药物注射联合针刀治疗肩周炎临床疗效及安全性分析

Analysis on the Clinnical Efficacy and Safety of Medicine Injection Combined with Needle-knife in the Treatment of Scapulohumeral Periarthritis

为探讨针刀联合曲安奈德、正清风痛宁、利多卡因治疗肩周炎的临床疗效及安全性分析,本研究选取2016年1月至2017年12月来东南大学附属中大医院疼痛科就诊肩周炎患者120例,随机数字表法分为药物治疗组40例(曲安奈德+正清风痛宁+利多卡因+臭氧治疗),针刀治疗组40例,综合治疗组40例(曲安奈德+正清风痛宁+利多卡因+臭氧+针刀治疗),对比分析各组治疗前后肩关节功能评分、视觉模拟评分法(visual analogue score, VAS)评分、不良反应发生率。结果显示,组内比较,3组治疗后VAS和肩关节功能评分与治疗前比较,差异具有统计学意义(p<0.001)。组间比较,治疗前3组VAS和肩关节功能评分比较,差异不具有统计学意义;综合治疗组各时间点VAS评分均低于药物及针刀治疗组,综合治疗组肩关节功能评分在治疗后1个月和2个月高于药物及针刀治疗组,差异具有统计学意义(p<0.001)。3组的不良反应发生率,差异不具有统计学意义(p>0.05)。综上所述,针刀治疗联合曲安奈德、正清风痛宁、利多卡因及臭氧在关节腔及关节周围注射治疗肩周炎安全有效,值得在临床中推广应用。

In order to di scuss the clinical efficacy and safety of needle-knife combined with Triamcinolone acetonide, Sinomenine and Lidocaine in the treatment of scapulohumeral periarthritis. A total of 120 cases of patients with scapulohumeral periarthritis treated in the pain department, Zhongda Hospital Southeast University from January 2016 to December 2017, were randomly divided into single drug treatment group(Triamcinolone acetonide, Sinomenine Lidocaine and Ozone treatment, n=40), acupotomy treatment group(n=40), and comprehensive treatment group(needle-knife combined with Triamcinolone acetonide, Sinomenine Lidocaine and Ozone treatment, n =40). The score of shoulder joint function, VAS score, and incidence of adverse reactions were compared between the three groups before and after treatment. The results showed that intra-group comparison:the score of shoulder joint function and VAS score were compared before and after the treatment between the three groups, and the differences were statistically significant(p<0.001). Inter-group comparison: the score of shoulder joint function and VAS score were compared before the treatment between these three groups, and the difference was not statistically significant;VAS score at all time points in the comprehensive treatment group were lower than those in the acupotomy group and drug treatment grou p, the score o f shoulder function at one and two months following the treatment in the comprehensive group were higher than those in the acupotomy group and drug treatment group, and the differences were statistically significant(p<0.001). The incidence of adverse reactions were compared between the three groups, and the differences were not statistically significant(p>0.05). In conclusion,Needle-knife combined with Triamcinolone acetonide, Sinomenine Lidocaine and Ozone in the treatment of scapulohumeral periarthritis is safe and effective, and is worth popularizing in clinical application.