肌骨超声引导下注射正清风痛宁联合关节松动术对肩关节周围炎的临床疗效观察

Clinical Observation of Musculoskeletal Ultrasound-guided Injection of Zhengqing Fengtongning Combined with Joint Mobilization on Periarthritis of Shoulder

目的:探讨肌骨超声引导下注射正清风痛宁联合关节松动术对肩关节周围炎的临床疗效。方法:选择2020年3月-2021年10月景德镇市第二人民医院收治的肩关节周围炎患者100例作为研究对象,采用随机数字表法将其分为观察组(50例)和对照组(50例)。对照组采用关节松动术进行治疗,观察组在对照组基础上增加肌骨超声引导下正清风痛宁局部注射,比较两组临床疗效、治疗前后的肩关节疼痛视觉模拟评分法(VAS)评分、肩关节活动度(ROM)、美国加州大学洛杉矶分校肩关节评分系统(UCLASS)评分及血浆β-内啡肽(β-EP)和P物质(SP)表达水平。结果:观察组治疗总有效率高于对照组,观察组治疗后VAS评分低于对照组,观察组治疗后肩关节ROM均大于对照组,观察组治疗后UCLASS评分高于对照组,观察组治疗后β-EP水平高于对照组,SP水平低于对照组,差异均有统计学意义(P<0.05)。结论:肌骨超声引导下正清风痛宁局部注射联合关节松动术治疗肩关节周围炎可提高治疗效果,改善患者肩关节功能及疼痛情况,可能与调节SP及β-EP水平有关。

Objective:To investigate the clinical effect of musculoskeletal ultrasound-guided injection of Zhengqing Fengtongning combined with joint mobilization on periarthritis of the shoulder.Method:A total of 100 patients with periarthritis of shoulder who were treated in the Second People’s Hospital of Jingdezhen from March 2020 to October 2021 were selected as the research objects.They were divided into the observation group(50 cases)and the control group(50 cases)by random number table method.The control group was treated with joint mobilization,and the observation group was given local injection of Zhengqing Fengtongning under the guidance of musculoskeletal ultrasound on the basis of the control group.The clinical efficacy,the visual analogue scale(VAS)of shoulder joint pain,shoulder range of motion(ROM),University of California at Los Angeles scoring system(UCLASS)scores and the expression levels of plasma β-endorphin(β-EP)and substance P(SP)between the two groups before and after treatment were compared.Result:The total effective rate of the observation group was higher than that of the control group,the VAS score of the observation group was lower than that of the control group after treatment,the ROM angles of the shoulder joint in the observation group were greater than that of the control group after treatment,the UCLASS score of the observation group was higher than that of the control group after treatment,the level ofβ-EP was higher than that of the control group,and the level of SP was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusion:Under the guidance of myosseous ultrasound,local injection combined with joint loosening in the treatment of periarthritis of shoulder can improve the shoulder function and pain in patients,which may be related to the regulation of SP and-EP levels.