杠杆扳法治疗肩关节功能障碍疗效的临床对照试验

A controlled clinical trial of pulling method with lever for the treatment of functional disturbance of shoulder joint

目的:比较常规治疗和杠杆扳法治疗肩关节功能障碍的疗效。方法:60例肩关节功能障碍患者,男33例,女27例;年龄24～60岁,平均44岁。分为2组,分别采用常规治疗(A组)和杠杆扳法治疗(B组),每组30例,在治疗1个疗程(10次)后利用UCLA进行功能评分,比较两种治疗方法在疼痛、功能、主动前屈活动、前屈肌力及患者满意度方面的差异。结果:经治疗1个疗程后,A组在疼痛、功能及患者满意度方面较治疗前有改善(P<0.05),但在主动前屈活动和前屈肌力方面效果不明显。B组不但在疼痛、功能及患者满意度方面较治疗前有明显改善(P<0.01),且在主动前屈活动和前屈肌力方面亦有改善(P<0.01或P<0.05)。B组在疼痛、功能、患者满意度、前屈活动方面明显优于A组(P<0.01,P<0.05),在改善前屈肌力方面优势不明显(P>0.05)。结论:肩关节杠杆扳法利用人体小杠杆原理治疗肩关节功能障碍,增大肩峰下间隙,缓解疼痛,疗效优于常规疗法,值得临床推广使用。

Objective：To compare the effect between routine manipulation and pulliog method with lever（PMWL） in treating functional disturbance of shoulder joint.Methods：Sixty patients with functional disturbance of shoulder joint,including 33 male and 27 female with the age from 24 to 60 years（mean 44 years）,were divided randomly into two groups（group A and B）.The patients were treated with routine manipulation（group A,30 cases） and PMWL（group B,30 cases） respectively.The difference pain,function,range of active anteflexion,anteflexion strength and satisfaction degree of patient were analyzed according to UCLA scoring system after one period of treatment score.Results：The pain,function and satisfaction degree of patient after treatment got better than those before treatment in group A（P〈0.05）;the active range and anteflexion strength had no improvement.However,in group B,not only the pain,function and satisfaction degree of patient after treatment got better than those before treatment（P〈0.01）;but also the active range and anteflexion strength got better than those before treatment（P〈0.01 or P〈0.05）.The pain,function,satisfaction degree of patient,range of anteflexion after treatment in group B were better than those in group A（P〈0.01,P〈0.05）;the amelioration of anteflexion strength was not obvious（P〉0.05）.Conclusion：PMWL utilize the mechanism of lever in treating functional disturbance of shoulder joint.It can extend the sub-acromial space of shoulder joint and restrain the pain.The effect is better than routine manipulation.