肌骨超声引导下针刀整体松解联合发散式体外冲击波治疗粘连期肩周炎临床研究

Clinical Study on Musculoskeletal Ultrasound-Guided Overall Acupotomy Release Combined with Radial Extracorporeal Shock Wave for Periarthritis of Shoulder in Adhesive Phase

目的:观察肌骨超声引导下针刀整体松解联合发散式体外冲击波治疗粘连期肩周炎的临床效果。方法:按随机数字表法将92例粘连期肩周炎患者分为观察组与对照组各46例。对照组采用常规针刀整体松解联合发散式体外冲击波治疗,观察组采用肌骨超声引导下针刀整体松解联合发散式体外冲击波治疗,2组均连续治疗3周。比较2组治疗前后McGill疼痛评分、改良Constant-Murley肩关节功能量表(CMS)评分及肩关节活动度;比较2组临床疗效及不良反应发生情况。结果:观察组愈显率80.43%,高于对照组60.87%(P<0.05)。2组治疗后McGill疼痛评分中现在疼痛状况(PPI)、视觉模拟评分法(VAS)和疼痛评级指数(PRI)评分均低于治疗前(P<0.05),且观察组治疗后上述指标均低于对照组(P<0.05)。2组治疗后改良CMS评分及肩关节前屈上举、外展、后伸、内旋及外旋活动度均较治疗前升高(P<0.05),且观察组治疗后上述指标高于对照组(P<0.05)。2组均未发生不良反应。结论:肌骨超声引导下针刀整体松解联合发散式体外冲击波治疗粘连期肩周炎,能够有效减轻患者疼痛,改善肩关节活动度和肩关节功能,提高临床疗效,安全性较高。

Objective:To observe the clinical effect of musculoskeletal ultrasound-guided overall acupotomy release combined with radial extracorporeal shock wave on periarthritis of shoulder in adhesive phase.Methods:A total of 92 cases of patients with periarthritis of shoulder in adhesion phase were divided into the observation group and the control group according to the random number table method,with 46 cases in each group.The control group was treated with routine overall acupotomy release combined with radial extracorporeal shock wave,and the observation group was treated with musculoskeletal ultrasound-guided overall acupotomy release combined with radial extracorporeal shock wave.Both groups were treated continuously for 3 weeks.McGill pain scores,modified Constant-Murley Shoulder Function Scale(CMS)scores and shoulder range of motion were compared before and after treatment between the two groups.The clinical effects and the incidence of adverse reactions were compared between the two groups.Results:The cure rate was 80.43%in the observation group,higher than that of 60.87%in the control group(P<0.05).After treatment,the McGill pain scores of Present Pain intensity(PPI),Visual Analogue Scale(VAS)and Pain Rating Index(PRI)in the two groups were decreased when compared with those before treatment(P<0.05),and the above indexes in the observation group were lower than those in the control group(P<0.05).After treatment,modified CMS scores and the shoulder range of motion including anterior flexion,upward lifting,abduction,backward extension,internal rotation and external rotation in the two groups were increased when compared with those before treatment(P<0.05),and the above indexes in the observation group were higher than those in the control group(P<0.05).No adverse reaction occurred in the two groups.Conclusion:Musculoskeletal ultrasoundguided overall acupotomy release combined with radial extracorporeal shock wave for periarthritis of shoulder in adhesive phase can effectively reduce the pain of patients,improve the range of motion and function of shoulder joints and enhance the clinical effect,with high safety.