肩关节周围炎的多种病因病理学说

Etiological and pathological theories about shoulder periarthritis

目的:探讨引发肩关节周围炎的多种病因及病理变化学说。资料来源:应用计算机检索中国期刊全文数据库1994/2004的相关文章,限定文章语言为中文。检索词“肩周炎、肩关节周围炎、发病机制、病因、病理。资料选择:对资料进行初审,选取实验性研究,然后筛除低水平重复性文章和综述,对剩余文献进行全文阅读。纳入标准:①实验性研究。②临床治疗方法的研究。资料提炼:共收集了59篇文章,19篇符合纳入标准,其余40篇文章均为重复内容。资料综合:在19篇文章中,综合筛选出引发肩关节周围炎的7种病因(年龄因素、风寒湿侵袭、解剖学因素、肩部活动减少、肩部急慢性损伤、神经损伤因素和其他因素)和7种病理变化(慢性炎症学说、微循环障碍学说、退变性因素、纤维增生因素、肩周肌群痉挛、蛋白多糖成分改变和自由基代谢失调)。结论:肩关节周围炎临床症状明确,但所致疾病的病因病理复杂。

OBJECTIVE:To investigate the multiple etiological and pathological theories about shoulder periarthritis. DATA SOURCES:Related articles to shoulder periarthritis published between 1994 and 2004 were searched for in the China Journal Full-text Database(CJFD) using computer with the “shoulder periarthritis,periarthritis of shoulder joint,pathogenesis,etiology,pathology”,and the language was limited to Chinese. STUDY SELECTION:Based on the primary trial,the articles were included about experimental studies,and excluded about low-level repetitive studies and reviews,followed by check-up of full texts in the selected articles.The inclusion criteria was:①experimental studies,②clinical therapies. DATA EXTRACTION:In 59 collected articles,19 were accordant with the inclusion criteria,and 40 were excluded due to their repetition. DATA SYNTHESIS:By screening the 19 articles synthetically,shoulder periarthritis was related to 7 etiological factors:age,wind-cold-damp invasion,anatomy,decreasing movement of shoulder,chronic and acute injuries to shoulder,nerve injury and other factors,and 7 pathological changes:chronic inflammation,microcirculation disorder,degeneration,fiber hyperplasia,spasm of muscle group around shoulder,component changes of proteoglycan and metabolism disturbance of free radicals. CONCLUSION:Shoulder periarthritis has defined clinical symptoms,but its etiological and pathological factors are greatly complicated.