温针灸结合肩关节手法松解治疗肩周炎的效果及对关节受限的改善作用

Effect of warm acupuncture combined with relaxation of shoulder joint on scapulohumeral periarthritis and improvement of joint limitation

目的研究温针灸结合肩关节手法松解治疗肩周炎的效果及对关节受限的改善作用。方法选取2018年10月至2020年1月本院收治的肩周炎患者164例作为此次研究对象,按简单随机化分组方法分为两组,各82例。甲组男37例,女45例,年龄(47.57±6.13)岁;乙组男39例,女43例,年龄(48.25±6.98)岁。甲组采用温针灸治疗,乙组采用温针灸联合肩关节手法松解治疗;比较两组治疗前及治疗4周后肩关节功能评分、疼痛评分及体内炎性因子水平,并评估两组治疗效果。结果治疗前,两组患者肩关节功能评分量表(Constant-Murley-Score,CMS)及疼痛数字评分法(Numerical Rating Scale,NRS)比较,差异均无统计学意义(均P>0.05);治疗4周后,乙组关节活动度、日常生活工作能力、肌力评分分别为(34.08±2.81)分、(14.19±2.49)分、(17.65±3.98)分,均高于甲组(32.96±2.59)分、(12.87±2.66)分、(15.97±3.69)分,NRS评分为(4.21±3.09)分,低于甲组(5.68±3.22)分,差异均有统计学意义(均P<0.05);治疗前,两组患者炎性因子水平比较,差异均无统计学意义(均P>0.05);治疗4周后,乙组白细胞介素-6(interleukin-6,IL-6)、白细胞介素-10(interleukin-10,IL-10)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平分别为(50.67±4.75)ng/L、(6.76±3.49)ng/L、(14.73±3.72)ng/L,均低于甲组(52.62±4.58)ng/L、(8.18±3.31)ng/L、(16.62±3.81)ng/L,差异均有统计学意义(均P<0.05);乙组治疗4周后治疗总有效率为93.90%(77/82),高于甲组84.15%(69/82),差异有统计学意义(P<0.05)。结论温针灸结合肩关节手法松解治疗可明显改善肩周炎患者肩关节活动度,提高患者日常生活工作能力,增加肩关节肌力,并有效缓解患者肩关节疼痛,减轻炎症反应,疗效显著。

Objective To study the effect of warm acupuncture combined with relaxation of shoulder joint in the treatment of scapulohumeral periarthritis and the improvement of joint limitation.Methods One hundred and sixty-four patients with scapulohumeral periarthritis treated at our hospital from October,2018 to January,2020 were selected as the research objects.According to the simple randomized grouping method,they were divided into group A and group B,with 82 cases in each group.There were 37 males and 45 females in group A;they were(47.57±6.13)years old.There were 39 males and 43 females in group B;they were(48.25±6.98)years old.Group A were treated with warm acupuncture,and group B with warm acupuncture and shoulder joint relaxation.The shoulder joint function scores,pain scores,and inflammatory factor levels of the two groups before and 4 weeks after the treatment were compared.The therapeutic effects of the two groups were evaluated.Results Before the treatment,there were no statistical differences in the scores of constant-murley-score(CMS)and numerical rating scale(NRS)between the two groups(all P>0.05).After 4 weeks'treatment,the scores of ROM,ADL,and muscle strength were higher and the NRS score was lower in group B than in group A[(34.08±2.81)vs.(32.96±2.59),(14.19±2.49)vs.(12.87±2.66),(17.65±3.98)vs.(15.97±3.69),and(4.21±3.09)vs.(5.68±3.22);all P<0.05].Before the treatment,there were no statistical differences in the levels of inflammatory factors between the two groups(all P>0.05);after 4 weeks'treatment,the levels of interleukin-6(IL-6),interleukin-10(IL-10),and tumor necrosis factor-α(TNF-α)were lower in group B than in group A[(50.67±4.75)ng/L vs.(52.62±4.58)ng/L,(6.76±3.49)ng/L vs.(8.18±3.31)ng/L,and(14.73±3.72)ng/L vs.(16.62±3.81)ng/L;all P<0.05].After 4 weeks'treatment,the treatment effect was higher in group B than in group A[93.90%(77/82)vs.84.15%(69/82),P<0.05].Conclusion Warm acupuncture combined with relaxation of shoulder joint can significantly improve the range of motion of shoulder joint in patients with scapulohumeral periarthritis,improve their ability of daily life and work as well as their muscle strength of shoulder joints,and effectively relieve their pain of shoulder joints and inflammatory reaction.