个体化作业联合小针刀对顽固性肩周炎疗效及患者三角肌肌信号的影响

Curative Effects of Individualized Therapy and Small Needle-knife in Treating Refractory Scapulohumeral Periarthritis and Its Influence on Deltoid Muscle Signal

目的:探讨个体化作业联合小针刀治疗顽固性肩周炎的疗效及对患者三角肌肌信号的影响。方法:将120例顽固性肩周炎患者按照随机数字表法分为观察组和对照组各60例。对照组采用小针刀治疗,观察组采用个体化作业联合小针刀治疗。比较两组患者临床疗效、视觉模拟评分法(visual analogue scale,VAS)评分、三角肌肌信号、Constant-Murley肩关节评分量表(Constant-Murley shoulder scoring scale,CMS)评分、肩关节活动度、炎症指标[白细胞介素10(interleukin-10,IL-10)、白细胞介素1β(interleukin-1β,IL-1β)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、前列腺素E_(2)(prostaglandin E_(2),PGE_(2))]水平。结果:观察组有效率为91.67%,高于对照组的78.33%(P<0.05);治疗后观察组VAS评分低于对照组,三角肌肌信号、CMS评分高于对照组(P<0.05);治疗后观察组前屈、后伸、内旋、外旋、外展最大活动度大于对照组(P<0.05);治疗后观察组IL-10水平高于对照组,IL-1β、TNF-α、PGE_(2)水平低于对照组(P<0.05)。结论:个体化作业联合小针刀能够降低顽固性肩周炎患者肩周区疼痛程度,改善三角肌肌信号,增加肩关节活动度,促进炎症恢复,从而提高肩关节功能评分及临床疗效,效果优于单独应用小针刀。

Objective:To discuss clinical effects of individualized therapy combined with small needle-knife in the treatment of refractory scapulohumeral periarthritis and its effects on deltoid muscle signal.Methods:All 120 patients were randomized into the observation group the control group according to random number table method,with 60 cases in each group.The control group adopted small needle-knife,and the observation group individualized therapy as well as small needle-knife.To compare clinical effects,VAS scores,deltoid muscle signal,CMS,range of motion(ROM)of shoulder joint,the levels of inflammatory biomarkers[IL-10,IL-1β,TNF-α and PGE_(2)]between both groups.Results:The effective rate of the observation group was 91.67%,higher than 78.33%of the control group(P<0.05);after treatment,the observation group was lower than the control group in VAS scores,higher than the control group in deltoid muscle signal and CMS(P<0.05);after treatment,the observation group was larger than the control group in maximum ROM of pronation,extension,intorsion,extorsion and abduction(P<0.05);after the treatment,the observation group was higher than the control group in the levels of IL-10,lower than the control group in the levels of IL-1β,TNF-α and PGE_(2)(P<0.05).Conclusion:Individualized therapy and small needle-knife could reduce pain degrees around shoulder area,improve deltoid muscle signal,increase ROM of shoulder joint,promote the recovery of inflammation,thus improving the scores of CMS and clinical effects,and its effects are better than these of single use of small needle-knife.