关节腔注射复方倍他米松结合弹力带训练治疗肩峰下滑囊炎的疗效

Efficacy of intra-articular injection of compound betamethasone combined with elastic band training in treating subacromial bursitis

目的观察关节腔注射复方倍他米松结合弹力带训练治疗肩峰下滑囊炎(SAB)的疗效。方法63例SAB患者随机分为两组,对照组31例给予关节腔注射复方倍他米松治疗,观察组32例在对照组基础上增加弹力带训练。比较两组治疗前、治疗3周时及治疗后12周的VAS疼痛评分、肩关节主动关节活动度(AROM)和Constant-Murley肩关节功能评分(CMS),随访1年的再治疗率。结果与治疗前比较,治疗3周时和治疗后12周两组患者VAS疼痛评分降低,肩关节外展、前屈、外旋、内旋AROM增加,CMS增高(P<0.05)。治疗前及治疗3周时,两组患者上述指标比较均无统计学差异(P>0.05);治疗后12周,观察组上述指标改善均优于对照组(P<0.05)。治疗后随访1年中,观察组再治疗率低于对照组(12.5%vs.83.9%)(P<0.05)。结论与单一的关节腔注射复方倍他米松治疗比较,加用弹力带训练更能有效缓解SAB患者的肩痛,增强肩周肌群力量,促进肩关节功能的恢复。

Objective To observe the efficacy of intra-articular injection of compound betamethasone combined with elastic band training in the treatment of subacromial bursitis(SAB).Methods A total of 63 SAB patients were randomly divided into two groups of A(31 cases,treated with compound betamethasone intra-articular injection)and B(32 cases,treated with elastic band training combined with compound betamethasone intra-articular injection).The VAS pain score,shoulder active range of motion(AROM)and Constant-Murley shoulder function score(CMS)of two groups were compared before treatment,3 weeks during treatment and 12 weeks after treatment.Retreatment rates of the patients in one year were followed up.Results Compared with before treatment,the VAS pain score was decreased,shoulder AROM of abduction,flexion,external rotation and internal rotation were increased,and CMS was increased in two groups at 3 weeks and 12 weeks after treatment(P<0.05).Before treatment and 3 weeks during treatment,there were no significant differences in the above indexes between the two groups(P>0.05).The improvement of the above indexes in group B was better than that in group A at 12 weeks after treatment(P<0.05).During the 1-year follow-up after treatment,the retreatment rate in group B was lower than that in group A(12.5%vs 83.9%)(P<0.05).Conclusion Compared to intra-articular injection of compound betamethason alone,combined use of elastic band training can more effectively relieve shoulder pain,enhance the strength of shoulder muscles,and promote the recovery of shoulder joint function in the patients with SAB.