加味葛根汤联合手法整复治疗肩周炎寒湿痹阻证临床观察

Clinical Observation of Modified Gegen Tang Combined with Manipulative Reduction for Scapulohumeral Periarthritis with Cold-dampness Impeding Syndrome

目的:观察加味葛根汤联合手法整复治疗肩周炎寒湿痹阻证的临床疗效。方法:将128例肩周炎寒湿痹阻证患者随机分为对照组和观察组各64例。2组均采用手法整复治疗,对照组加用小活络丸口服,观察组在手法整复的基础上联合加味葛根汤内服。治疗前后采用McGill疼痛问卷(SF-MPQ)评价疼痛情况,采用肩关节功能评价量表及美国肩肘外科协会评分(ASES)评价肩关节功能,观察患者中医症状的改善情况。结果:观察组总有效率95.00%,高于对照组的83.05%(P<0.05)。治疗后,2组疼痛分级指数(PRI)、视觉模拟评分法(VAS)、现在疼痛状况(PPI)评分及总分均较治疗前下降(P<0.01);观察组PRI、VAS、PPI及总分均低于对照组(P<0.01)。治疗后,2组5项肩关节功能评分及总分均较治疗前上升(P<0.01);观察组5项肩关节功能评分及总分均高于对照组(P<0.01)。治疗后,2组中医证候积分均较治疗前下降(P<0.01),ASES评分均较治疗前升高(P<0.01);观察组中医证候积分低于对照组(P<0.01);ASES评分高于对照组(P<0.01)。结论:加味葛根汤联合手法整复治疗寒湿痹阻型肩周炎,能有效改善患者的肩关节功能,缓解疼痛,临床疗效显著。

Objective：To observe the clinical effect of modified Gegen tang combined with manipulative reduction for scapulohumeral periarthritis with cold-dampness impeding syndrome. Methods： Divided 128 cases of patients with scapulohumeral periarthritis of cold-dampness impeding syndrome into the control group and the observation group randomly,64 cases in each group. Based on manipulative reduction,the control group was additionally given the oral administration of Xiaohuoluo pills,while the observation group was additionally given the internal administration of modified Gegen tang.Evaluated the pain before and after treatment by simplified McGill pain questionnaire（SF-MPQ） and shoulder joint function by using rating scale of shoulder joint function as well as rating scale of American shoulder and elbow surgeons（ASES）,and observed the improvement of Chinese medicine symptoms of patients. Results：After treatment,the total effective rate was95.00% in the observation group,being higher than 83.05% in the control group. Pain rating index（PRI）,visual analogue scale（VAS）,present pain index（PPI）,and the total scores in both groups were all decreased when compared with those before treatment（P〈0.01）;PRI,VAS,PPI,and the total scores in the observation group were all lower than those in the control group（P〈0.01）. After treatment,five scores of shoulder joint function and the total scores in both groups were all increased when compared with those before treatment（P〈0.01）;five scores of shoulder joint function and the total score in the observation group were all higher than those in the control group（P〈0.01）. After treatment,Chinese Medicine syndrome scores in both groups were decreased when compared with those before treatment（P〈0.01）,while ASES scores were both increased when compared with those before treatment（P〈0.01）;Chinese Medicine syndrome scores in the observation group were lower than those in the control group（P〈0.01）,while ASES scores in the observation group were higher than those in the control group（P〈0.01）. Conclusion：The therapy of modified Gegen tang combined with manipulative reduction for scapulohumeral periarthritis with cold-dampness impeding syndrome can effectively improve shoulder joint function of patients,relieve pain,and has significant clinical effect.