美洛昔康痛点注射配合肌筋膜牵拉手法治疗肩关节周围炎

Clinical Observation on Trigger Point Injection with Meloxicam Combined with Myofascial Traction for treating Periarthritis of Shoulder

目的:观察美洛昔康痛点注射配合肌筋膜牵拉手法治疗肩关节周围炎的临床效果和安全性。方法:106个门诊病例应用随机分为美洛昔康+肌筋膜牵拉手法组(A组)、肌筋膜牵拉手法组(B组)和常规推拿手法组(C组),3组均进行手法治疗和自主康复训练,C组进行常规推拿手法,A、B组进行肌筋膜牵拉手法,A在手法结束后进行痛点注射;每日1次,7d为1个疗程,每2个疗程间休息2d,痛点注射每周1次,共4个疗程。根据Constant-Murley score来评价疗效,根据并发症来评价安全性。结果:疗效比较,A组(100%)和B组(93.7%)高于C组(70%)(P<0.05),差异有统计学意义;A组与B组比较,前者优于后者,差异具有统计学意义(P<0.05)。3组均无并发症发生。结论:美洛昔康痛点注射配合肌筋膜牵拉手法对肩周炎进行治疗,可以有效松解肩关节周围软组织粘,明确减轻患者的疼痛,改善患肩功能,减轻操作者的劳动强度,是一种简单、安全、有效的方法,易于临床推广应用。

Objective.. To observe the efficacy and safety of trigger point injection with meloxicam combined with myofascial traction for treating periarthritis of shoulder. Methods：All 106 outpatients were randomly divided into treatment group Ⅰ （meloxicam combined with myofascial traction group）, treatment group Ⅱ （myofascial traction group）, and control group （routine massage group）. Three groups were administrated with manipulation treatment and self-rehabilitation. The pa- tients were performed with routine massage in control group and myofascial traction in treatment group, and plus trigger point injection once a weeks in treatment group Ⅰ. All groups were treated once a day, 7 days for a treatment course, ev- ery 2 courses with 2 day＇s interval, and a total of four courses. The efficacy and safety were evaluated according to Con- stant-Murley score and complications. Results：The efficacy of treatment group Ⅱ （100%） and Ⅱ（93.7%） were higher than control group （70%, P〈0.05）, and treatment group Ⅰ was higher than treatment group Ⅱ （P〈0.05）. There was no complication in all groups. Conelusion..Trigger point injection with meloxieam combined with myofascial traction can ef- fectively loosen adhesion of soft tissue in frozen shoulder, relieve pain, improve function of shoulder, and reduce labor in- tensity of operator. It is easy, safe, and effective for clinical application.