腕踝针在肩袖损伤术后康复治疗中的应用

目的:探讨腕踝针在肩袖损伤术后康复治疗中的应用价值。方法:纳入肩袖损伤肩关节镜下肩袖修复术后患者80例,随机分为腕踝针联合康复训练组和康复训练组,每组40例。术后第1天开始,腕踝针联合康复训练组患者进行腕踝针治疗和康复训练;康复训练组患者单纯进行康复训练。腕踝针治疗取患侧上4穴和上5穴,留针30 min,隔日治疗1次,治疗6周后改为每3 d治疗1次;康复训练分制动康复训练期和保护康复训练期2个阶段进行;共治疗12周。分别于治疗前及治疗12周后,采用视觉模拟量表(visual analogue scale,VAS)对2组患者肩关节疼痛情况进行评分;采用Constant-Murley肩关节评分和美国加州大学洛杉矶分校(the University of California-Los Angeles,UCLA)肩关节评分对2组患者肩关节功能进行评价。结果:2组患者均顺利完成12周的康复治疗。治疗前,2组患者肩关节疼痛VAS评分及肩关节Constant-Murley评分、UCLA评分比较,组间差异均无统计学意义(t=-0.234,P=0.816;t=-0.950,P=0.345;t=-0.627,P=0.533)。治疗12周后,2组患者肩关节疼痛VAS评分较治疗前降低,肩关节Constant-Murley评分和UCLA评分均较治疗前提高腕踝针联合康复训练组:(7.55±0.81)分,(0.88±0.79)分,t=1.207,P=0.000;(41.80±6.70)分,(90.95±4.64)分,t=8.737,P=0.000;(10.30±3.94)分,(31.53±2.82)分,t=4.288,P=0.000。康复训练组:(7.60±1.10)分,(2.40±0.81)分,t=1.305,P=0.000;(43.23±6.72)分,(88.90±3.54)分,t=7.976,P=0.000;(10.80±3.15)分,(30.20±2.39)分,t=4.290,P=0.000];且腕踝针联合康复训练组肩关节疼痛VAS评分低于康复训练组,肩关节Constant-Murley评分和UCLA评分均高于康复训练组(t=-8.520,P=0.000;t=2.221,P=0.029;t=2.268,P=0.026)。结论:腕踝针联合康复训练用于肩袖损伤术后患者的康复治疗,可缓解患肩疼痛、改善患肩功能,且疗效优于单纯康复训练。

Application of wrist-ankle acupuncture therapy to postoperative functional rehabilitation in patients with rotator cuff injuries

Objective:To explore the applied values of wrist-ankle acupuncture therapy in postoperative functional rehabilitation in patients with rotator cuff injuries.Methods:Eighty patients who received arthroscopic rotator cuff repairing surgery for rotator cuff injuries were selected and randomly divided into combination therapy group and rehabilitation training group,40 cases in each group.From postoperative day 1,the patients in combination therapy group were treated with wrist-ankle acupuncture therapy and rehabilitation training;while the patients in rehabilitation training group were merely treated with rehabilitation training.The wrist-ankle acupuncture were performed on patients at upper area 4 and upper area 5,and the needles were retained for 30 minutes,1 time every other day followed by 1 time every 3 days after 6-week treatment for consecutive 12 weeks.The rehabilitation training continued for consecutive 12 weeks,including braking rehabilitation training period and protection rehabilitation training period.The shoulder pain was evaluated by using visual analogue scale(VAS)and the shoulder functions were evaluated by using Constant-Murley shoulder scores and the University of California-Los Angeles(UCLA)shoulder scores before treatment and after 12-week treatment respectively.Results:The 12-week rehabilitation treatment were finished successfully in all patients.There was no statistical difference in shoulder pain VAS scores,Constant-Murley scores and UCLA scores between the 2 groups before treatment(t=-0.234,P=0.816;t=-0.950,P=0.345;t=-0.627,P=0.533).The shoulder pain VAS scores decreased,while the Constant-Murley scores and UCLA scores increased after 12-week treatment compared to pre-treatment in the 2 groups(Combination therapy group:7.55+/-0.81 vs 0.88+/-0.79 points,t=1.207,P=0.000;41.80+/-6.70 vs 90.95+/-4.64 points,t=8.737,P=0.000;10.30+/-3.94 vs 31.53+/-2.82 points,t=4.288,P=0.000.Rehabilitation training group:7.60+ / -1.10 vs 2.40+ / -0.81 points, t =1.305, P =0.000;43.23+ / -6.72 vs 88.90+ / -3.54 points, t =7.976, P =0.000;10.80+ / -3.15 vs 30.20+ / -2.39 points, t =4.290, P =0.000),and the shoulder pain VAS scores were lower and the Constant-Murley scores and UCLA scores were higher in combination therapy group compared to rehabilitation training group( t =-8.520, P =0.000;t = 2.221 , P =0.029;t =2.268, P =0.026). Conclusion: The combination therapy of wrist-ankle acupuncture and rehabilitation training can relieve the affacted shoulder pain and improve the affacted shoulder function in patients who received surgery for rotator cuff injuries,moreover,its curative effect is better than that of monotherapy of rehabilitation training.