关节镜松解术配合中药治疗原发性冻结肩的临床疗效观察

Clinical observation on treating primary frozen shoulder by arthroscopic release plus TCM medicine

目的:观察术前、术后患侧肩关节疼痛程度及肩关节评分的变化来评估关节镜松解术配合独活寄生汤治疗原发性冻结肩的有效性及安全性。方法:回顾性分析2015年6月-2016年12月我院采用关节镜松解术治疗的36例原发性冻结肩患者的病例资料,按术后处理的不同方式分为两组:对照组16例术后予以非甾体药物口服治疗,男6例,女10例,平均年龄(55.6±7.8)岁,平均病程(11.5±2.8)个月;观察组20例术后予以独活寄生汤口服治疗,男8例,女12例,年龄(56.1±8.0)岁,平均病程(12.6±3.2)个月;分别于术前、术后6个月采用视觉模拟评分(VAS)、肩关节的Constant评分对两组患侧肩关节进行疗效评估。结果:手术均顺利完成,切口Ⅰ期愈合,无相关并发症发生。36例患者均获随访,对照组术前、6个月VAS评分和Constant评分为(7.8±1.3)分、(55.9±5.5)分,(1.8±0.5)分、(83.8±5.1)分;观察组术前、6个月VAS评分和Constant评分为(8.1±1.1)分、(54.7±5.6)分,(1.0±0.4)分、(88.5±4.4)分。两组各自术后6个月与术前评分比较,差异有统计学意义(P<0.05);术后6个月观察组VAS评分及Constant评分分别优于对照组,差异有统计学意义(P<0.05)。结论:关节镜松解术治疗原发性冻结肩是安全有效的治疗方法,术后配合独活寄生汤具有缓解术后疼痛快,创伤小,功能恢复好,安全有效性高的特点。

Objective： To observe the changes of preoperative and postoperative shoulder pain and shoulder score and evaluate the safety and efficacy of arthroscopic lysis with the Duhuo Jisheng decoction（ 独活寄生汤） on idiopathic frozen shoulder. Methods： A retrospective analysis of the clinical data of 36 patients with arthroscopic primary frozen shoulder treated in our hospital from June 2015 to December 2016 was made. The patients were divided into 2 groups according to the different patterns of postprocessing： 16 cases in the control group were given non steroidal drugs treatment, with 6 male cases and 10 female cases, the average age was（55.6±7.8） years, the average duration was of（11.5±2.8） months; 20 cases in observation group were given the Duhuo Jisheng decoction, with 8 male cases and 12 female cases, the average age was（56.1±8） years, the average duration was of（12.6±3.2）months; visual analogue scale（VAS）, shoulder Constant score of preoperative and postoperative 6 months were used to evaluate the shoulder joint of two groups. Results： All the operations were completed successfully, and the incision was healed in stage I without any related complications. 36 patients were followed up. The VAS score and Constant score of the control group before and after surgery was（7.8±1.3）,（55.9±5.5）,（1.8±0.5）,（83.8±5.1） points respectively while that of the observation group was（8.1±1.1）,（54.7±5.6）,（1.0±0.4）,（88.5±4.4） points respectively. Compared with preoperative score, the difference in both groups was statistically significant（P〈0.05）; 6 month after treatment, VAS score and Constant score of the observation group were better than those of the control group, the difference was statistically significant（P〈0.05）. Conclusion： Arthroscopic primary frozen shoulder was a safe and effective therapy, combined with postoperative the Duhuo Jisheng decoction, it could relieve postoperative pain rapidly and was of less trauma and quicker recovery, which was safe and effective.