推拿结合关节松动手法治疗肩周炎临床研究

Clinical Study on Tuina Combined with Manipulation of Joint Mobilization for Scapulohumeral Periarthritis

目的:观察在扶他林干预基础上以推拿结合关节松动手法治疗肩周炎气滞血瘀证的疗效。方法:选取104例肩周炎气滞血瘀证患者,随机分为对照组和观察组各52例。2组均采取扶他林干预和推拿治疗,观察组加予关节松动手法治疗。2组疗程均为4周。观察2组治疗前后肩关节疼痛程度、肩关节功能的改善情况,统计2组的临床疗效。结果:治疗后,观察组总有效率96.15%,高于对照组的80.77%,差异有统计学意义(P <0.05)。2组疼痛评级指数(PRI)、现在疼痛状况(PPI)、视觉模拟评分法(VAS)评分均较治疗前减少(P <0.01),观察组3项评分均低于对照组(P <0.01)。2组Constant-Murley量表疼痛、关节活动度、日常生活活动和肌力评分均较治疗前增加(P <0.01),观察组疼痛、关节活动度、日常生活活动评分均高于对照组(P <0.01)。结论:在扶他林干预基础上以推拿结合关节松动手法治疗肩周炎,可有效促进疼痛和肩关节功能的改善,提高疗效。

Objective:To observe the curative effect of tuina combined with manipulation of joint mobilization based on the intervention of voltaren for scapulohumeral periarthritis with syndrome of qi stagnation and blood stasis. Methods:A total of104 cases of patients with scapulohumeral periarthritis with syndrome of qi stagnation and blood stasis were randomly divided into the control group and the observation group,52 cases in each group. Both groups were treated with the intervention of voltaren and tuina, and the observation group was additionally treated with manipulation of joint mobilization. Both groups were treated for four weeks. The improvement of shoulder joint pain and function in the two groups before and after treatment was observed,and the clinical effect in the two groups was counted. Results:After treatment,the total effective rate was96.15% in the observation group,higher than that of 80.77% in the control group,the difference being significant(P < 0.05).The scores of pain rating index(PRI),present pain intensity(PPI) and visual analogue scale(VAS) in the two groups were decreased when compared with those before treatment(P < 0.01),and the above three scores in the observation group were lower than those in the control group(P < 0.01). The scores of pain,range of motion,activities of daily living and muscle strength in the Constant-Murley scale in the two groups were increased when compared with those before treatment(P < 0.01), and the above scores in the observation group were higher than those in the control group(P < 0.01). Conclusion:The therapy of tuina combined with manipulation of joint mobilization based on the intervention of voltaren in treating scapulohumeral periarthritis can effectively promote the improvement of pain and shoulder joint function and improve the curative effect.