冻结肩合并糖尿病的治疗进展

Progress in the treatment of frozen shoulder with diabetes mellitus

冻结肩是临床上常见的疾病,以肩关节疼痛和活动受限为主要特征,严重影响患者的生活质量。冻结肩的发生与许多疾病相关,比如糖尿病、高脂血症、甲状腺疾病等,其中糖尿病与冻结肩的关系最为密切。糖尿病作为一种慢性疾病,长期的血糖控制和胰岛素使用情况影响着冻结肩的发生和预后。冻结肩的病理机制主要认为和肩关节的慢性炎症和肩关节囊的挛缩、纤维化相关,糖尿病患者中糖基化终产物参与了其中。目前对于冻结肩合并糖尿病的治疗方式包括口服药物、关节腔注射、物理治疗、手术治疗等,常根据疾病阶段和病情需要选择合适的治疗方案,尚未达成共识。本文对冻结肩合并糖尿病的流行病学、病理机制、诊疗进展等方面文献进行总结,为临床提供参考。

Frozen shoulder is a common clinical disease,mainly characterized by shoulder joint pain and mobility restriction,which seriously affects patients'quality of life.The occurrence of frozen shoulder is associated with many diseases,such as diabetes,hyperlipidemia,thyroid disease,and so on,among which diabetes is the most closely related to frozen shoulder.Diabetes mellitus is a chronic disease.Long-term glycemic control and insulin use affect the occurrence and prognosis of frozen shoulder.The pathological mechanism of frozen shoulder is mainly believed to be related to the chronic inflammation of the shoulder joint and the contracture and fibrosis of the shoulder capsule,in which glycosylation end products in diabetic patients are involved.At present,the treatment methods of frozen shoulder complicated with diabetes include oral drugs,joint injection,physical therapy,surgical treatment,etc.,and the appropriate treatment plan is often selected according to the disease stage and condition needs,but no consensus has been reached.This paper summarizes the literature on epidemiology,pathological mechanism,diagnosis and treatment progress of frozen shoulder complicated with diabetes,and provides reference for clinical practice.