穴位点按疗法治疗老年急性期肩周炎的临床观察

Clinical observation of acupoint pressing therapy in the treatment of acute scapulohumeral periarthritis in elderly patients

目的观察点按合谷穴和颈肩穴对急性期肩周炎的即刻疗效,量化点按合谷穴治疗急性期肩周炎的刺激方式、时间和强度,为临床治疗肩周炎提供的依据。方法选择2018年4月-2020年10月在复旦大学附属金山医院就诊的老年肩周炎患者180例,按照数字表法随机分为3组:对照组(n=60)、观察1组(n=60)和观察2组(n=60)。对照组采用针刺双侧合谷穴治疗;观察1组采取点按合谷穴,点按2s,放松1s,再点按2s放松1s,频率为20次/min,治疗时间3 min,点按颈肩穴,给予强刺激点按3s,放松局部肌肉10 s后再点按颈肩穴3s,共计循环治疗2次;观察2组采用持续性点按刺激合谷穴治疗,持续治疗时间3 min,点按颈肩穴,给予强刺激点按3 s,放松局部肌肉10 s后再点按颈肩穴3s,共计循环治疗2次。每组治疗前后,应用VAS疼痛量表评价疼痛程度、UCLA肩关节评分系统评价肩关节功能、人体压痛测定仪评价压痛阈值。结果最终完成试验者有167例,观察1组56例,观察2组55例,对照组56例。与治疗前比较,治疗后观察1组、观察2组及对照组VAS评分下降(P<0.05);治疗后观察1组与观察2组之间VAS评分无统计学差异(P>0.05),两组均高于对照组(P<0.05)。与治疗前比较,治疗后观察1组、观察2组及对照组UCLA肩关节评分增加(P<0.05),治疗后观察1组与观察2组之间UCLA肩关节评分无统计学差异(P>0.05),两组均低于对照组(P<0.05)。与治疗前比较,治疗后观察1组、观察2组及对照组压痛阈值升高(P<0.05);治疗后3组之间压痛阈值接近(P>0.05)。临床疗效看,观察1组有效率为91.0%,观察2组的有效率为89.1%,均与对照组89.3%接近(P>0.05)。结论点按合谷穴和颈肩穴对急性期肩周炎有一定的即刻镇痛作用,其镇痛效果与针刺治疗近似。

Objective To observe the immediate curative effect of pressing Hegu acupoint and neck shoulder acupoint on acute scapulohumeral periarthritis,and quantify the stimulation mode,time and intensity of Hegu acupoint in the treatment of acute scapulohumeral periarthritis,so as to provide a basis for the treatment of the disease.Methods 180 elderly patients with scapulohumeral periarthritis who were treated in Jinshan Hospital Affiliated to Fudan University from April 2018 to Oc-tober 2020 were selected and randomly divided into 3 groups according to the number table:control group(n=60),observation group 1(n=60)and observation group2(n=60).The control group were treated with acupuncture at bilateral Hegu point.The observation group 1 was treated by pressing Hegu acupoint and neck shoulder acupoint.Press Hegu acupoint for 2 s,.relax for 1 S,then press 2 S to relax for 1 S,the frequency was 20 times/min,and the treatment time was 3 min.Press the neck shoulder acupoint with a strong stimulation,press the acupoint for 3 s,relax the local muscles for 10 s,and then press the neck shoulder acupoint for 3s,a total of 2 cycles of treatment.The observation group 2 were treated with continuous pressing Hegu acupoint and neck shoulder acupoint.Firstly,press the Hegu acupoint continuously for 3 min,then press the neck shoulder acupoint with a strong stimulation for 3 s,relax the local muscles for 10 s,and then press the neck shoulder acupoint for 3s,a total of 2 cycles of treatment.Before and after treatment,V AS pain scale was used to evaluate the degree of pain,UCLA Shoulder Scoring System was used to evaluate the function of shoulder joint,and human tenderness tester was used to determine the tenderness threshold.Results 167 patients completed the experiment,including 56 ones in the ob-servation group 1,55 ones in the observation group 2 and 56 ones in the control group.Compared with before treatment,VAS score of the three groups decreased after treatment(P<0.05).After treatment,there was no significant score between the observation group 1 and observation group 2(P>0.05),but their VAS scores were higher than that of the control group(P<0.05).Compared with before treatment,UCLA shoulder score of the three groups increased after treatment(P<0.05),and there was no significant A shoulder score between the observation group 1 and the observation group2(P>0.05),but their UCLA shoulder scores were higher than that of the control group(P<0.05).Compared with before treatment,the ten-derness threshold of the three groups increased after treatment(P<0.05).and the tenderness threshold of the three groups were similar(P>0.05).The effective rate of the observation group 1,observation group 2 and control group were 91.0%,89.1%and 89.3%,respectively,and were no significant difference among three groups(P>0.05).Conclusion Pressing Hegu acupoint and neck shoulder acupoint has a certain immediate analgesic effect on acute scapulohumeral periarthritis,and its analgesic effect is similar to that of acupuncture.