电针治疗骨折术后肩关节活动功能障碍疗效观察

Observation on therapeutic effect of electroacupuncture on activity disturbance of the shoulder joint after operation of fracture

目的:观察电针、红外线照射加被动运动治疗肱骨外科颈骨折术后肩关节活动功能障碍的临床疗效。方法:将60例患者随机分为针刺合运动组(32例)和运动疗法组(28例)。针刺合运动组取患肩部僵硬软组织进行电针治疗,并行红外线照射;配穴取血海、三阴交、阳陵泉,予针刺治疗,取针后被动活动肩关节。运动疗法组先被动活动肩关节后再行主动运动训练。治疗1个月后统计疗效,并观察治疗前后患者肩部疼痛视觉模拟评分(visual analogue scale,VAS)和肩关节活动功能评分变化。结果:针刺合运动组总有效率为84.4%,运动疗法组为64.3%,针刺合运动组疗效优于运动疗法组。针刺合运动组治疗前后VAS评分分别为5.8±0.5、3.1±0.3,运动疗法组分别为5.7±0.5、4.3±0.4,两组VAS评分治疗后较治疗前均显著下降(均P<0.001),针刺合运动组较运动疗法组下降更显著(P<0.001)。针刺合运动组肩关节活动功能总分治疗前后分别为103.38±11.10、193.61±10.21,运动疗法组分别为103.01±10.01、133.45±9.81,两组较治疗前均有显著提高(均P<0.001),且针刺合运动疗法组优于运动疗法组(P<0.001)。结论:电针、红外线照射加被动运动治疗肱骨外科颈骨折术后肩关节活动功能障碍疗效显著。

Objective To observe clinical therapeutic effects of electroacupuncture, radiation of infrared rays plus passive exercise on movement disorders of shoulder joint after operation of fracture of surgical neck of humerous. Methods Sixty cases were randomly divided into an acupuncture plus exercise group （n=32） and an exercise therapy group （n=28）. The acupuncture plus exercise group were treated with electroacupuncture and infrared ray radiation at rigid soft tissue on the affected side, with adjuvant points, Xuehai （SP 10）, Sanyinjiao （SP 6） and Yang-lingquan （GB 34） selected for acupuncture treatment and after the needles were withdrawn passive exercise of the shoulder joints were made. The exercise therapy group were treated by active exercise after passive exercise of shoulder joint. Therapeutic effects were observed after treatment for one month, and shoulder pain scores VAS and scores of activity of shoulder joint before and after treatment were observed. Results The total effective rate of 84.4% in the acupuncture plus exercise group was better than 64.3% in the exercise group. Before and after treatment, the VAS scores were 5.8±0.5 and 3.1±0.3 in the acupuncture plus exercise group, and 5.7±0.5, 4.3±0.4 in the exercise therapy group, respectively, with significant decreases after treatment in the two groups （both P〈0.001）, the acupuncture plus exercise group being more significantly decreased than the exercise therapy group （P〈0.001）. Before and after treatment, the total scores of activity of shoulder joint were 103.38±11.10 and 193.61±10.21 in the acupuncture plus exercise group, and 103.01±10.01 and 133.45±9.81 in the exercise therapy group, respectively, with significant increases after treatment in the two groups （both P〈0.001）, the acupuncture plus exercise group being better than the exercise therapy group （P〈0.001）. Conclusion Electroacupuncture, radiation of infrared rays plus passive exercise has obvious therapeutic effect on movement disorders of shoulder joint after operation of fracture of surgical neck of humerous.