高频超声全程引导下“汉派骨伤”三联疗法在肩周炎患者中的应用及对证候积分的影响研究

Application of Fully High-Frequency Ultrasound Guided “Hanpai Bone Injury” Triple Therapy in Patients with Scapulohumeral Periarthritis and the Effects on Syndrome Scores

目的:体内高频超声全程引导下"汉派骨伤"三联疗法在肩周炎患者中的应用及对证候积分的影响研究。方法:选取2018年1月至2018年12月武汉中医医院收治的肩周炎患者120例作为研究对象,按随机数字表法分观察组与对照组,每组60例;对照组给予局部痛点阻滞治疗+传统手法治疗,观察组采用"汉派骨伤"三联疗法治疗,2组治疗4周后对患者效果进行评估,比较2组临床疗效及治疗前、治疗后4周的Constant-Murley肩关节功能评分、中医证候评分,并统计围术期并发症发生率。结果:2组疗效等级差异有统计学意义(P<0.05),观察组总有效率显著高于对照组(P<0.05)。Constant-Murley肩关节功能评分治疗前2组比较,差异无统计学意义。2组治疗后与治疗前比较,VAS评分、主证、次证评分下降(P<0.05),且观察组评分低于对照组,ADL、ROM、MMT评分均显著上升(P<0.05),且观察组ADL、ROM、MMT评分高于对照组(P<0.05);观察组均顺利完成臂丛神经麻醉,均1次穿刺成功,且2组均未见肩关节脱位、肱骨外科颈骨折等严重并发症,观察组术后头晕、血压异常升高及患侧肢体麻木各1例,对照组2例血压升高比较,差异无统计学意义(P>0.05)。结论:高频超声全程引导下"汉派骨伤"三联疗法治疗肩周炎安全性佳,且较局部痛点阻滞治疗+传统手法治疗,其对肩周炎患者肩关节功能及临床症状改善更显著,值得临床推介。

Objective:To study the application of"Hanpai bone injury"triple therapy in patients with frozen shoulder and the influence on syndrome scores.Methods:A total of 120 cases of scapulohumeral periarthritis admitted to Wuhan Chinese Medicine Hospital from January 2018 to December 2018 were selected as research subjects,and they were divided into an observation group and a control group according to random number table,with 60 cases in each group.The control group was given local pain point block treatment+traditional manual therapy.The observation group was treated with"Hanpai bone injury"triple therapy.The effects of the 2 groups were evaluated after 4 weeks of treatment.The clinical efficacy of the 2 groups and the Constant-Murley shoulder function scores and TCM syndromes scores before and 4 weeks after treatment were compared.The incidence of perioperative complications was calculated.Results:There were significant differences in the efficacy grades between the 2 groups(P<0.05).The total effective rate of the observation group was higher than the control group(P<0.05).There was no difference in the Constant-Murley shoulder function score between the 2 groups before treatment.After treatment,the VAS score,primary syndrome and secondary syndrome scores decreased after treatment(P<0.05).The scores of the observation group were lower than the control group.ADL,ROM and MMT scores of the 2 groups increased significantly(P<0.05),and ADL,ROM and MMT scores of the observation group were higher than the control group(P<0.05).The observation group successfully completed the brachial plexus anesthesia,and one puncture was successful.No serious complications such as shoulder dislocation,sacral neck fracture,etc.occurred in both groups.There were 1 case of postoperative dizziness,1 case of blood pressure abnormal elevation and 1 case of numbness of the affected limbs in the observation group.There were 2 cases of blood pressure elevation in the control group.The differences were not statistically significant(P>0.05).Conclusion:The high-frequency ultrasound guided"Hanpai bone injury"triple therapy for the treatment of scapulohumeral periarthritis is safe,and it is more effective than local pain point block treatment+traditional manipulation.It improves the shoulder function and clinical symptoms of patients with scapulohumeral periarthritis more significantly,and it is worthy of clinical promotion.