奇穴特效针法与常规针法治疗肩关节周围炎改善疼痛及功能障碍的效果比较

Relief of pain and improvement of dysfunction in shoulder periarthritis following Qi acupoint specific acupuncture versus conventional acupuncture

目的:观察针刺健侧小腿穴位的奇穴特效针法对肩关节周围炎患者疼痛和运动功能的影响,并与传统针法进行比较。方法:选择2004-01/12在解放军广州疗养院颈肩腰腿痛中医特色疗法专科门诊及广州中医药大学第三附属医院骨科门诊就诊的肩关节周围炎患者115例,均符合《实用骨科学》中的诊断标准,随机分为治疗组80例,对照组35例。治疗组采用奇穴特效针法,取穴以左有病而右畔取,头有病而脚上针为原则,均取健侧小腿穴位,主穴肾关,配穴四肢或地皇。针法采用倒马针法、再配动气针法、削骨针法。对照组主穴取肩三针或肩骨禺、肩、肩,配穴取巨骨、曲池、合谷等,常规取穴,常规针法。两组均每天治疗1次,留针30min/次,每次治疗前后分别行疼痛程度(用0～10的数字进行量化,0对应无痛,10对应无法忍受)和肩关节运动功能(5级分类,0分为功能无限制,4分为严重限制)评估,1个疗程(5d)后进行综合效果评定,显效为肩痛显著缓解,肩关节运动功能提高2分以上。结果:进入结果分析治疗组和对照组分别保持为80和35例。①疼痛评分:1个疗程后治疗组评分显著低于对照组犤(0.80±0.56)分,(2.25±0.44)分,(t=13.62,P<0.01)犦。②肩关节运动功能评分:1个疗程后治疗组评分显著低于对照组犤(0.75±0.61)分,(1.97±0.45)分,(t=10.68,P<0.01)犦。③显效率:1个疗程后治疗组显著高于对照组犤92.50%,34.29%,(χ2=43.75,P<0.01)犦。结论:与传统针刺疗法相比,奇穴特效针法治疗肩关节周围炎可以明显缓解疼痛、改善肩关节运动功能、提高干预效果,其原因可能与奇穴特效针法重视整体观念,能集中定向冲击病灶有关。

AIM： To study the effect of Qi acupoint specific acupuncture on points of the unaffected legs on pain and motor function in patients with shoulder periarthritis, and then compare with the effect of conventional acupuncture. METHODS： From January and December 2004, 115 patients with shoulder periarthritis accordant with the diagnostic criteria in Practical Orthopaedics, were selected from the Professional Traditional Chinese Medicine Clinic of Characteristic Therapy for Cervicodynia and Lumbodynia, Guangzhou Sanitarium of Chinese PLA and the clinic of Department of Orthopaedics, Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. They were divided into treatment group （n=80） and control group（n=35）. Qi acupoint specific acupuncture was used in the treatment group according to the principles that acupuncture was on the right acupoints if the left side was attacked or on the feet if the head was found attacked. The points of healthy legs were acupunctured according to the following principles：main acupoint--Shenguan,coordinated acupointsfour limbs or Dihuang. Acupuncture took inverse horse acupuncture, combined with arterial pulsation acupuncture and cutting spiculum acupuncture. The main acupoints in control group took 3 points on shoulder or Jianyu, Jianliao, Jiannao, coordinated acupoints, Jugu, Quchi, Hegu, etc., by routinely taking acupoints and routine acupuncture. All patients were acupunctured once a day keeping the needle for 30 minutes once. The degree of pain（quantification by number 0 to 10, 0 as be painless, and 10 as intolerable pain） and motor function of shoulder （5 grades： 0 point as be unlimited and 4 as be greatly limited） were evaluated before and after each acupuncture. The synthetic outcomes were assessed after 1 course（5 days）, and the remarkable effectiveness manifested the apparent alleviation of shoulder pain and the motor function of shoulder joint more than 2 marks. RESULTS： The 80 patients in the treatment group and 35 in the control group were all analyzed in the result. ①The score of pain after 1 course was significantly lower in the treatment group than in the control group [（0.80±0.56） points vs （2.25±0.44） points, t=13.62,P 〈 0.01]. ②The score of motor function of shoulder joint after 1 course in the treatment group [（0.75±0.61） points] was significantly higher than that in the control group [（1.97±0.45） points]（t=10.68, P 〈 0.01）.③The markedly effective rate after 1 course was significantly higher in the treatment group than in the control group（92.50% vs 34.29%, X^2=43.75, P 〈 0.01）. CONCLUSION： Compared with traditional acupuncture, Qi aeupoint specific acupuncture can alleviate pain, improve the motor function of shoulder joint and promote the interventional outcomes of shoulder periarthritis more evidently, which may be associated with the acupuncture emphasizing the general opinions and centering on the directional impact on the focus.