无痛松解手法结合痛点封闭治疗重症肩周炎的临床研究

Painless Manipulation combined with Pain Point Blocking Therapy in Treating Severe Shoulder Periarthritis

目的:通过临床随机对照研究,对无痛麻醉下手法松解结合痛点封闭治疗重症肩周炎进行疗效评估和量化评价。方法:将200例重症肩周炎患者随机分为治疗组和对照组,每组100例。治疗组采用无痛麻醉下手法松解结合局部痛点封闭治疗,对照组采用单纯局部痛点封闭治疗,比较两组治疗前后疗效和肩关节功能评价量表、视觉模拟疼痛量量表(VAS)的差异。结果:采用意向性治疗分析,两组受试对象治疗2周后临床疗效与治疗前比较,治疗组有效率为97%,对照组为71%,两组比较差异具有统计学意义(P<0.05),治疗组有效率高于对照组。治疗2周后两组间肩关节功能评分比较差异有统计学意义(P<0.05),VAS评分比较差异无统计学意义(P>0.05)。3月后随访肩关节功能评分和VAS评分,两组比较差异有统计学意义(P<0.05)。两组患者肩关节功能评分量表的子量表中,在治疗后2周时疼痛子量表评分、局部形态子量表和肌力子量表两组比较差异均无统计学意义(P>0.05),关节功能活动度(ROM)子量表和日常功能评分(ADL)两组比较差异有统计学意义(P<0.05)。治疗3个月随访时,疼痛子量表评分、关节功能活动度(ROM)子量表、日常功能评分(ADL)和局部形态子量表两组比较差异有统计学意义(P<0.05),肌力子量表两组比较差异无统计学意义(P>0.05)。结论:无痛麻醉下手法松解结合局部封闭治疗重症肩周炎有较好的短期和中期疗效。

Objective：To evaluate the manipulation release under anesthesia combined with pain point blocking therapy in treating severe shoulder periarthritis through a randomized controlled trial. Methods： Two hundred patients with severe shoulder periarthritis were randomized into treatment group and control group, 100 in each group. Treatment group received manipulation release under anesthesia combining local pain point blocking, while control group only received local pain point blocking therapy. The clinical effects, the evaluation scale of shoulder function as well as Visual Analogue Scale （VAS） between the two groups before and after the treatment were compared. Results.. After 2 weeks treatment, the effective rate was 97% in treatment group and 71~ in control group. There was significant difference between the two groups （P〉0.05）. There was also remarkable difference in evaluation scale of shoulder function between the two groups （P〈0. 05）, but insignificant difference in VAS （P〉0.05）. Follow-up after 3 months showed that there were obvious differences in evaluation scales of shoulder function and VAS between the two groups （P〈0.05）. Conclusion.. Release manipulation under anesthesia combined with local blocking has good short- and long-term therapeutic effects in treating severe shoulder periarthritis.