肩关节手法松解联合局部体外冲击波治疗冻结前期肩周炎的临床效果

Effect of shoulder joint manual release combined with local extracorporeal shock wave for the treatment of patients with scapulohumeral periarthritis in prefrozen stage

目的探讨肩关节手法松解联合局部体外冲击波治疗冻结前期肩周炎的临床效果。方法收集2017年8月至2018年8月江汉大学附属湖北省第三人民医院疼痛科收治的冻结前期肩周炎患者80例,年龄≥50岁,性别不限。均经口服洛索洛芬钠片60 mg/次,3次/d,1周后疼痛控制不佳的肩周炎患者。先采用肩关节手法松解治疗,3 d后行体外冲击波治疗,每周1次,共治疗3次。按照Constant-Murley评分法综合评价治疗结束后1、3、6个月时的治疗效果。结果在疼痛评分、日常生活活动能力(ADL)及关节活动度范围(ROM)方面,治疗后1、3、6个月时均优于治疗前,差异有统计学意义(P均<0.05);治疗后6个月时ROM优于治疗后1个月,差异有统计学意义(37.9±2.2比30.5±3.3,P<0.05);在疼痛评分和ADL方面,治疗后6个月与治疗后1个月时相比差异无统计学意义(P均>0.05)。治疗后1个月及3个月时有效率均为100%;治疗后6个月时有2例复发,有效率为98%。结论采用肩关节手法松解联合体外冲击波治疗冻结前期肩周炎,可明显减轻患者疼痛,并改善肩关节功能。

Objective To investigate the clinical effect of shoulder joint manual release therapy combined with local extracorporeal shock wave in the treatment of patients with scapulohumeral periarthritis in prefrozen stage.Methods From August 2017 to August 2018,80 patients with scapulohumeral periarthritis in prefrozen stage over 50 years old,who had poor pain control 1 week after taking loxoprofen sodium tablets orally,were collected in the department of Pain Medicine of the Third People's Hospital Affiliated to Jianghan University.All patients were treated with shoulder joint manual release first,and then underwent extracorporeal shock wave therapy 3 days later,once a week for 3 times.According to the Constant-Murley scoring method,the pain,function and the therapeutic effect of scapulohumeral periarthritis were evaluated comprehensively before the treatment and 1,3 and 6 months after the treatment respectively.Results The pain score,activity of daily living(ADL)and range of motion of joints(ROM)were significantly better at 1,3 and 6 months after the treatment than those before the treatment(all P<0.05).The range of motion of joints(ROM)was significantly better at 6 months after the treatment than that at 1 month after the treatment(37.9±2.2 vs.30.5±3.3,P<0.05).There was no significant difference in pain score and ADL between 6 months and 1 month after the treatment(all P>0.05).The effective rate was 100%at 1 month and 3 months,but 98%at 6 months after the treatment.Conclusion Shoulder joint manual release combined with extracorporeal shock wave therapy can significantly relieve pain and improve shoulder joint function in patients with scapulohumeral periarthritis in prefrozen stage.