超声引导下J型针刀联合推拿手法治疗原发性粘连性肩关节囊炎的临床观察

Clinical observation on treatment of primary adhesive shoulder bursitis with J-shaped needle knife combined with massage manipulation under ultrasound guidance

目的探讨超声引导下J型针刀配合推拿手法治疗原发性粘连性肩关节囊炎的疗效。方法选择2020年6月~2021年6月我院收治的诊断为原发性粘连性肩关节囊炎患者60例为研究对象,按随机数字表法分为对照组和研究组,每组30例。对照组采用单纯局部封闭治疗联合推拿手法,研究组采用超声引导下J型针刀联合推拿手法治疗。治疗2周后,比较两组患者治疗前后的疼痛视觉模拟评分(VAS)、疼痛强度(PPI)评分、Constant-Murley肩关节功能评分(CMS)以及肩关节活动度。结果治疗后,两组患者的VAS、PPI评分与治疗前比较均显著下降,CMS评分显著升高,差异均有统计学意义(均P<0.05);研究组治疗后各项评分改善均优于对照组,差异均有统计学意义(均P<0.05)。两组患者的肩关节活动度比较,与治疗前相比,两组患者的肩关节前屈、后伸、外展、内旋、外旋活动度均显著增加(均P<0.05),且研究组肩关节活动度各指标改善显著优于对照组(均P<0.05)。结论超声引导下采用J型针刀配合推拿手法能有效缓解患者疼痛,改善患者肩关节功能,提高肩关节活动度。

Objective To investigate the efficacy of ultrasound-guided J-shaped acupotomy combined with massage manipulation in the treatment of primary adhesive capsulitis of the shoulder.Methods A total of 60 patients diagnosed with primary adhesive shoulder bursitis who were admitted to our hospital from June 2020 to June 2021 were included in the study,and were randomly divided into the control group and the combined group by the random number table method.Thirty cases in the control group were treated with partial sealing alone combined with massage manipulation,while 30 cases in the combined group were treated with ultrasound-guided J-shaped needle knife combined with massage manipulation.After 2 weeks of treatment,the pain visual analogue scale(VAS score),pain intensity(PPI)score,Constant-Murley shoulder function score(CMS score)and the range of motion of the shoulder joint were compared between the two groups before and after treatment.Results Compared with before treatment,the VAS scores and PPI scores of the two groups after treatment were significantly decreased(P<0.05 for both),and the CMS scores were significantly increased(P<0.05);and the VAS scores and PPI scores of the combined group after treatment all were lower than the control group(P<0.05 for both),and the CMS score was higher than that of the control group(P<0.05).Compared with before treatment,the range of motion of shoulder joint in flexion,extension,abduction,internal rotation,and external rotation in both groups were significantly increased(P<0.05 for both),and the shoulder joint in the combined group was flexed,extended,and extended significantly after treatment.The activities of abduction,internal rotation and external rotation were significantly greater than those of the control group(P<0.05).Conclusion The use of J-shaped needle knife combined with massage manipulation under the guidance of ultrasound can effectively relieve the pain,improve the function of the shoulder joint,and improve the range of motion of the shoulder joint.