Hold-relax手法联合中药溻渍治疗肩袖损伤疗效观察

Observation on curative effect of Hold-relax manipulation combined with Chinese medicine for soaking on rotator cuff injury

目的探讨保持-放松(Hold-relax)手法联合中药溻渍治疗肩袖损伤患者的临床疗效。方法选取石家庄市人民医院2016年4月—2017年12月收治的106例肩袖损伤患者为研究对象,随机分成观察组和对照组,每组53例。对照组给予常规手法、药物及物理治疗,观察组给予Hold-relax手法联合中药溻渍治疗。比较2组患者治疗前及治疗1周、4周、12周、1年后UCLA肩关节评分,治疗前及治疗12周后肩关节前屈、内旋、外旋活动度和疼痛数字评分量表(NRS)评分、功能独立性测量(FIM)量表中的自理能力评分,统计2组治疗12周后肩关节功能恢复优良率。结果观察组治疗1周、4周、12周、1年后UCLA评分中疼痛、功能、关节主动前屈、前屈曲力量、患者满意度评分均较本组治疗前明显升高(P均<0.05),且治疗4周、12周、1年后各项评分均明显高于对照组同期(P均<0.05)。对照组治疗1周、4周后疼痛、功能、主动前屈、前屈曲力量评分及治疗12周后疼痛、功能评分均较本组治疗前明显升高(P均<0.05),治疗1年后疼痛、功能、主动前屈、前屈曲力量评分与本组治疗前比较差异无统计学意义(P均>0.05),治疗后各时间点患者满意度评分与本组治疗前比较差异均无统计学意义(P均>0.05)。2组治疗12周后肩关节前屈、内旋、外旋活动度均较本组治疗前扩大(P均<0.05),且观察组均大于对照组(P均<0.05)。2组治疗12周后NRS评分均降低,FIM评分均升高,且观察组NRS评分低于对照组,FIM评分高于对照组,差异均有统计学意义(P均<0.05)。治疗12周后,观察组优良率为88.67%(47/53),对照组为77.36%(41/53),观察组优于对照组(P<0.05)。结论Hold-relax手法联合中药溻渍治疗可快速改善肩袖损伤患者肩关节功能和疼痛症状,临床疗效显著。

Objective It is to explore the clinical effect of the hold-relax manipulation combined with traditional Chinese medicine for soaking in the treatment of patients with rotator cuff injury.Methods A total of 106 patients with rotator cuff injury admitted to Shijiazhuang People’s Hospital from April 2016 to December 2017 were selected as the research objects,and they were randomly divided into observation group and control group,with 53 cases in each group.The control group was treated with conventional manipulation,medicine and physical therapy,and the observation group was treated with Hold-relax manipulation combined with Chinese medicine for soaking.The UCLA shoulder joint scores before treatment and after treatment for 1 week,4 weeks,12 weeks,1 year,the motion range of shoulder joint forward flexion,internal rotation,external rotation,the scores of Numerical Rating Scale(NRS),self-care ability score of functional independence measurement(FIM)scale before treatment and after treatment for 12 weeks were compared between the two groups,the recovery rate of shoulder joint function in the two groups after 12 weeks of treatment was assessed.Results The scores of pain,function,joint active forward flexion,forward flexion strength,and patient satisfaction in UCLA scores after treatment for 1 week,4 weeks,12 weeks,and 1 year in the observation group were significantly higher than those before treatment(P<0.05),and the scores after treatment for 4 weeks,12 weeks,and 1 year were significantly higher than those of the control group at the same period(P<0.05).The scores of pain,function,active forward flexion and flexion strength after treatment for 1 week and 4 weeks,and the pain and function scores after 12 weeks of treatment were significantly higher than those before treatment in the control group(P<0.05),but the score of pain,function,active forward flexion,and forward flexion strength after 1 year of treatment were not statistically different from those before treatment(P>0.05),there was no significant difference in patient satisfaction scores at each time point after treatment and before treatment in the control group(all P>0.05).The movement range of shoulder joint flexion,internal rotation and external rotation after treatment were all larger than those before treatment in the two groups(P<0.05),and the observation group was larger than the control group(P<0.05).After treatment for 12 weeks,the NRS scores were significantly decreased,and the FIM scores were significantly increased in the two groups(all P>0.05),the NRS score was lower and the FIM score was higher in the observation group than that in the control group,the differences were statistically significant(both P<0.05).After treatment for 12 weeks the excellent and good rate of the observation group was 88.67%(47/53),and that of the control group was 77.36%(41/53),the observation group was better than the control group(P<0.05).Conclusion Hold-relax manipulation combined with the traditional Chinese medicine for soaking can quickly improve the shoulder joint function and pain symptoms of patients with rotator cuff injury,and the clinical effect is significant.