循经远取动法针刺结合关节腔注射治疗肩周炎的疗效观察

Clinical Observation of Needling Distal Point along Meridian plus Exercising Combined with intra⁃articular Injection in the Treatment of Frozen Shoulder

目的 观察循经远取动法针刺结合肩关节注射治疗对肩周炎的临床疗效。方法 选取 2020年1月—2022年10月在九江市第一人民医院疼痛科就诊的肩周炎患者58例,通过随机数字表法分为观察组和对照组,每组29例。对照组采用单纯影像引导下肩关节注射治疗;观察组在肩关节注射基础上加用循经远取动法针刺治疗。治疗前后分别对2组患者视觉模拟量表评分(VAS)、肩关节评分量表Constant Murley(CMS)值对比分析,并评价临床疗效。结果 2组患者治疗后VAS评分[观察组(2.14±1.43)、对照组(2.24±1.35)]较治疗前[观察组(5.28±1.03)、对照组(5.48±1.12)]均降低(P<0.01);CMS评分[观察组(71.52±13.36)、对照组(63.55±16.16)]值较治疗前[观察组(50.21±13.12)、对照组(51.59±12.27)]均提高(P<0.01);2组治疗前后VAS评分差值相当(P>0.05),但观察组治疗前后CMS评分差值较对照组升高更明显[(21.86±16.1)vs(11.97±7.79),P<0.01];观察组的治疗愈显率62.1%(18/29),高于对照组的24.1%(7/29)。结论 循经远取动法结合肩关节注射治疗可明显缓解肩周炎患者疼痛,并有效改善关节活动度,且疗效优于单纯肩关节注射。

Objective To observe the clinical efficacy of the method of needling distal point along meridian plus exerci⁃sing combined with intra⁃articular Injection in the treatment of frozen shoulder.Methods From January 2020 to October 2022,58 patients with Frozen shoulder who were treated in the Department of Pain,JiuJiang No.1 People􀆳s Hospital were divided in⁃to an observation group and a control group by random number table method,29 cases in each group.Patients were treated with intra⁃articular Injection under image guidance in the control group;while in the observation group,patients were treated with needling distal point along meridian plus exercising combined with intra⁃articular Injection.The visual analog scale(VAS)and Constant⁃Murley scores(CMS)of the two groups were compared before and after treatment.Also,the clinical efficacy was evaluated.Results After treatment,the VAS scores of the two groups[observation group(2.14±1.43)、control group(2.24±1.35)]were significantly lower than that before treatment[observation group(5.28±1.03)、control group(5.48±1.12)](P<0.01);and the CMS scores of the two groups[observation group(71.52±13.36)、control group(63.55±16.16)]were significantly higher than that before treatment[observation group(50.21±13.12)、control group(51.59±12.27)](P<0􀆰01);The difference in VAS scores between the two groups before and after treatment was similar(P>0.05);The differ⁃ence in CMS scores before and after treatment in the observation group was significantly higher than that in the control group[(21.86±16.1)vs(11.97±7.79),P<0.01];The treatment response rate of the observation group was 62.1%(18/29),higher than that of the control group(24.1%(7/29).Conclusion Needling distal point along meridian plus exercising com⁃bined with intra⁃articular Injection can significantly relieve the pain of patients with frozen shoulder and effectively improve the shoulder joint function,and the effect is better than that of simple shoulder joint injection.