经络理论指导体外冲击波治疗冻结肩的临床研究

Clinical Study of Extracorporeal Shock Wave Therapy Guided by Meridian Theory for Treatment of Patients with Frozen Shoulder

【目的】探索经络理论指导体外冲击波冲击穴位治疗冻结肩(肩周炎)的疗效。【方法】将60例冻结肩患者随机分为试验组和对照组,每组各30例。试验组对冻结肩患者患肩局部腧穴及四肢远端腧穴行体外冲击波治疗,对照组对冻结肩患者患肩痛点行常规体外冲击波治疗,2组均每周治疗1次,共治疗5次。观察2组患者治疗前、末次治疗后和治疗结束后4周时的疼痛视觉模拟量表(VAS)评分、日常生活活动能力(ADL)评分和肩关节活动度(ROM)评分的变化情况,并评价2组患者的临床疗效及安全性。【结果】(1)治疗结束后4周,试验组的总有效率为96.7(29/30),对照组为90.0%(27/30);组间比较(非参数秩和检验),试验组的疗效略优于对照组,差异有统计学意义(P<0.05)。(2)末次治疗后及治疗结束后4周,2组患者的VAS评分均较治疗前明显降低(P<0.05),ADL评分和ROM评分均较治疗前明显提高(P<0.05或P<0.01),且试验组对VAS评分的降低作用及对ADL评分和ROM评分的提高作用均明显优于对照组,差异均有统计学意义(P<0.05或P<0.01)。(3)治疗过程中,2组患者均未出现呼吸、脉搏、心率、血压等生理指标的异常变化,除少数患者治疗局部出现瘀斑、触痛(但能自行消除)外,未见其他不良反应发生。【结论】以中医经络理论指导的体外冲击波治疗冻结肩疗效确切,能够明显缓解患者的疼痛症状,改善患者的患肩活动度,提高患者的生活质量。

Objective To investigate the therapeutic effect of extracorporeal shock wave shock acupoint therapy guided by meridian theory for the treatment of frozen shoulder(also known as scapulohumeral periarthritis).Methods Sixty patients with frozen shoulder were recruited from April 2019 to December 2019.The patients were divided into trial group and control group,30 cases in each group.The trial group was given extracorporeal shock wave shock acupoint therapy on focal acupoints of the affected shoulder and the acupoints on the four limbs.The control group was given extracorporeal shock wave therapy on the foci of the affected shoulder.The two groups received the corresponding therapy once a week,and the treatment was performed for 5 times.Before treatment,at the end of the last treatment,and 4 weeks after the last treatment,the visual analogue scale(VAS)pain scores,the activities of daily living(ADL)scores and the scores of the range of motion(ROM)of the shoulder in the two groups were compared.And after treatment,the clinical efficacy and safety in the two groups were also evaluated.Results(1)Four weeks after the last treatment,the total effective rate of the trial group was 96.7(29/30)and that of the control group was 90.0%(27/30).The intergroup comparison by nonparametric rank sum test showed that the therapeutic efficacy of the trial group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)At the end of the last treatment and 4 weeks after the last treatment,VAS scores of the two groups were obviously decreased(P<0.05),and ADL scores and ROM scores were obviously increased in comparison with those before treatment(P<0.05 or P<0.01).The trial group had stronger effect on decreasing VAS scores and on increasing ADL scores and ROM scores than the control group,the difference being statistically significant(P<0.05 or P<0.01).(3)During the trial,no abnormal changes were found in the respiration,pulse,heart rate,or blood pressure.A few patients had focal ecchymosis and tenderness(disappearing spontaneously),and there was no other adverse reaction occurring in the two groups.Conclusion Extracorporeal shock wave shock therapy guided by meridian theory exerts certain effect for the treatment of frozen shoulder.The therapy is effective for significantly relieving the pain symptom,and can improve the range of movement of the affected shoulder and the quality of life of the patients.