曲安奈德关节腔注射与冲击波治疗肩周炎的对比研究

Comparative Study of Triamcinolone Acetonide Injected into Articular Cavity and Shock Wave in Treatment of Periarthritis

目的观察曲安奈德关节腔注射、冲击波治疗肩周炎与物理治疗的临床效果及安全性。方法将120例肩周炎患者分为3组,每组40例。对照组:采用非甾体消炎药塞来昔布200 mg口服+局部微波及偏振光照射;曲安奈德肩关节腔注射组:自肩峰下方肱骨大结节上方间隙中入注关节腔及肱骨大结节区痛点,注射曲安奈德10 mg,每周1次,连续3次;冲击波组:给予1.5～2.5 MPa治疗压力,频率10 Hz,冲击剂量1800～2000次,共治疗4周。比较3组患者的治疗前、治疗后第4周、8周疼痛缓解评价、治疗后8周疗效判断。结果两治疗组效果均优于对照组,两组之间无差异。结论曲安萘德与冲击波组均能能有效地应用于肩周炎治疗,冲击波更在对有肾上腺皮质激素禁忌症的患者中具有优越性。

Objective To observe the clinical efficacy and safety in the treatment of periarthritis by triamcinolone acetonide injected into articular cavity, shock wave treatment and physical therapy, respectively. Methods One hundred and twenty cases with periarthritis were divided into three groups and 40 cases were in each group. In controlled group, the non-steroid anti-inflammatory drug celecoxib 200 mg oral combined with local microwave and polarized light irradiation was adopted. In the group of triamcinolone acetonide injected into shoulder joint cavity, triamcinolone acetonide 10 mg once a week was injected from the clearance of the below of shoulder peak and the above of greater tuberosity into articular cavity and pain points of the greater tuberosity of humerus area for three times. Shock wave group was given 1.5-2.5 MPa pressure treatment for a total of 4 weeks withl0 Hz frequency and impact doses of 1800-2000 times. The status of pain relief was evaluated before and after treatment of 4 weeks, 8 weeks in three groups and the curative effect was judged after treatment of 8 weeks. Results Compared with the controlled group, the curative effect was better in the both of treatment groups, and no difference existed between two groups. Conclusion Triamcinolone acetonide and shock wave can effectively be applied to the treatment of periarthritis. Shock wave has the superiority in the patients with contraindications to adrenocortical hormones.