超声引导下肩袖间隙注射及肩胛上神经阻滞联合触发点针刺治疗粘连性肩关节囊炎的疗效分析

Efficacy of Ultrasound-guided Rotator Cuff Space Injection and Suprascapular Nerve Block Combined with Trigger Point Acupuncture in the Treatment of Adhesive Shoulder Capsitis

目的探讨超声引导下肩袖间隙注射及肩胛上神经阻滞联合触发点针刺在粘连性肩关节囊炎中的应用效果。方法选取2020年9月—2022年6月镇江市第一人民医院疼痛科收治的80例粘连性肩关节囊炎患者作为研究对象,根据治疗方法不同分为对照组与观察组,每组40例。对照组接受针刺肌筋膜触发点治疗,观察组在对照组治疗基础上联合超声引导下肩袖间隙注射及肩胛上神经阻滞治疗,连续治疗4周。治疗前和治疗后对比两组患者疼痛数字评分(Numerical Rating Scale,NRS)、肩关节功能量表(Constant-murley Score,CMS)评分及肩关节疼痛与功能障碍指数(Shoulder Pain and Disability Index,SPADI),并比较两组临床治疗总有效率。结果治疗后两组NRS评分和SPADI评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.001);治疗后两组CMS各项评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.001);观察组临床疗效的总有效率为85.7%,高于对照组的61.8%,差异有统计学意义(χ^(2)=5.130,P<0.05)。结论触发点针刺联合超声引导下肩袖间隙注射及肩胛上神经阻滞治疗可有效提升粘连性肩关节囊炎患者的临床治疗效果,减轻肩关节疼痛、改善肩关节功能,提高日常生活自理能力。

Objective To investigate the effect of ultrasound-guided rotator cuff space injection and suprascapular nerve block combined with trigger point acupuncture in the treatment of adhesive shoulder capsultis.Methods 80 patients with adhesive shoulder osteoarthritis admitted to the Pain Department of Zhenjiang First People's Hospital from September 2020 to June 2022 were selected as the research subjects and divided into control group and observation group according to different treatment methods,with forty cases in each group.The control group received acupuncture of myofascia trigger point treatment,and the observation group was combined with ultrasound guided injection of rotator cuff space and suprascapular nerve block treatment on the basis of the control group treatment,continuous treatment for 4 weeks.Before and 3 months after treatment,two groups of the patients were compared by Numerical Rating Scale(NRS),Constant-murley Score(CMS)and Shoulder Pain and Disability Index(SPADI),and the total effective rate of clinical treatment was compared between the two groups.Results After the treatment,the NRS score and SPADI score of the two groups were lower than before treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.001).After treatment,the CMS scores of both groups were higher than before treatment,and the observation group was higher than the control group,the difference was statistically significant(P<0.001).The total effective rate of clinical efficacy in the observation group was 85.7%,higher than 61.8%in the control group,the difference was statistically significant(χ^(2)=5.130,P<0.05).Conclusion Trigger point acupuncture combined with ultrasound-guided rotator cuff space injection and suprascapular nerve block treatment can effectively improve the clinical treatment effect of patients with adhesive shoulder capsitis,reduce shoulder pain,improve shoulder function,and improve daily self-care ability.