以肩三穴为主穴针刺联合特定电磁波照射治疗肩周炎70例临床观察

Clinical observation on 70 cases of periarthritis of shoulder treated by acupuncture at three scapulohumeral points as main acupoint combined with TDP irradiation treatment

目的观察以肩三穴(肩前、肩髃、肩髎)为主穴针刺联合特定电磁波(TDP)照射治疗肩周炎的临床疗效。方法将140例肩周炎患者采用随机数字表法分为对照组和治疗组,各70例。对照组采用超短波电疗机和电脑中频治疗仪联合治疗;治疗组选取患肩肩三穴(肩前、肩髃、肩髎)为主穴深刺,并联合TDP照射,配以肩井、肩贞、臂臑、外关、合谷穴等常规针刺。2组均每日治疗1次,连续治疗5次休息2 d,治疗10次为1个疗程,1个疗程后比较2组的临床疗效以及治疗前后的夜间视觉模拟评分法(VAS)评分、肩关节功能(包括疼痛、肩关节活动范围、日常生活能力、肌力、肩关节局部形态等5项)评分,观察2组患者的不良反应发生情况。结果对照组总有效率为71.43%(50/70),治疗组为97.14%(68/70),2组比较差异有统计学意义(P<0.01);治疗后2组夜间VAS评分均明显降低,与同组治疗前比较差异有统计学意义(P<0.01),且治疗组降低更明显,与对照组治疗后比较差异有统计学意义(P<0.01);治疗后治疗组肩关节功能各项评分均明显升高,对照组除肩关节局部形态评分外,其他各项评分均明显升高,与同组治疗前比较差异有统计学意义(P<0.05或P<0.01),治疗后治疗组除肩关节局部形态评分外,其他各项评分均明显高于对照组,差异有统计学意义(P<0.05);2组患者在治疗期间均未发生明显不良反应。结论以肩三穴为主穴针刺联合TDP照射治疗肩周炎疗效显著,可有效缓解肩周疼痛,改善肩关节功能,疗程短,且无明显不良反应,值得临床推广应用。

Objective To observe the clinical efficacy of needling at three scapulohumeral points[Jianqian,Jianyu( LI 15) and Jianliao( TE 14) ]as main acupoint combined with TDP irradiation treatment for periarthritis of shoulder. Methods Totally 140 cases of periarthritis of shoulder were divided into control group and treatment group according to random number table method,with 70 cases in each group. In the control group,ultrashort wave diathermy apparatus and computerized intermediate frequency therapy apparatus were given as combined treatment;In the treatment group,three scapulohumeral points[Jianqian,Jianyu( LI 15) and Jianliao( TE 14) ] of affected shoulder were selected as main acupoints for deep needling,and combined with TDP irradiation treatment,cooperated with routine acupuncture at points of Jianjing( GB 21),Jianzhen( SI 9),Binao( LI 14),Waiguan( TE 15) and Hegu( LI 4) etc. The 2 groups were treated once a day for 5 consecutive times,rested for 2 days,and treated for 10 times as 1 course of treatment. After 1 course of treatment,the clinical efficacy,the scores of night visual analogue scale( VAS) and shoulder joint function( including pain,shoulder joint range of motion,activity of daily living,myodynamia and local morphology of the shoulder joint) before and after treatment of the 2 groups were compared,and the incidence of adverse reactions of the 2 groups was observed. Results The total effective rate was 71.43%( 50/70) in the control group and 97.14%( 68/70) in the treatment group,and the difference was statistically significant between the 2 groups( P<0.01). After treatment,the night VAS scores of the 2 groups significantly decreased,and the difference was statistically significant than those of the same group before treatment( P<0.01),moreover,the decrease in the treatment group was more significant,and the differences were statistically significant than those of the control group after treatment( P<0.01). After treatment,in the treatment group,the scores of various items of function of the shoulder joint significantly increased,while in the control group,except the score of local morphology of the should joint,the scores of other various items significantly increased,and the differences were statistically significant than those of the same group before treatment( P<0.05 or P<0.01),except the score of local morphology of the shoulder joint,the scores of various items in the treatment group after treatment were significantly higher than those of the control group,and the differences were statistically significant( P<0.05 or P<0.01). There were no significant adverse reactions in the 2 groups during treatment. Conclusion It has marked efficacy,can effectively alleviate scapulohumeral pain,and improve function of the should joint,with short course of treatment and no marked adverse reactions to needling at three scapulohumeral points as main acupoint combined with TDP irradiation treatment for periarthritis of shoulder,which deserves clinical promotion and application.