中医经络辨证下放散式体外冲击波治疗肩周炎的临床观察

Clinical Study of Radial Extracorporeal Shockwave Therapy Guided by Syndrome Differentiation of Meridian on Scapulohumeral Periarthritis

目的 观察经络辨证指导放散式体外冲击波治疗肩周炎的临床疗效。方法 将90例肩周炎患者随机分为对照组与治疗组各45例,对照组采用痛点放散式体外冲击波治疗,治疗组根据经络辨证后制定放散式体外冲击波治疗,4周后评价疗效。观察两组患者视觉模拟量表(VAS)评分、肩关节主动活动度(ROM)的变化情况。结果 在治疗后,两组患者的VAS评分与治疗前比较降低显著(P <0.01),且同时间点(第2次治疗后和第4次治疗后)治疗组的VAS评分低于对照组(P <0.05)。与本组治疗前比较,治疗组在第1、2、4次治疗后前屈、外展、后伸、内收、内旋、外旋活动度显著提高(P <0.01),对照组在第1、2、4次治疗后前屈、外展、内收、内外旋活动度方面显著提高(P <0.01),同时对照组在第2次治疗后后伸活动度有提高(P <0.05)。与对照组同时间点比较,第1、2次治疗后外展活动度显著提高(P <0.01),第4次治疗后前屈、内旋、外旋活动度均有提高(P <0.05),且外展明显优于对照组(P <0.01)。治疗组总有效率为93.33%,对照组为77.78%,两组比较差异有统计学意义(P <0.05)。结论 经络辨证指导放散式体外冲击波能减轻患者疼痛症状,提高日常生活能力,增加关节活动度,临床应用优于单纯使用放散式体外冲击波治疗。

Objective:To observe the clinical efficacy of radial extracorporeal shockwave therapy(rESWT)guid-ed by syndrome differentiation of meridian for scapulohumeral periarthritis.Methods:A total of 90 patients with scapulohumeral periarthritis were randomly divided into the control group and treatment group,with 45 patients in each group.The control group was treated with rESWT by pain point,while the treatment group was treated with rESWT guided by syndrome differentiation of meridian.Four weeks later,the efficacy was compared in the two groups.The visual analogue scale(VAS)score and active range of motion(ROM)were observed between the two groups.Results:After treatment,the VAS score of two groups was significantly lower than those before treatment(P<0.01),and the VAS score of the treatment group was lower than that in the control group at the same time point(after the second treatment and after the fourth treatment)(P<0.05).Compared within the group before treat-ment,the scores of forward flexion,abduction,extension,adduction,internal rotation and external rotation after the first,second and fourth treatment in the treatment group were significantly improved(P<0.01),while the scores of forward flexion,abduction,adduction and external rotation after the first,second and fourth treatment in the control group were significantly improved(P<0.01).At the same time,the extension score of the control group was in-creased after second treatment(P<0.05).Compared with the control group at the same time point,the abduction score was significantly increased after the first and second treatment(P<0.01),the forward flexion,internal rota-tion and external rotation scores were increased after the fourth treatment(P<0.05),and the abduction score was significantly better than control group(P<0.01).The total effective rate was 93.33%in the treatment group and 77.78%in the control group.The curative effect of treatment group was significantly better than control group(P<0.05).Conclusion:rESWT guided by syndrome differentiation of meridian can reduce the pain symptoms,im-prove the ability of daily living,increase the ROM of the joint,and is superior to simple rESWT.