三种外治法治疗肩凝症90例临床观察

Clinical Observation on Three External Therapies for 90 Cases of Frozen Shoulder

目的观察3种外治法对肩凝症的临床症状、体征改善作用,同时评价其安全性。方法将90例肩凝症患者随机分为手法组、针刺组和扶他林组各30例,在相同功能锻炼的情况下,分别给予手法治疗、针刺治疗和扶他林外敷治疗,疗程均为14天。分别对肩周静止痛、活动痛、压痛、肩关节活动范围,在治疗前、治疗后7天、治疗后14天时进行评分,同时观察其安全性。结果治疗后7天各组疗效比较,手法组有效率明显高于针刺组(P<0.01),而与扶他林组比较差异无统计学意义(P>0.05)。治疗后14天,手法组和扶他林组痊愈率和显效率明显高于针刺组(P<0.01),手法组和扶他林组比较差异无统计学意义(P>0.05);手法组总有效率高于其余两组(P<0.05)。治疗后7天、14天,各组肩部静止痛、肩部活动痛、肩部压痛、肩关节活动范围评分均显著下降(P<0.01)。治疗后14天,针刺组与手法组肩周压痛评分差异比较有统计学意义(P<0.05),手法组和扶他林组比较差异无统计学意义(P>0.05);其他指标分值比较无统计学意义(P>0.05)。3组均无不良反应发生。结论手法、针刺、扶他林外敷治疗肩凝症均安全可靠。其中手法对改善肩凝症肩周压痛作用明显高于针刺治疗。

Objective To observe the clinical effect and safety of three kinds of external therapy for frozen shoulder. Methods Ninety cases of frozen shoulder were randomized into manipulation group, acupuncture group and Voltaren group, with 30 in each. The manipulation, acupuncture and Vlotaren were added to the three groups respectively for 14 days besides normal function exercises. The symptoms and signs such as shoulder pain, activity pain, tenderness and shoulder flexibility were observed and scored before the treatment and on the 7th and 14th day of the treatment. The safety was observed as well. Results On the 7th day of the treatment, the effective rate of the manipulation group was significantly higher than that of the acu-puncture group （P〈0.01）, but the difference between the manipulation group and Voltaren group was not statistically signifi- cant （P〉0.05）. On the 14th day of the treatment, the recovery rate and excellence rate of the manipulation group and Voltaren group were significantly higher than those of the acupuncture group （P〈0.01）, but the difference between the ma- nipulation group and Voltaren group was not statistically significant （P〉0.05）. Comparing with other two groups, the total effective rate of the manipulation group was significantly higher （P〈0.05）. The scores of main symptoms and signs were all significantly decreased on the 7th day and 14th day of the treatment in three groups （P〈0.01）. On the 14th day of the treat- ment, the difference was statistically significant in should tenderness between the acupuncture group and manipulation group （P 〈0.05）, but there was no statistical significance between the manipulation group and Voltaren group （P〉0.05）. There was no statistical significance in other index （P〉0. 05）. There was no adverse reaction in all groups. Conclusion The manipulation, acupuncture and Voltaren are safe for frozen shoulder. The effect of relieving shoulder tenderness of manipulation and Voltaren are superior to that of acupuncture