中药超声导入结合按摩手法与护理措施干预肩周炎临床研究

Clinical Study of Sonophoresis of Chinese Herbal Medicine Combined with Massage and Nursing for Scapulohumeral Periarthritis

目的:观察在按摩手法和护理措施基础上加用中药超声导入治疗肩周炎的临床疗效。方法:将90例寒湿瘀阻型肩周炎患者随机分为对照组和观察组各45例。2组均予按摩手法治疗,并予健康宣教、心理护理等护理措施。观察组加用中药超声导入治疗。每周治疗5天,共治疗4周。治疗前后分别采用视觉模拟评分法(VAS)评定肩关节的疼痛程度,采用Constant-Murley肩关节功能评分量表评定肩关节功能,采用美国肩与肘协会评分系统(ASES)评价日常活动情况。比较2组的临床疗效。结果:治疗后,观察组的临床疗效优于对照组(P<0.05)。2组VAS评分和ASES评分均较治疗前下降(P<0.01),观察组VAS评分和ASES评分均低于对照组(P<0.01)。2组Constant-Murley量表疼痛、日常生活活动、肩关节活动度3个维度的评分和总分均较治疗前上升(P<0.01),2组肌力评分治疗前后比较,差异无统计学意义(P>0.05)。观察组疼痛、日常生活活动、肩关节活动度3个维度的评分和总分均高于对照组(P<0.01)。结论:在按摩手法和护理措施基础上加用中药超声导入治疗肩周炎,可有效减轻疼痛程度,改善关节功能,提高患者的日常生活活动能力,临床疗效显著。

Objective:To observe the clinical effect of sonophoresis of Chinese herbal medicine based on massage and nursing for scapulohumeral periarthritis.Methods:A total of 90 cases of patients with scapulohumeral periarthritis of colddampness stasis obstruction type were randomly divided into the control group and the observation group,45 cases in each group.Both groups were given massage and nursing measures such as health propaganda and education as well as psychological nursing.The observation group was additionally treated with sonophoresis of Chinese herbal medicine.Both groups were treated for five days a week for four weeks.Before and after treatment,the pain of shoulder joint was evaluated by Visual Analogue Scale(VAS),the function of shoulder joint by Constant-Murley Shoulder Joint Function Assessment Scale,and the daily activity by the American Shoulder and Elbow Surgeons(ASES).The clinical effect in the two groups was compared.Results:After treatment,the clinical effect in the observation group was superior to that in the control group(P<0.05).The scores of VAS and ASES in the two groups were decreased when compared with those before treatment(P<0.01),and the scores in the observation group were lower than those in the control group(P<0.01).The scores of pain,activities of daily living and range of motion of shoulder joint in Constant-Murley Score and their total scores in the two groups were increased when compared with those before treatment(P<0.01);there was no significant difference being found in the comparison of the scores of muscle strength before and after treatment in the two groups(P>0.05).The scores of pain,activities of daily living and range of motion of shoulder joint as well as their total scores in the observation group were all higher than those in the control group(P<0.01).Conclusion:The therapy of sonophoresis of Chinese herbal medicine based on massage and nursing in treating scapulohumeral periarthritis can effectively relieve the pain and improve the joint function and activities of daily living of patients,with significant clinical effect.