针刀联合热敷散治疗粘连期肩周炎临床观察

Clinical Observation on Treatment of Scapulohumeral Periarthritis with Acupotomy Combined with Refu Powder(热敷散)

目的观察针刀联合热敷散治疗粘连期肩周炎的临床疗效。方法选择2020年9月—2021年1月陕西中医药大学附属医院康复医学科住院的粘连期肩周炎患者共78例,随机分为治疗组和对照组,每组39例。治疗组予针刀联合热敷散治疗,对照组单纯予针灸联合热敷散治疗,治疗4个疗程后对比两组临床疗效,McGill疼痛量表评分[现在疼痛情况(PPI)、视觉疼痛评分(VAS)、疼痛评级指数(PRI)],白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平,肩关节活动度(前屈、后伸、外展),治疗结束后6~8个月随访复发率及加重率。结果治疗组总有效率(94.9%)较对照组(84.6%)显著增高(P<0.05)。治疗组复发率(8.1%)较对照组(24.2%)显著降低(P<0.05);治疗组加重率(0)较对照组(12.8%)显著降低(P<0.05)。两组患者McGill疼痛量表评分(PPI、VAS、PRI)均较治疗前显著降低(P<0.05);治疗组较对照组评分降低显著(P<0.05)。两组患者IL-6、TNF-α水平均较治疗前显著降低(P<0.05);治疗组较对照组水平降低显著(P<0.05)。治疗组与对照组肩关节活动度(前屈、后伸、外展)较治疗前显著扩大(P<0.05);治疗组较对照组关节活动度扩大显著(P<0.05)。结论针刀联合热敷散治疗粘连期肩周炎患者可显著缓解疼痛及改善功能活动,值得临床推广。

Objective To observe the clinical efficacy of acupotomy combined with Refu Powder(热敷散)in the treatment of periarthritis of shoulder at adhesion stage.Methods A total of 78 patients with scapulohumeral periarthritis at adhesion stage who were hospitalized in the department of rehabilitation medicine,affiliated hospital of Shaanxi university of traditional Chinese medicine from September 2020 to January 2021 were randomly divided into treatment group and control group,with 39 cases in each group.The treatment group was treated with acupotomy combined with Refu Powder,and the control group was treated with acupuncture combined with Refu Powder.After 4 courses of treatment,the clinical efficacy,McGill pain scale(PPI,VAS,PRI)score,IL-6,TNF-α,range of motion of shoulder(flexion,extension and abduction),recurrence rate and aggravation rate were compared between the two groups during 6-8 months after treatment.Results The total effective rate of the treatment group was 94.9%,which was significantly higher than that of the control group(84.6%)(P<0.05).The recurrence rate of 8.1%in treatment group was significantly lower than 24.2%in control group(P<0.05).The aggravation rate of the treatment group was 0,which was significantly lower than that of the control group(12.8%)(P<0.05).McGill pain scale(PPI,VAS,PRI)scores of two groups were significantly lower than before treatment,and the differences were as follows:IL-6 and TNF-αof two groups were significantly lower than before treatment(P<0.05).Compared with the control group(IL-6,TNF-α),IL-6 and TNF-αin the treatment group were significantly decreased(P<0.05).The range of motion(flexion,extension and abduction)of shoulder joint in the treatment group and the control group was significantly increased compared with that before treatment(P<0.05).The range of motion in the treatment group was significantly higher than that in the control group(P<0.05).Conclusion Acupotomy combined with Refu Powder can significantly relieve pain and improve functional activities in patients with adhesion periarthritis of shoulder,which is worthy of clinical promotion.