不同刺激方法治疗肩周炎疗效比较

Efficacy comparison of different stimulation therapies for periarthritis of shoulder

目的:比较电针疗法、经皮电刺激疗法、穴位按摩法治疗肩周炎的临床疗效差异。方法:将120例患者随机分为电针组、经皮电刺激组、穴位按摩组,每组40例。3组患者取穴相同,均为肩前、侠白、肩髃、臂臑、肩髎、臑会、小海、后溪,分别予以电针疗法(疏密波,通电30min)、经皮电刺激疗法(疏密波,通电30min)以及穴位按摩配合肩关节松动手法。均每天治疗1次,每周治疗6天,共治疗4周。观察患者治疗前后视觉模拟量表(VAS)评分和肩关节活动改善程度。结果:3组患者治疗后VAS评分、肩关节活动程度均明显改善(均P<0.001),且穴位按摩组较电针组与经皮电刺激组改善程度更显著(均P<0.05)。穴位按摩组镇痛愈显率为61.5%(24/39),优于电针组的42.9%(15/35)及经皮电刺激组的44.4%(16/36,均P<0.05)。穴位按摩组肩关节功能活动愈显率为61.5%(24/39),优于电针组的48.6%(17/35)及经皮电刺激组的44.4%(16/36,均P<0.05)。结论:穴位按摩疗法治疗肩周炎疗效显著,可有效镇痛,改善肩关节活动功能,且疗效优于电针疗法和经皮电刺激疗法。

Objective To compare clinical efficacy differences among electroacupuncture （EA）, transcutaneous electrical nerve stimulation （TENS） therapy and acupoint massage （AM） on periarthritis of shoulder. Methods One hundred and twenty cases were randomly divided into an EA group, a TENS group and an AM group, 40 ca- ses in each one. The selection of acupoints in the three groups were all the same, which were Jianqian （Extra）, Xiabai （LU 4）, Jianyu （L115）, Binao （L114）, Jianliao （TE 14）, Naohui （TE 13）, Xiaohai （SI 8） and Houxi （SI 3）. EA was applied in the EA group with dense-disperse wave for 30 min, TENS therapy with dense-disperse wave for 30 min in the TENS group and AM combined with mobilization manipulation of Tuina on the shoulder in the AM group. All of the treatment was given once a day, six times a week and totally 4 weeks were required. The score of visual analogue scale （VAS） and improvement of shoulder joint activities in the three groups before and af- ter the treatment were observed. Results After the treatment, the VAS score and activities of shoulder joint were all improved in the three groups （all P^0. 001） and AM group had more obvious improvement than TENS group and EA group （all P%0.05）. The effective and curative rate was 61.5% （24/39） in the AM group, which was superior to 42.90//oo （15/35） in the EA group and 44.4M （16/36） in the TENS group （both P%0.05）. The effec- tive and curative rate of shoulder joint activities in the AM group was 61. 5% （24/39）, which was superior to 48.6% （17/35） in the EA group and 44.4% （16/36） in the TENS group （both P〈0.05）. Conclusion The acu- point massage has obvious clinical efficacy on periarthritis of shoulder, which could effectively relieve the pain and improve activities of shoulder joint, and it is superior to EA and TENS therapy.