超声引导下针刀松解腋下关节囊治疗冻结期冻结肩的疗效观察

Clinical Observation on the Therapeutic Effect of Ultrasound-Guided Acupotomy Loosening the Subaxillary Joint Capsule for the Treatment of Frozen Shoulder in the Freezing Period

【目的】观察超声引导下针刀松解腋下关节囊治疗冻结期冻结肩的临床疗效。【方法】将60例冻结期冻结肩的患者随机分为观察组和对照组,每组30例。观察组给予超声引导下肩关节腔液压扩张联合针刀松解腋下关节囊治疗,对照组给予超声引导下肩关节腔液压扩张联合安慰针刀治疗。2组患者均每周治疗1次,共治疗3次。治疗3次后,评价2组临床疗效,观察2组患者治疗前后Constant-Murley肩关节功能量表评分的变化情况,以及疼痛视觉模拟量表(VAS)评分的情况。比较2组患者治疗前后腋下关节囊厚度的变化情况。【结果】(1)研究过程中,对照组脱落1例。最终观察组30例、对照组29例纳入疗效统计。(2)治疗后,观察组患者的Constant-Murley评分明显改善(P<0.05),且观察组在改善Constant-Murley评分方面明显优于对照组,差异有统计学意义(P<0.01)。2组患者Constant-Murley评分治疗前后差值比较,差异有统计学意义(P<0.01)。(3)治疗后,2组患者的VAS评分明显改善(P<0.05),与对照组比较,观察组在改善VAS评分方面,差异无统计学意义(P>0.05)。2组患者VAS评分治疗前后差值比较,差异无统计学意义(P>0.05)。(4)治疗后,观察组患者的腋下关节囊厚度明显改善(P<0.01),且观察组在改善腋下关节囊厚度方面明显优于对照组,差异有统计学意义(P<0.01)。2组患者腋下关节囊厚度治疗前后差值比较,差异有统计学意义(P<0.05)。(5)观察组总有效率为96.67%(29/30),对照组为75.86%(22/29)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。【结论】超声引导下针刀松解腋下关节囊治疗冻结期冻结肩,能明显减轻患者的疼痛症状,改善患者肩关节的活动功能,减小腋下关节囊厚度,疗效显著。

Objective To observe the clinical efficacy of ultrasound-guided acupotomy loosening subaxillary joint capsule in the treatment of frozen shoulder in freezing period.Methods Sixty patients with frozen shoulder in freezing period were randomly divided into observation group and control group,30 cases in each group.The observation group was treated with ultrasound-guided hydraulic expansion of the shoulder joint cavity combined with acupotomy to loosen the subaxillary joint capsule,and the control group was treated with ultrasound-guided hydraulic expansion of the shoulder joint cavity combined with soothing acupotomy.Patients in the two groups were treated once a week for a total of 3 times.After 3 treatments,the clinical efficacy of the two groups was evaluated,and the change of Constant-Murley shoulder function scale score and visual analogue scale(VAS)score were observed before and after the treatment of the two groups.The changes in subaxillary joint capsule thickness were compared between the two groups before and after treatment.Results(1)During the study,1 case sfell off in the control group.Finally,30 cases in the observation group and 29 cases in the control group were included in the treatment statistics.(2)After treatment,the Constant-Murley scores of the observation group of patients were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the Constant-Murley scores,and the differences were statistically significant(P<0.01).There was significant difference between the pre-and post-treatment differences in Constant-Murley score of the two groups(P<0.01).(3)After treatment,the VAS scores of patients in the two groups were significantly improved(P<0.05),but the differences were statistically in significant between the two groups(P>0.05).The difference between the pre-and post-treatment differences in VAS scores of patients in the two groups was not statistically significant(P>0.05).(4)After treatment,the thickness of subaxillary joint capsule was significantly improved in the two groups(P<0.01),and the thickness subaxillary joint capsule in the observation group was significantly superior to that in the control group(P<0.01).There was significant difference in the thickness of subaxillary joint capsule between the two groups before and after treatment(P<0.05).(5)The total effective rate was 96.67%(29/30)in the observation group and 75.86%(22/29)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).Conclusion Ultrasoundguided acupotomy loosening subaxillary joint capsule in the treatment of frozen shoulder in freezing period can significantly reduce the pain symptoms of the patients,improve the mobility function of the shoulder joints of the patients,and reduce the thickness of subaxillary joint capsule,and the therapeutic efficacy is remarkable.