加味川羌活汤联合手法推拿、理疗对肩关节疼痛患者肩关节功能及肩周炎症的影响研究

Study on Effects of Modified Chuanqianghuo Tang Combined with Tuina with Manipulation and Physiotherapy on Shoulder Joint Function and Scapulohumeral Periarthritis in Patients with Shoulder Pain

目的:观察加味川羌活汤联合手法推拿、理疗对肩关节疼痛患者肩关节功能及肩周炎症的影响。方法:采用信封法将128例肩关节疼痛患者分为2组各64例。对照组采用手法推拿和理疗治疗,观察组在对照组基础上联合加味川羌活汤治疗,比较2组治疗效果、关节主动活动度、疼痛情况、肩关节功能及炎症因子水平。结果:观察组治疗总有效率95.31%,高于对照组82.81%(P<0.05)。与同组治疗前比较,治疗后2组关节主动活动度均增大(P<0.05),各项肩关节功能评分及血清白细胞介素-10(1L-10)水平均升高(P<0.05),疼痛视觉模拟评分法(VAS)、疼痛分级指数(PRI)、现在疼痛状况(PPI)评分及血清前列腺素E2(PGE2)、肿瘤坏死因子-α(TNF-α)、血浆P物质(SP)水平均降低(P<0.05);与对照组治疗后比较,观察组治疗后关节主动活动度较大(P<0.05),各项肩关节功能评分及血清IL-10水平均较高(P<0.05),VAS、PRI、PPI评分及血清PGE2、TNF-α、SP水平均较低(P<0.05)。结论:加味川羌活汤联合手法推拿、理疗治疗肩关节疼痛效果较好,可缓解肩周炎症状,恢复肩关节功能,其机制可能与正向调节炎症因子水平有关。

Objective:To observe the effects of modified Chuanqianghuo tang combined with tuina with manipulation and physiotherapy on shoulder joint function and scapulohumeral periarthritis in patients with shoulder pain.Methods:A total of 128 cases of patients with shoulder joint pain were divided into two groups by envelope method,with 64 cases in each group.The control group was treated with tuina with manipulation and physiotherapy,and the observation group was additionally treated with modified Chuanqianghuo tang based on the treatment of the control group.Curative effects,active range of joint motion,pain status,shoulder joint function and levels of inflammatory factor were compared between the two groups.Results:The total effective rate was 95.31%in the observation group,higher than that of 82.81%in the control group(P<0.05).After treatment,active range of joint motion in the two groups was increased when compared with that before treatment(P<0.05);each score of shoulder joint function and levels of serum interleukin-10(IL-10)were increased(P<0.05);scores of Visual Analogue Scale(VAS)of pain,Pain Rating Index(PRI),and Present Pain Intensity(PPI),as well as levels of prostaglandin E2(PGE2)and tumor necrosis factor-α(TNF-α)in serum,and substance P(SP)in plasma were decreased(P<0.05).After treatment,active range of joint motion in the observation group was larger than that in the control group(P<0.05),each score of shoulder joint function and serum IL-10 level higher(P<0.05),scores of VAS,PRI,and PPI,as well as levels of PGE2 and TNF-αin serum,and SP lower(P<0.05).Conclusion:Modified Chuanqianghuo tang combined with tuina with manipulation and physiotherapy has a good effect in the treatment of shoulder joint pain,and can relieve scapulohumeral periarthritis and recover shoulder joint function.Its mechanism maybe related to its positive regulation of inflammatory factor levels.