针刀镜配合手法松解治疗重度肩周炎的中长期疗效及对血清炎性因子的影响

Long Term Efficacy of Acupotomy Scope Combined with Manipulation Release on the Treatment of Severe Periarthritis of Shoulder and Its Influence on Serum Inflammatory Factors

目的:观察针刀镜配合手法松解治疗重度肩周炎的中长期疗效及对血清炎性因子的影响。方法:按照随机数字表法将2019年7月至2021年12月收治的96例重度肩周炎患者随机分为对照组(全麻下手法松解结合银质针温针灸治疗组)和治疗组(针刀镜配合手法松解组),每组各48例。观察两组患者治疗前、治疗后1周血清IL-1、IL-6、IL-8、TNF-α水平,及治疗前、治疗后1周、1个月、3个月及6个月后的肩关节疼痛、肩关节活动功能、日常生活能力评分及总评分,并比较两组患者的临床疗效。结果:两组患者治疗后1周的血清IL-1、IL-6、IL-8、TNF-α水平较治疗前均有所降低,且治疗组下降的幅度大于对照组,差异有统计学意义(P<0.05);两组患者治疗后各个时间段的肩关节疼痛、肩关节活动功能、日常生活能力评分及总评分均高于治疗前,且治疗组的评分均高于对照组,总疗效优于对照组,差异有统计学意义(P<0.05)。结论:针刀镜配合手法松解治疗重度肩周炎能降低血清IL-1、IL-6、IL-8、TNF-α水平,减轻肩关节疼痛,改善肩关节活动功能,提高日常生活能力,具有良好的中长期疗效。

Objective:To observe the medium and long term efficacy of acupotomy scope combined with manipulation release on the treatment of severe periarthritis of shoulder and its efficacy on serum inflammatory factors.Methods:According to the random number table method,96 patients with severe periarthritis of shoulder admitted from July 2019 to December 2021 were divided into control group(manipulation release under general anesthesia combined with silver needle warm acupuncture group)and treatment group(acupotomy scope combined with manipulation release group),with 48 cases in each group.By observing and comparing the levels of serum IL-1,IL-6,IL-8 and TNF-αbefore and 1 week after treatment,as well as the scores of shoulder pain,shoulder activity function,daily living ability and total scores before and 1 week,1 month,3 months and 6 months after treatment,the clinical treatment efficacy of the two groups were compared.Results:The levels of serum IL-1,IL-6,IL-8 and TNF-αin two groups after treatment were decreased compared with before treatment,and the decrease in treatment group was greater than that in control group,the difference was statistically significant(P<0.05).The scores of shoulder pain,shoulder activity function,daily living ability and total scores of two groups after treatment were higher than before,and the scores of the treatment group were higher than the control group,and the total efficacy was better than the control group,the differences were statistically significant(P<0.05).Conclusion:Acupotomy scope combined with manipulation release on the treatment of severe periarthritis of shoulder can reduce the levels of serum IL-1,IL-6,IL-8,TNF-α,relieve shoulder pain,improve shoulder activity function,improve the ability of daily life,with a good medium and long term efficacy.