解热镇痛汤联合针刺按摩治疗肩周炎随机平行对照研究

Randomized Parallel Controlled Study of Antipyretic Analgesic Decoction combined with Acupuncture and Massage Therapy for Frozen Shoulder

[目的]观察针刺按摩联合解热镇痛汤治疗肩周炎疗效。[方法]使用随机平行对照方法,将65例门诊患者按门诊号抽签方法简单随机分为两组。对照组32例镇痛类药物,布洛芬1粒/次,2次/d,口服;维生素B11.2~1.5mg/次,3次/d,口服;肩部按摩:拇指或手掌自上而下于患侧肩关节外侧及前部按揉1~2min,随后用食指、中指及无名指按揉肩关节后部,发现局部痛点则手指点按,由下至上揉捏肩部2min;拍打整个肩后部。治疗组33例针刺、按摩+解热镇痛汤,针刺:外关、曲池、肩贞、肩贞、肩井、血海及肩髃等;疼痛位于肩膀内侧,在尺泽、太渊针刺;疼痛位于肩膀外侧,在后溪、小海针刺;得气之后,留针30min,每10min行针1次;按摩肩部,力度适中,顺肩前、后、侧方向往返揉滚,弹拨三角肌等部位,适当旋转肩部,缓慢拉伸肢体,约30min;解热镇痛汤:蜈蚣4g,全蝎、三七各5g,威灵仙、红花、桑寄生、补骨脂、姜黄、乌鞘蛇、桃仁各10g,鸡血藤、羌活、透骨草各15g,黄芪、内熟地各20g;虚寒加细辛,水煎400m L,早晚分服。连续治疗1周为1疗程。观测临床症状、Melle评分、VAS评分、不良反应。连续治疗3疗程(3周),判定疗效。[结果]治疗组显效24例,有效8例,无效1例,总有效率96.67%;对照组显效15例,有效9例,无效8例,总有效率75.00%;治疗组疗效优于对照组(P<0.05)。Melle评分、VAS评分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]针刺按摩联合解热镇痛汤治疗肩周炎,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the curative effect of acupuncture massage combined with antipyretic and analgesic decoction in the treatment of frozen shoulder. [Methods] 65 cases of outpatients were randomly divided into two groups by random parallel control method. Control group of 32 cases of analgesic drugs, ibuprofen 1/time, 2 times/d, oral; vitamin B11.2~1.5 mg/times, 3 times/d, oral; shoulder massage： thumb or palm from the and then under the side of the ipsilateral shoulder and anterior rubbing 1~2 min, followed by the index finger, middle finger and ring finger kneading the shoulder joint and found that the local pain point finger click, from the bottom up kneading shoulder 2 min; shoulder. Treatment group of 33 cases of acupuncture, massage＋antipyretic analgesic soup, acupuncture： external customs, Qu pool, shoulder Zhen, shoulder Zhen, shoulder well, blood and shoulder and so on; pain is located on the inside of the shoulder, acupuncture acupuncture; pain in the shoulders outside, in the post-river, small sea acupuncture; get gas after the needle 30 min, every 10 min line needle 1; massage the shoulder, moderate strength, along the front, plaques, the scorpion, the three seven of the 5 g, clematis, safflower, mulberry parasitic, psoralen, psoriasis, Turmeric, hamster snake, peach kernel 10 g, millettia, notopterygium, speranskia the 15 g, astragalus, the ripening of the 20 g; deficiency plus asarum, decoction 400 m L, sooner or later sub-service. Continuous treatment for 1 week for a course of treatment. Observation of clinical symptoms, melle score, VAS score, adverse reactions. Continuous treatment of 3 courses（3 weeks）, to determine the efficacy. [Results] The treatment group was effective in 24 cases, effective in 8 cases, ineffective in 1 case, the total effective rate was 96.67%; control group markedly effective in 15 cases, effective in 9 cases, 8 cases, the total effective rate 75.00%; the treatment group was better than the control group（P0.05）. Melle score and VAS score improved （P0.01）, and the treatment group was better than the control group （P0.01）. [Conclusion] Acupuncture massage combined with antipyretic analgesic decoction in the treatment of frozen shoulder, the effect is satisfactory, no serious adverse reactions, it is worth promoting.