经穴推拿疗法联合针刺条口穴及体外冲击波治疗肩袖损伤的临床研究

Clinical Study on Rotator Cuff Injury Treated with Acupoint Massage Combined with Acupuncture at Tiaokou Point and Extracorporeal Shock Wave

目的:探讨经穴推拿疗法联合针刺条口穴及体外冲击波对肩袖损伤患者疼痛、功能恢复和血清前列腺素E_(2)(PGE_(2))、5-羟色胺(5-HT)的影响。方法:将88例肩袖损伤患者随机分为治疗组、对照组各44例。患者均行常规康复锻炼,对照组给予体外冲击波治疗,治疗组在对照组基础上给予经穴推拿疗法+针刺条口穴治疗,均治疗8周。比较两组肩部疼痛VAS评分、肩关节功能评分(UCLA、CMS评分)、肩关节活动度及血清PGE_(2)、5-HT水平。结果:治疗4周、8周,两组患者VAS评分与前一时间点相比均降低(P<0.05),且治疗组患者治疗4周、8周时的VAS评分均低于对照组(P<0.05);两组患者UCLA、CMS评分与前一时间点相比均提高(P<0.05),且治疗组患者治疗4周、8周时的UCLA、CMS评分均高于对照组(P<0.05);两组患者肩关节前屈、外展、后伸活动度与前一时间点相比均增大(P<0.05),且治疗组患者治疗4周、8周时的前屈、外展、后伸活动度均大于对照组(P<0.05)。治疗后,两组患者血清PGE_(2)、5-HT水平相比治疗前水平降低(P<0.05);且治疗组血清PGE_(2)、5-HT水平均低于对照组(P<0.05)。结论:经穴推拿疗法联合针刺条口穴及体外冲击波治疗肩袖损伤患者可明显下调PGE_(2)、5-HT水平,缓解肩部疼痛,增加肩关节活动度,促进功能恢复。

Objective:To investigated the effects of acupoint massage therapy combined with acupuncture at the Tiaokou(St38)point and extracorporeal shock wave on the pain,functional recovery and serum prostaglandin E_(2)(PGE_(2))and 5-hydroxytryptamine(5-HT)of patients with rotator cuff injury.Methods:88 patients with rotator cuff injury were randomly divided into treatment group and control group(44 cases in each).All patients underwent conventional rehabilitation exercises,the control group was given extracorporeal shock wave therapy,and the treatment group was given acupoint massage+acupuncture at Tiaokou(St38)point on the basis of the control group for 8 weeks.Compared shoulder pain VAS score,shoulder joint function score(UCLA,CMS score),shoulder joint mobility and serum PGE_(2),5-HT levels in the two groups.Results:At 4 weeks and 8 weeks for treatment;the VAS scores of the two groups were lower than the previous time point(P<0.05),and the VAS scores of patients in the treatment group were lower than those of the control group(P<0.05);the scores of UCLA and CMS in the two groups were increased compared with the previous time point(P<0.05);and both of patients in the treatment group were higher than those of the control group(P<0.05);the flexion,abduction,and extension of the shoulders of the two groups were increased compared with the previous time point(P<0.05),and the activities of forward flexion,abduction and extension of the patients in the treatment group were greater than those of the control group(P<0.05).After treatment,the levels of serum PGE_(2)and 5-HT levels in the two groups were lower than those before treatment(P<0.05),and the levels of serum PGE_(2)and 5-HT in the treatment group were lower than those in the control group(P<0.05).Conclusion:Acupoint massage therapy combined with acupuncture at Tiaokou points and extracorporeal shock wave treatment can significantly reduce the levels of PGE_(2)and 5-HT in patients with rotator cuff injury and relieve shoulder pain,increase shoulder joint mobility,and promote functional recovery.