肩周炎患者针灸与主动功能锻炼分期治疗方案的优化及远期疗效观察

Long-term Effect of Acupuncture and Dirigation Programs on Periarthritis of Shoulder

目的:研究针灸结合主动功能锻炼分期治疗肩周炎的优化方案,并观察其远期疗效。方法:将192例肩周炎患者按分层的原则按L827的正交设计表随机分组,分别采用A(针刺时机)、B(选穴配方)、C(灸法)、D(主动锻炼)4个因素及相应的2水平进行治疗,观察治疗前后的疗效,对影响肩周炎针刺疗效的A(针刺时机)、B(选穴配方)、C(温针灸)、D(主动锻炼)4因素2水平组合方案进行优选。结果:A(针刺时机)、B(选穴配方)、C(温针灸)、D(主动锻炼)均为影响疗效的主要因素,并优选出最佳治疗方案。结论:肩周炎急性期采用局部取穴结合温针灸与主动功能锻炼,慢性期采用远端取穴结合温针灸与主动功能锻炼为最佳治疗方案,可改善患者日常生活能力,并有着较好的远期疗效,在临床治疗中需综合考虑患者年龄、性别、肩关节功能状态与疗程对疗效的影响。

Objective：To investigate the long-term effect of acupuncture and dirigation programs on periarthri-tis of shoulder.Methods：One hundred and Ninty-two patients with periarthritis of shoulder were randomly di-vided and treated according to the table of L8 27 in orthogonal test.They were treated with different combined programs of 4 factors and 2 levels, including factor A （ acupuncture opportunity） , B （ acupoints prescription） , C （ acupuncture plus moxibustion） and D （ dirigation） .Results：Factors A,B,C and D were all the major fac-tors which would affect the efficacy.The best treatment program would be optimized.Conclusion：The best treat-ment program for periarthritis of shoulder is the treatment of local aqupoints acupuncture, acupuncture plus moxibustion and dirigation in the acute stage.In the chronic stage the best treatment program for periarthritis of shoulder is the treatment of local points acupuncture with distal aqupoints acupuncture, acupuncture plus moxi-bustion and dirigation.And the results suggest that they can receive a better long-term effect.When using this method we should consider the relationship of the effect with the age, sex and the shoulder joint function score and other related factors.