套管针刀组合火针治疗风寒湿型原发性冻结肩疗效观察

Observation on the curative effect of trocar needle-knife combined with fire-needle on primary frozen shoulder of wind-cold-dampness type

目的观察套管针刀组合火针治疗风寒湿型原发性冻结肩的疗效。方法将2017年4月—2019年4月广州市中西医结合医院诊治的60例风寒湿型原发性冻结肩患者随机分为对照组和观察组,每组30例。对照组给予套管针刀治疗,观察组予套管针刀组合火针治疗,均每10 d治疗1次,连续治疗2次。观察2组患者疼痛VAS评分、Constant-Murley肩关节功能评分以及肩关节活动度变化,记录不良事件发生情况。结果治疗1个月、治疗3个月、治疗6个月后,2组患者VAS评分逐渐降低,Constant-Murley评分逐渐升高,且观察组VAS评分、Constant-Murley评分改善程度均明显优于同期对照组,差异均有统计学意义(P均<0.05)。治疗6个月后,2组患者肩关节前屈、外展、体侧外旋、体侧内旋角度均明显提高(P均<0.05),且观察组均明显高于对照组(P均<0.05)。所有患者均无不良事件发生。结论套管针刀组合火针治疗风寒湿型原发性冻结肩临床疗效优于单纯针刀治疗,且不增加不良事件的风险,具有操作简单、创伤小、风险低、早期临床疗效确切等优点。

Objective It is to observe the efficacy of trocar needle-knife combined with fire-needle in the treatment of primary frozen shoulder of wind-cold-dampness type.Methods Sixty patients with primary frozen shoulder of wind-cold-dampness type treated in Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine from April 2017 to April 2019 were randomly divided into control group and observation group,30 cases in each group.The control group was treated with trocar needle-knife,the observation group was treated with trocar needle-knife combined with fire-needle.Both treatments were performed one time every 10 days for 2 times.The changes in pain VAS score,Constant-Murley shoulder joint function score,and shoulder joint range of motion were observed in the two groups,and the occurrence of adverse events was recorded.Results After 1 month,3 months and 6 months of treatment,the VAS scores of the two groups of patients were gradually decreased,and the Constant-Murley shoulder joint function scores were gradually increased(P<0.05),and the improvement of VAS score and Constant-Murley’s shoulder joint function score in the observation group was better than that in the control group during the same period,and the differences were statistically significant(all P<0.05).After 6 months of treatment,the angles of shoulder joint flexion,abduction,lateral external rotation,and lateral internal rotation of the two groups were significantly increased(P<0.05),and the observation group was significantly higher than the control group(P<0.05).No adverse events occurred in all patients.Conclusion The clinical efficacy of trocar needle-knife combined with fire-needle is better than that of acupotomy alone without increasing the risk of adverse events in the treatment of primary frozen shoulder of wind-cold-dampness type.It has the advantages of simple operation,less trauma,low risk,and accurate early clinical efficacy.