影响瘀滞型肩周炎针刺疗效的多因素分析

Analysis of Multiple Factors Influencing the Therapeutic Effect of Acupuncture on Scapulohumeral Periarthritis of Stasis Type

目的探讨影响瘀滞型肩关节周围炎患者针刺治疗效果的多因素作用。方法选择瘀滞型肩周炎患者60例,按正交设计方案随机分组治疗,分别采用穴位、针刺刺激量、留针时间等3因素及相应的2水平(穴位以靳氏肩三针为主、传统肩三针为主;针刺刺激量为重刺激、轻刺激;留针时间为30min、60min),以肩部症状体征功能评分为观察指标,优选治疗方案。结果直观分析和方差分析显示,穴位以靳氏肩三针为主、针刺为重刺激对肩部症状体征功能评分改善有非常明显影响(P<0.05,P<0.01)。穴位是影响疗效的最主要因素,其次为针刺刺激量,留针时间为非显著因素。结论瘀滞型肩周炎的针刺效果受穴位和针刺刺激量因素影响,最佳方案为以靳氏肩三针为主,行重刺激针法,留针30min或60min治疗。

Objective To explore the influencing actions of multiple factors on the therapeutic effect of acupuncture on scapulohumeral periarthritis of stasis type. Methods Sixty patients with scapulohumeral periarthritis of stasis type were randomly grouped according to an orthogonal design. They were treated by three factors：acupoints,needling stimulation intensity and needle retention time and two corresponding levels （Jin＇s shoulder three needles as major acupoints and conventional shoulder three needles as major acupoints; high stimulation intensity and low stimulation intensity; 30 min and 60 min）,respectively. Shoulder symptom,sign and function scores were used as observation indices to select the optimum protocol. Results Intuitionistic and variance analyses showed that Jin＇s shoulder three needles as major acupoints plus high needling stimulation intensity had a very marked improving effect on shoulder symptoms,signs and function. Acupoints were the main factor influencing the therapeutic effect. Needling stimulation intensity was the next. Needle retention time was not a significant factor. Conclusion The therapeutic effect of acupuncture on scapulohumeral periarthritis of stasis type is affected by acupoints and needling stimulation intensity. The optimum protocol is a combination of Jin＇s shoulder three needles as major acupoints,high needling stimulation intensity and 30 or 60 min retention of needles.