针刀联合小剂量激素封闭疗法治疗肩峰撞击综合征的临床观察

Clinical Observation of Acupotomy Combined with Low-dose Hormone Blocking Therapy for Acromion Impingement Syndrome

目的观察针刀联合小剂量激素封闭疗法治疗肩峰撞击综合征的临床疗效。方法选取80例肩峰撞击综合征患者,根据治疗方式的不同分为针刀组和封闭组各40例。针刀组行针刀联合小剂量激素封闭疗法,封闭组行常规剂量激素封闭治疗。治疗前及治疗后1周、4周、8周、12周采用视觉模拟量表(VAS)评分评价肩关节疼痛情况,采用Constant-Murley肩关节功能评分评价肩关节功能情况。末次随访时对两组进行疗效判定,评价治疗效果。结果治疗后,随着时间的延长,针刀组的VAS评分逐渐下降(P<0.05),封闭组的VAS评分在治疗后1周时显著下降,但是治疗后4周、8周及12周又逐渐升高;两组的Constant-Murley肩关节功能评分逐渐升高(P<0.05),但封闭组肩关节功能改善幅度远低于针刀组(P<0.05)。治疗后1周、4周、8周及12周针刀组的VAS评分均低于封闭组(P<0.05);治疗后1周、4周、8周及12周针刀组Constant-Murley肩关节功能评分均高于封闭组(P<0.05)。末次随访时,针刀组总有效率显著高于封闭组(P<0.05)。结论针刀联合小剂量激素封闭疗法治疗肩峰撞击综合征能够有效缓解肩关节疼痛,改善肩关节活动功能,治疗效果优于单纯常规剂量激素封闭疗法,在弥补封闭疗法不足的同时还能够避免大剂量激素对机体的损害反应。

Objective:To observe the clinical efficacy of acupotomy combined with low-dose hormone blocking therapy in the treatment of acromial impingement syndrome.Methods:A total of 80 patients with acromion impingement syndrome were selected and divided into the acupotomy group and blocking group according to different treatment methods,with 40 patients in each group.The acupotomy group received acupotomy combined with lowdose hormone blocking therapy,and blocking group received conventional dose hormone blocking therapy.The VAS score was used to evaluate shoulder pain before treatment and at 1,4,8 and 12 weeks after treatment,and Constant-Murley shoulder function score was used to evaluate shoulder function.At the last follow-up,the curative effect of the two groups was evaluated.Results:After treatment,the VAS score in the acupotomy group decreased gradually(P<0.05).The VAS score of blocking group decreased significantly at 1 week after treatment,but gradually increased at 4,8 and 12 weeks after treatment.Constant-Murley score of shoulder function increased gradually in both groups(P<0.05),but the improvement of shoulder function in the blocking group was much lower than that in the acupotomy group(P<0.05).The VAS score of 1,4,8 and 12 weeks after treatment in the acupotomy group was lower than that in blocking group,and the difference was statistically significant(P<0.05).Constant-Murley function score of shoulder joint in the acupotomy group was higher than that in blocking group at 1,4,8 and 12 weeks after treatment(P<0.05).At the last follow-up,the overall effective rate of acupotomy group was significantly higher than that of blocking group with statistical significance(P<0.05).Conclusion:Acupotomy combined with low-dose hormone blocking therapy in the treatment of acromion impingement syndrome can relieve effectively shoulder joint pain and improve shoulder joint mobility,and the therapeutic effect is superior to conventional hormone blocking therapy,which can make up for the deficiency of blocking therapy and avoid the harmful reaction of high-dose hormone to the body.