臂丛神经阻滞下针刺松解肌筋膜触发点治疗肩关节周围炎的效果

Effect of acupuncture release myofascial trigger points under brachial plexus block on scapulohumeral periarthritis

目的探讨臂丛神经阻滞下针刺松解肌筋膜触发点治疗肩关节周围炎的效果。方法选择2020年3月至2022年12月长春中医药大学附属第三临床医院就诊的肩关节周围炎中晚期患者80例为研究对象,按照随机数字表法将其分为对照组与观察组,每组40例。对照组施用超声引导臂丛神经阻滞下手法松解治疗肩关节周围炎,观察组在对照组的基础上配合针刺松解肌筋膜触发点治疗肩关节周围炎,治疗3周。比较两组临床疗效;比较两组治疗前,治疗后1、3个月视觉模拟评分法(VAS)评分;比较两组治疗前及治疗后3个月,肩关节活动度(ROM)。结果观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。整体比较:两组VAS评分组间、时间及交互作用比较,差异有统计学意义(P<0.05)。进一步两两比较,组内比较:两组不同时间点VAS评分两两比较,差异有统计学意义(P<0.05)。组间比较:治疗后1、3个月,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。治疗后3个月,两组前屈、后伸、内收、外展、外旋ROM高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论臂丛神经阻滞下针刺松解肌筋膜触发点治疗肩关节周围炎,效果更佳,远期效果更好,值得推广应用。

Objective To investigate the effect of acupuncture release myofascial trigger points under brachial plexus block on scapulohumeral periarthritis.Methods A total of eighty cases with scapulohumeral periarthritis middle-late patients treated in outpatient department of the Third Affiliated Hospital of Changchun University of Chinese Medicine from March 2020 to December 2022 were selected.They were divided into control group and observation group according to random number table method,with 40 cases in each group.The control group was treated with ultrasound-guided brachial plexus block and manual release for scapulohumeral periarthritis.On the basis of control group,observation group was treated with acupuncture release myofascial trigger points for scapulohumeral periarthritis,treatment for three weeks.The clinical efficacy was compared between two groups;the visual analogue scale(VAS)scores were compared between two groups before treatment,one and three months after treatment;the range of motion(ROM)of shoulder joint before treatment,one and three months after treatment was compared between two groups.Results The clinical efficacy of observation group was better than that of control group,and the difference was statistically significant(P<0.05).Overall comparison:there were statistically significant differences in VAS scores between groups,time,and interaction between two groups(P<0.05).Further pairwise comparison,intra-group comparison:the VAS scores of two groups at different time points were compared,and the differences were statistica lly significant(P<0.05).Group comparison:one and three months after treatment,VAS scores of observation group were lower than those of control group,and the differences were statistically significant(P<0.05).Three months after treatment,the ROM of flexion,extension,adduction,abduction,and external rotation of two groups were higher than those before treatment,and observation group was higher than control group,and the differences were statistically significant(P<0.05).Conclusion Acupuncture release myofascial trigger points under brachial plexus block has better effect and long-term effect in the treatment of scapulohumeral periarthritis,which is worthy of popularization and application.