改良鸡尾酒疗法和手法松解联合康复锻炼治疗原发性冻结肩疗效

Modified cocktail therapy and release manipulation combined with rehabilitation exercise in the treatment of primary frozen shoulder

目的观察改良鸡尾酒和手法松解联合康复锻炼治疗原发性冻结肩(PFS)的近远期疗效。方法回顾性分析2014年1月至2016年1月经采用改良鸡尾酒和手法松解联合康复锻炼治疗PFS,记录治疗前后肩关节活动度、肩关节疼痛与功能障碍指数(SPADI)及治愈率。结果共有120例纳入研究。治疗3 d、1个月肩关节主动前屈上举、外展上举、内收、后伸、内外旋活动度较治疗前有明显改善,差异有统计学意义(P <0. 01);治疗1个月与治疗3 d比较,差异有统计学意义(P <0. 01)。患者治疗前、治疗3 d、治疗1个月和治疗1年SPADI评分分别为(67. 87±19. 24)分、(30. 35±15. 53)分、(15. 63±7. 32)分、(10. 28±5. 26)分,与治疗前比较,治疗3 d、治疗1个月、治疗1年SPADI评分显著降低(P <0. 01),且随治疗时间延长,SPADI评分逐渐降低(P <0. 01)。治疗3 d、治疗1个月、治疗1年治愈率分别为66. 7%、91. 7%、99. 2%,且随治疗时间延长,治愈率逐渐增加(P <0. 01)。结论改良鸡尾酒疗法和手法松解联合康复锻炼治疗PFS可显著减轻疼痛,快速改善肩关节功能,近、远期疗效均较好。

Objective To observed the short-and long-term effect of modified cocktail therapy and manipulation under anesthesia（MUA） combined with rehabilitation exercise in the treatment of primary frozen shoulder（PFS）. Method Retrospective analysis was carried out with modified cocktail therapy and release manipulation combined with rehabilitation exercise for PFS patients who received treatment from January 2014 to January 2016. The range of motion and shoulder pain and disability index（SPADI） before and after the treatment and cure rate were recorded and compared. Results A total of120 PFS patients were included in the study. After 3 days and 1 month of treatment,the active flexion and uplift,abduction and uplift,adduction,extension,internal and external rotation of shoulder joint were significantly improved（all P〈0. 01）,and these improvements at 1 month after the treatment were better than those at 3 days after the treatment（all P〈0. 01）.Before the treatment,3 d,1 month and 1 year after the treatment,the SPADI was gradually reduced with the prolonged treatment time（67. 87 ± 19. 24 vs 30. 35 ± 15. 53 vs 15. 63 ± 7. 32 vs 10. 28 ± 5. 26,P〈0. 01）. After 3 days,1 month and 1 year of treatment,the cure rate increased gradually with the prolonged treatment time（66. 7% vs 91. 7% vs 99. 2%,P〈0. 01）. Conclusion In the treatment of primary frozen shoulder,modified cocktail therapy and manipulation combined with rehabilitation exercise could significantly relieve pain and improve shoulder function,and its curative effect of both shortand long-term is good.