针刀整体松解术联合臭氧注射治疗粘连期肩周炎的临床效果
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摘要
目的观察针刀整体松解术联合臭氧注射治疗粘连期肩周炎的临床效果。方法选取2017年1月～2018年12月福建中医药大学附属人民医院收治的粘连期肩周炎患者90例,按随机数字表法将其分为A组、B组和C组,每组各30例。A组采用针刀整体松解术联合臭氧注射治疗,B组采用针刀整体松解术治疗,C组则采用臭氧注射治疗,1次/周,共治疗4次。分别比较三组治疗前后视觉模拟评分(VAS)、调整Constant-Murley肩功能评分、肩关节热成像和治疗后总体疗效的差异。结果三组患者VAS评分较治疗前显著降低,调整Constant-Murley肩功能评分和肩关节热成像感兴趣点温度较治疗前升高,差异有统计学意义(P <0.05或P <0.01)。A组治疗后VAS评分明显低于B、C组,调整Constant-Murley肩功能评分和肩关节热成像感兴趣点温度明显高于B、C组,差异有统计学意义(P <0.05或P <0.01)。A组治愈率高于C组,差异有统计学意义(P <0.017),与B组比较差异无统计学意义(P> 0.017)。结论针刀整体松解术联合臭氧注射较单纯针刀整体松解术和单纯臭氧注射能更好地减轻患者肩部疼痛,改善肩部功能,促进肩部血液循环。
Objective To observe the clinical effect of overall acupotome lysis combined with ozone injection in the treatment of scapulohumeral periarthritis at adhesion stage. Methods A total of 90 patients with scapulohumeral periarthritis at adhesion stage admitted to the People′ s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2017 to December 2018 were selected and divided into group A, group B and group C by random number table method, with 30 cases in each group. Group A was treated with overall acupotome lysis combined with ozone injection, group B was treated with overall acupotome lysis, group C was treated with ozone injection, once a week, four times in total. The visual analogue scale(VAS), adjusted Constant-Murley shoulder function score, shoulder joint thermography before and after treatment and the general threapeutic effect after treatment were compared among the three groups. Results After treatment, the VAS scores in the three groups were significantly lower than those before treatment, while the adjusted Constant-Murley shoulder function score and the temperature of region of interest in thermography was higher than those before treatment,the differences were statistically significant(P < 0.05 or P < 0.01). The VAS scores of group A were significantly lower than those of group B and C, while the adjusted Constant-Murley shoulder function scores and the temperature of region of interest in thermography of group A were significantly higher than those of group B and C, the differences were statistically significant(P < 0.05 or P < 0.01). The cure rate in group A was higher than that of group C, the difference was statistically significant(P < 0.017), while there was no significant difference between group A and group B(P > 0.017). Conclusion Compared with single overall acupotome lysis or ozone injection, overall acupotome lysis combined with ozone injection can better relieve shoulder pain, improve shoulder function and blood circulation.
Objective To observe the clinical effect of overall acupotome lysis combined with ozone injection in the treatment of scapulohumeral periarthritis at adhesion stage. Methods A total of 90 patients with scapulohumeral periarthritis at adhesion stage admitted to the People′ s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2017 to December 2018 were selected and divided into group A, group B and group C by random number table method, with 30 cases in each group. Group A was treated with overall acupotome lysis combined with ozone injection, group B was treated with overall acupotome lysis, group C was treated with ozone injection, once a week, four times in total. The visual analogue scale(VAS), adjusted Constant-Murley shoulder function score, shoulder joint thermography before and after treatment and the general threapeutic effect after treatment were compared among the three groups. Results After treatment, the VAS scores in the three groups were significantly lower than those before treatment, while the adjusted Constant-Murley shoulder function score and the temperature of region of interest in thermography was higher than those before treatment,the differences were statistically significant(P < 0.05 or P < 0.01). The VAS scores of group A were significantly lower than those of group B and C, while the adjusted Constant-Murley shoulder function scores and the temperature of region of interest in thermography of group A were significantly higher than those of group B and C, the differences were statistically significant(P < 0.05 or P < 0.01). The cure rate in group A was higher than that of group C, the difference was statistically significant(P < 0.017), while there was no significant difference between group A and group B(P > 0.017). Conclusion Compared with single overall acupotome lysis or ozone injection, overall acupotome lysis combined with ozone injection can better relieve shoulder pain, improve shoulder function and blood circulation.
