电针联合手法复位对初次肩关节脱位患者肩关节功能的影响

Effect of acupuncture plus manipulative reduction on shoulder function in patients with first-time shoulder dislocation

目的观察电针联合手牵足蹬手法复位对初次肩关节脱位患者肩关节功能的影响。方法将78例初次肩关节脱位的患者,随机分为对照组和观察组,每组39例。对照组采用手牵足蹬法复位进行治疗,观察组在对照组的基础上联合电针治疗。观察两组治疗前后Neer肩关节功能评分、Rowe氏评分系统中稳定性及活动度评分、肩关节角度及治疗前、出院时和出院后1个月疼痛视觉模拟量表(visual analog scale,VAS)评分变化,并比较两组不良反应发生率。结果治疗后,两组Neer肩关节功能评分各项评分及总分均升高(P<0.05),且观察组疼痛和运动范围评分及总分高于对照组(P<0.05);两组Rowe氏评分中的稳定性和活动度评分均升高(P<0.05),且观察组高于对照组(P<0.05);两组前屈上举、外展外旋角度均增大(P<0.05),且观察组大于对照组(P<0.05),两组体侧外旋角度比较差异无统计学意义(P>0.05)。两组出院时、出院后1个月VAS评分均低于治疗前,且观察组出院时、出院后1个月VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论针刺联合手牵足蹬手法复位可改善初次肩关节脱位患者的肩关节功能及疼痛情况,无明显不良反应,是一种安全、有效的治疗方法。

Objective To observe the effect of eletroacupuncture plus hand-pulling foot-striking manipulative reduction on should function in patients with first-time shoulder dislocation.Method Seventy-eight patients with first-time shoulder dislocation were randomly assigned to a control group and an observation group,with 39 cases in each group.The control group was treated with hand-pulling foot-striking reduction,and the observation group received additional eletroacupuncture treatment.Before and after treatment,the Neer score of shoulder joint function,Rowe’s rating system for Bankart repair(stability and range of motion scores),and the angle of motion of the shoulder joint were observed,as well as the visual analog scale(VAS)score before treatment,at discharge,and 1 month after discharge.The adverse reaction rate was also compared between the two groups.Result After treatment,the general and component Neer scores of shoulder joint function increased in both groups(P<0.05);the pain and range of motion component scores and general score were higher in the observation group than in the control group(P<0.05).The scores of stability and range of motion in Rowe’s rating system increased in the two groups after treatment(P<0.05)and were higher in the observation group than in the control group(P<0.05).The ranges of flexion and lifting and abduction and external rotation were enlarged after treatment in both groups(P<0.05)and were larger in the observation group than in the control group(P<0.05);there was no significant difference in the range of external rotation with the arm abducted between the two groups(P>0.05).At discharge and 1 month after discharge,the two groups had lower VAS scores compared with their pre-treatment baseline,and the scores in the observation group were significantly lower than those in the control group(P<0.05).There was no statistical significance in comparing the adverse reaction rate between the two groups(P>0.05).Conclusion Eletroacupuncture plus hand-pulling foot-striking reduction is a safe and effective approach for first-time shoulder dislocation patients;it can improve shoulder function and pain without causing notable adverse reactions.