肩三针穴位注射联合小针刀松解配合手法治疗肩周炎的疗效

Effect of three-needle acupoint injection combined with acupotomy with manipulations on scapulohumeral periarthritis

目的观察肩三针穴位注射联合小针刀松解配合手法治疗肩周炎的临床疗效。方法将68例确诊为肩周炎的患者随机分为注射针刀手法治疗组(采用肩三针穴位注射联合针刀松解和手法治疗)和针刀手法治疗组(采用单纯针刀松解联合手法治疗),每组34例。两组患者均每周治疗1次,连续治疗3周。在治疗前和治疗后3、7、21d应用VAS评分评估患者的主观疼痛感受。肩周炎临床疗效标准分为治愈、显效、好转、无效,治愈、显效、好转纳入治疗总有效率计算中。结果与治疗前相比,两组治疗后3、7、21d的疼痛VAS评分均较同组治疗前显著降低(P值均<0.01)。注射针刀手法治疗组治疗后3、7d的疼痛VAS评分显著低于针刀手法治疗组同时间(P值均<0.01),两组间治疗后21d疼痛VAS评分的差异无统计学意义(P>0.05)。全部治疗结束后,注射针刀手法治疗组治愈27例、显效3例、有效3例、无效1例;针刀手法治疗组治愈24例、显效5例、有效4例、无效1例。两组的治疗总有效率均为97.06%,差异无统计学意义(P>0.05)。结论应用肩三针穴位注射联合小针刀松解配合手法治疗肩周炎能快速缓解肩周疼痛,改善临床症状,具有一定的临床价值。

Objective To observe the clinical outcomes of the three-needle acupoint injection combined with acupotomy with manipulations for scapulohumeral periarthritis. Methods A total of 68 patients with scapulohumeral periarthritis were randomly treated by three-needle acupoint injection combined with acupotomy with manipulations （ injection-I- acupotomy group, n = 34） or by acupotomy with manipulations （acupotomy group, n = 34）. All the patients were treated weekly for three consecutive weeks. Visual analogus scale （VAS） scoring was used to evaluate the pain before and 3, 7, 21 d after treatment. The criterion of therapeutical effect was divided into cured, excellent, improved, and ineffective, and the first three were taken as total effective rate. Results The pain VAS score on day 3, 7, and 21 after treatment was significantly lower than that before treatment in both groups （all P〈0.01 ）. The pain VAS score in injection＋ acupotomy group was significantly lower than that in acupotomy group on day 3 and 7 after treatment （both P〈0.01 ）. There was no significant difference in the VAS score between the two groups on day 21 after treatment （P〉0.05）. The clinical outcome was cured in 27 cases, excellent in 3, improved in 3 and ineffective in 1 in injection-t-acupotomy group. The clinical outcome was cured in 24 cases, excellent in 5, improved in 4 and ineffective in 1 in acupotomy group. The total effective rate in the two groups was 97.06 %, and there was no significant difference in effective rate between the two groups （P〉 0.05）. Conclusion The three-needle acupoint injection combined with acupotomy and manipulations can quickly relieve shoulder pain and ameliorate clinical symptoms in patients with scapulohumeral periarthritis.