推拿疗法对不同证型肩周炎的临床疗效研究与分析

Study and analysis of the clinical efficacy of tuina therapy for different types of shoulder periarthritis

目的:观察推拿疗法对不同证型肩周炎的疗效并分析其治疗机理。方法:将150例肩周炎患者辨证分为风寒湿型、气滞血瘀型及气血虚型三组,予相同推拿手法,以肩关节疼痛和功能活动度为主要观察指标对比三组的临床疗效。结果:三组均有远期效应(P<0.05)。风寒湿型和气滞血瘀型的镇痛疗效、改善肩周炎患者远期总分数及疼痛分数方面均优于气血虚型(P<0.05),三组改善肩关节功能活动疗效差异不明显(P>0.05)。风寒湿型、气滞血瘀型及气血虚型的总体有效率分别为87.3%、71.5%和51.3%。结论:辨证论治是中医理论体系的特色,手法治疗肩周炎应按中医特点辨证分型。手法对风寒湿型和气滞血瘀型肩周炎更有效,而对气血虚型肩周炎的疗效欠佳。

Objective：To observe the clinical efficacy of tuina therapy on different types of periarthritis of shoulder,and analysis its therapeutic mechanism. Methods： 150 patients with periarthritis of shoulder dialectical type was divided into three groups ：wind cold dampness type, qi stagnancy and blood stasis type, deficiency of qi and blood type. to the same manipulation, shoulder joint pain and functional activity as the main observation indexes to compare the clinical efficacy of three groups. Results：all of the three groups have long-term effect （P〈0.05）. Efficacy of wind cold dampness type and qi stagnancy and blood stasis type in analgesia, improving forward total scores and pain scores are better than deficiency of qi and blood type （P〈0.05）, efficacy of the three groups to improve the functional activity have not obvious difference （P〉0.05）. Wind cold dampness, qi stagnancy and blood stasis type, deficiency of qi and blood have overall effective rate of 87.3%, 71.5% and 51.3% respectively. Conclusion： treatment based on syndrome differentiation is the characteristics of TCM theoretical system, syndrome differentiation of TCM should be according to the treatment of periarthritis of shoulder. wind cold dampness type and qi stagnation and blood stasis type are more effective than the deficiency of qi and blood type.