引文
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[11]黄佩花,郑景辉.针刀治疗肩周炎疗效的系统性评价[J].中医药临床杂志,2015,27(1):120-123.
[12]张天民,张强.针刀治疗肩周炎临床与理论研究进展[J].湖北中医杂志,2016,38(9):77-79.
[13]蒋香玉,粟胜勇,黄小珍,等.针刀治疗肩周炎机制研究进展[J].辽宁中医药大学学报,2019,21(1):162-164.
[14]张平,裴久国,胡琼,等.针刀整体松解术配合手法治疗肩周炎临床研究[J].湖北中医药大学学报,2018,20(5):86-89.
[15]王旭,张天民.“C”形针刀整体松解术治疗肩部骨质疏松症性肩周炎13例[J].中医外治杂志,2016,25(3):18-19.
[16]李明辉,王俊华,张强.“C”形针刀松解术结合手法治疗肩周炎的临床研究[J].湖北中医杂志,2017,39(2):51-53.
[17]修忠标,刘洪,刘晶,等.改良“C”形针刀松解术治疗粘连期肩周炎临床效应分析[J].辽宁中医药大学学报,2017,19(12):20-22.
[18]阳芸,陈敏.肩峰下滑囊臭氧注射结合“肩三针”治疗肩周炎的临床观察[J].湖北中医杂志,2017,39(2):50-51.
[19]杜学忠,李庆.射频针刀联合臭氧关节腔注射治疗肩周炎临床疗效观察[J].天津中医药,2017,34(8):531-534.
[20]杜峰.“C”形针刀松解术联合红外线治疗仪对肩周炎患者肩关节活动度、生活质量及血清TGF-β1、PGE2水平的影响[J].广西医科大学学报,2019,36(2):290-293.
[21]李建国.针刺联合推拿在肩周炎患者中的应用效果[J].中国医药科学,2018,8(15):69-71.
[22]刘西纺,王瑾,杨民毅,等.物理疗法、手法和针灸治疗肩周炎优选方案的正交设计研究[J].中国医药导报,2018,15(36):62-66.
[23]沈爱东,徐瑞生,郑志荣,等.医用臭氧局部注射治疗肩周炎的疗效观察[J].中国疼痛医学杂志,2008,14(2):126-127.
[24]王冬梅.温针灸、理疗联合治疗肩周炎的疗效观察[J].中国现代医生,2018,56(31):84-86.
[25]陈志伍,陈红平.针刀整体松解术后手法治疗肩周炎临床疗效评价[J].针灸临床杂志,2010,26(7):1-3.
[26]孔德聪,黎洪健,陈剑飞,等.温针灸、运动疗法结合关节松动技术治疗肩周炎的疗效观察[J].中国医药科学,2018,8(2):42-44,198.
[27]聂建军,周浩.整脊手法配合小针刀治疗颈性眩晕[J].中国现代医生,2018,56(31):60-62.
[28]黄智勇,杨勇旺.臭氧扩张对冲击波松解治疗肩周炎患者效果的影响[J].医疗装备,2018,31(8):131-132.
[2]张天民,姚宪宝,龚重九,等.“C”字形针刀整体松解术治疗肩周炎的远期疗效疗观察[C]//第四届全国微创针刀学术年会暨第五次湖北省针灸学会针刀学术交流会会议论文集,2012:126-130.
[3]余红超,郭中华,董博,等.针刀整体松解术结合卧位平衡手法治疗肩关节周围炎90例临床观察[J].中国医药导报,2016,13(27):167-169.
[4] Isler SC,Unsal B,Soysal F,et al. The effects of ozone therapy as an adjunct to the surgical treatment of peri-implantitis[J]. J Periodontal Implant Sci,2018,48(3):136-151.
