力敏推拿治疗急性期肩周炎患者的临床疗效观察

Clinical Effect Observation of Force-sensitive Massage in Treating Patients with Acute Periarthritis of Shoulder

目的:总结急性期肩周炎患者力敏腧穴的分布规律,观察力敏推拿治疗急性期肩周炎的临床疗效,为优化临床选穴提供依据。方法:探查40例急性期肩关节周围炎患者体表力敏腧穴并记录,分析力敏腧穴与肢体部位、经脉、经穴的关系及其敏化反应特征;选取3~4个力敏腧穴,对患者进行力敏推拿治疗,连续治疗5天,比较治疗前、治疗1天及5天后视觉模拟评分法(VAS)评分、Constant-Murley肩关节功能评分变化。结果:(1)探查力敏腧穴共247穴次,出现频次由高到低依次是肩井、风池、缺盆、臂臑、云门、承山、大椎、清冷渊、手三里穴区,与经穴位置重合的力敏腧穴占70.45%。(2)足少阳胆经(46穴次,18.62%)、手阳明大肠经(38穴次,15.38%)、手太阳小肠经(33穴次,13.36%)、手少阳三焦经(28穴次,11.34%)上力敏腧穴分布频次最多。(3)与治疗前相比,治疗当天VAS评分、Constant-Murley肩关节功能评分差异均有统计学意义(P<0.05,P<0.01);与治疗1天相比,治疗5天后VAS评分、Constant-Murley肩关节功能评分均有明显差异(均P<0.01)。结论:(1)急性期肩周炎患者力敏腧穴分布最多的部位是上肢部与肩背部,与足少阳胆经、手三阳经关系最为密切。(2)力敏推拿能够改善急性期肩周炎患者的症状与功能障碍。

Objective:Summarize the distribution of force-sensitive acupoints in patients with acute periarthritis of shoulder,observe the clinical effect of force-sensitive massage in treating acute periarthritis of shoulder,and provide the basis for optimizing clinical acupoints selection.Methods:The force-sensitive acupoint on body surface of 40 patients with acute scapulohumeral periarthritis were explored and recorded,and the relationship between the force-sensitive acupoint and limb parts,meridians and acupoints as well as their sensitization characteristics were analyzed.Three or four of force-sensitive acupoints were selected and subjected to force-sensitive massage treatment for five consecutive days.The changes of visual analogue scale(VAS)and Constant-Murley shoulder function score before treatment,1 day and 5 days after treatment were compared.Results:(1)A total of 247 force-sensitive acupoints were explored,and the order of occurrence frequency from high to low was Jianjing,Fengchi,Quepen,Binao,Yunmen,Chengshan,Dazhui,Qinglengyuan and Shousanli,70.45%of the acupoints were sensitive to force,which coincided with the meridian acupoints.(2)The gallbladder meridian of foot-Shaoyang(46 acupoints,18.62%)was most frequently distributed,together with the large intestine meridian of hand-Yangming(38 acupoints,15.38%),small intestine meridian of hand-Taiyang(33 acupoints,13.36%)and sanjiao meridian of hand-Shaoyang(28 acupoints,11.34%).(3)Compared with those before treatment,there were significant differences in VAS score and Constant-Murley shoulder joint function score on the day of treatment(P<0.05,P<0.01);After 5 days of treatment,there were significant differences in VAS score and shoulder joint function as compared with those on day 1(P<0.01).Conclusion:(1)In patients with acute scapulohumeral periarthritis,the sites where the force-sensitive acupoints were most distributed were the upper limbs and shoulders and back,which were most closely related to the gallbladder meridian of gallbaldder meridian of foot-shaoyang and the three yang meridians of hand.(2)Force-sensitive massage can improve the symptoms and dysfunction of patients with acute periarthritis of shoulder.