肩三针温针灸联合小针刀治疗肩周炎的临床效果观察

Clinical effect of shoulder three-needling acupuncture and moxibustion combined with small needle knife in treatment of patients with shoulder periarthritis

目的探讨肩三针温针灸联合小针刀治疗肩周炎的临床效果。方法选取武警广东总队医院2020年1月至2022年12月期间收治112例肩周炎患者,按随机数字表法将患者分为两组,各56例。对照组中,男32例、女24例,年龄(71.45±4.06)岁;采取小针刀治疗,每周1次,连续3次,若1次治愈无须再次治疗。观察组中,男30例、女26例,年龄(71.22±4.13)岁;采取肩三针温针灸联合小针刀治疗,肩三针温针灸每天1次,连续5 d后,间隔2 d,再针灸5 d,小针刀治疗同对照组。比较两组治疗效果、中医证候积分、肩关节功能、疼痛程度及日常生活能力。采用t检验、χ^(2)检验进行统计分析。结果观察组治疗有效率[96.43%(54/56)]高于对照组[82.14%(46/56)],差异有统计学意义(χ^(2)=5.973,P<0.05)。治疗后,观察组肩部疼痛评分(1.88±0.25)分、活动受限(1.52±0.21)分、肩部沉重感评分(1.07±0.22)分,均显著低于对照组[(2.57±0.32)分、(2.11±0.29)分、(1.88±0.26)分],差异均有统计学意义(均P<0.05)。治疗后,观察组患者疼痛评分(12.42±2.28)分、日常生活评分(17.44±2.62)分、活动度(前屈、后伸、外展、内旋)评分(34.25±4.18)分、肌力评分(23.63±2.73)分及总评分(88.15±8.76)分,均显著高于对照组[(9.05±1.82)分、(14.63±2.24)分、(30.06±3.99)分、(20.11±2.52)分、(73.53±6.69)分],差异均有统计学意义(均P<0.05)。治疗后,观察组日常生活能力评分(85.52±8.92)分,显著高于对照组[(76.69±7.14)分],差异有统计学意义(t=5.783,P<0.05),观察组疼痛程度评分(1.62±0.43)分,显著低于对照组[(2.27±0.51)分],差异有统计学意义(t=7.291,P<0.05)。结论针对肩周炎患者采取肩三针温针灸联合小针刀治疗可促进症状缓解,减轻疼痛程度,改善活动度及日常活动水平,提高日常生活能力,值得推广。

Objective To investigate the clinical efficacy of shoulder three-needling acupuncture and moxibustion combined with small needle knife for patients with shoulder periarthritis.Methods A total of 112 patients with shoulder periarthritis treated at Armed Police Hospital of Guangdong Province between January 2020 and December 2022 were selected.They were divided into a control group and an observation group by the random number table method,with 56 cases in each group.There were 32 males and 24 females in the control group;they were(71.45±4.06)years old.There were 30 males and 26 females in the observation group;they were(71.22±4.13)years old.The control group received small needle knife treatment once a week,for 3 times;in addition,the observation group took shoulder three-needling acupuncture and moxibustion once a day for 5 d,and stopped 2 d,then continued the treatment for 5 d.The treatment effects,traditional Chinese medicine syndrome scores,shoulder joint function,pain degrees,and daily living abilities were compared between the two groups.t andχ^(2) tests were applied.Results The effective rate of the observation group was higher than that of the control group[96.43%(54/56)vs.[82.14%(46/56)],with a statistical difference(χ^(2)=5.973,P<0.05).After the treatment,the scores of shoulder pain,activity limitation,and heavy sensation in the observation group were significantly lower than those in the control group[1.88±0.25)vs.(2.57±0.32),(1.52±0.21)vs.(2.11±0.29),and(1.07±0.22)vs.(1.88±0.26)],with statistical differences(all P<0.05).After the treatment,the scores of pain,daily living ability,range of motion(flexion,extension,abduction,and internal rotation),and muscle strength and the total score in the observation group were significantly higher than those in the control group[(12.42±2.28)vs.(9.05±1.82),(17.44±2.62)vs.(14.63±2.24),(34.25±4.18)vs.(30.06±3.99),(23.63±2.73)vs.(20.11±2.52),and(88.15±8.76)vs.(73.53±6.69)],with statistical differences(all P<0.05).After the treatment,the scores of daily living ability and pain degree in the observation group were better than those in the control group[(85.52±8.92)vs.(76.69±7.14)and(1.62±0.43)vs.(2.27±0.51)],with statistical differences(t=5.783 and 7.291;both P<0.05).Conclusion Shoulder three-needling acupuncture and moxibustion combined with small needle knife for patients with shoulder periarthritis can promote symptom relief,reduce pain,improve their range of motion and daily living ability,and enhance their activity level,so it deserves further promotion.