the control group(P<0.05).Conclusion:Huoxue Tongluo formula combined with extracorporeal shock wave therapy can effectively relieve pain,inhibit inflammatory responses,improve muscle strength around the shoulder,restore shoulder joint mobility and function,and enhance daily living abilities in patients with acute stage periarthritis of shoulder(syndrome of qi stagnation and blood stasis),which demonstrates significant clinical efficacy.

关 键 词：肩周炎 活血通络方 急性期 气血瘀滞 临床疗效 

分 类 号：R684.3[医药卫生—骨科学]