[5] Braidy N,Izadi M,Sureda A,et al. Therapeutic Relevance of Ozone Therapy in degenerative diseases:Focus on Diabetes and Spinal Pain[J]. J Cell Physiol,2018,233(4):2705.
[6]中国针灸学会微创针刀专业委员会.针刀医学临床诊疗与操作规范[M].北京:中国中医药出版社,2016:20.
[7]李平华.肩周炎[M].4版.北京:人民军医出版社,2014.
[8] Huskisson EC. Measurement of pain[J]. Lancet,1974,2(7889):1127-1131.
[9] Fialka C,Oberleitner G,Stampfl P,et al. Modification of the Constant-Murley shoulder score-introduction of the individual relative Constant score Individual shoulder assessment[J]. Injury,2005,36(10):1159-1165.
[10]程少丹.肩关节周围炎的分型、分期、分度及治疗[C]//中国中西医结合学会骨伤科专业委员会中国中西医结合学会,2013:5.
[11]黄佩花,郑景辉.针刀治疗肩周炎疗效的系统性评价[J].中医药临床杂志,2015,27(1):120-123.
[12]张天民,张强.针刀治疗肩周炎临床与理论研究进展[J].湖北中医杂志,2016,38(9):77-79.
[13]蒋香玉,粟胜勇,黄小珍,等.针刀治疗肩周炎机制研究进展[J].辽宁中医药大学学报,2019,21(1):162-164.
[14]张平,裴久国,胡琼,等.针刀整体松解术配合手法治疗肩周炎临床研究[J].湖北中医药大学学报,2018,20(5):86-89.
[15]王旭,张天民.“C”形针刀整体松解术治疗肩部骨质疏松症性肩周炎13例[J].中医外治杂志,2016,25(3):18-19.
[16]李明辉,王俊华,张强.“C”形针刀松解术结合手法治疗肩周炎的临床研究[J].湖北中医杂志,2017,39(2):51-53.
[17]修忠标,刘洪,刘晶,等.改良“C”形针刀松解术治疗粘连期肩周炎临床效应分析[J].辽宁中医药大学学报,2017,19(12):20-22.
[18]阳芸,陈敏.肩峰下滑囊臭氧注射结合“肩三针”治疗肩周炎的临床观察[J].湖北中医杂志,2017,39(2):50-51.
[19]杜学忠,李庆.射频针刀联合臭氧关节腔注射治疗肩周炎临床疗效观察[J].天津中医药,2017,34(8):531-534.
[20]杜峰.“C”形针刀松解术联合红外线治疗仪对肩周炎患者肩关节活动度、生活质量及血清TGF-β1、PGE2水平的影响[J].广西医科大学学报,2019,36(2):290-293.
[21]李建国.针刺联合推拿在肩周炎患者中的应用效果[J].中国医药科学,2018,8(15):69-71.
[22]刘西纺,王瑾,杨民毅,等.物理疗法、手法和针灸治疗肩周炎优选方案的正交设计研究[J].中国医药导报,2018,15(36):62-66.
[23]沈爱东,徐瑞生,郑志荣,等.医用臭氧局部注射治疗肩周炎的疗效观察[J].中国疼痛医学杂志,2008,14(2):126-127.
[24]王冬梅.温针灸、理疗联合治疗肩周炎的疗效观察[J].中国现代医生,2018,56(31):84-86.
[25]陈志伍,陈红平.针刀整体松解术后手法治疗肩周炎临床疗效评价[J].针灸临床杂志,2010,26(7):1-3.
[26]孔德聪,黎洪健,陈剑飞,等.温针灸、运动疗法结合关节松动技术治疗肩周炎的疗效观察[J].中国医药科学,2018,8(2):42-44,198.
[27]聂建军,周浩.整脊手法配合小针刀治疗颈性眩晕[J].中国现代医生,2018,56(31):60-62.
[28]黄智勇,杨勇旺.臭氧扩张对冲击波松解治疗肩周炎患者效果的影响[J].医疗装备,2018,31(8):131-132.