臂丛麻醉下针刀、手法松解治疗肩关节周围炎的临床观察

目的:观察臂丛麻醉下针刀、手法松解治疗肩关节周围炎的临床疗效。方法:将72例肩周炎患者随机分为两组,治疗组36例采用臂丛麻醉下针刀联合手法松解治疗,对照组36例采用针灸及推拿治疗,观察两组的镇痛效果、肩关节活动度改善情况及综合疗效。结果:①肩关节疼痛程度:两组治疗后VAS评分均较治疗前降低(治疗组:t=42.730,P=0.000;对照组:t=30.156,P=0.000);但治疗后治疗组VAS评分的降低程度较对照组明显(t=8.475,P=0.000)。②肩关节活动度:两组治疗后肩关节Mallet评分均较治疗前降低(治疗组:t=22.254,P=0.000;对照组:t=19.486,P=0.000);但治疗后治疗组肩关节Mallet评分的降低程度较对照组明显(t=4.841,P=0.000)。③综合疗效:两组综合疗效比较,治疗组优于对照组(Z=-2.075,P=0.038)。结论:臂丛麻醉下针刀、手法松解治疗肩关节周围炎疗效显著,值得临床推广。

Clinical observation on the treatment of frozen shoulder through the method of acupotomy combined with manipulation under brachial plexus anesthesia

Objective：To observe the clinical curative effect of acupotomy combined with manipulation on the treatment of frozen shoulder under brachial plexus anesthesia.Methods：72 patients with frozen shoulder were randomly divided into 2 groups.36 cases in treatment group were administrated through acupotomy combined with manipulation under brachial plexus anesthesia,while the others in control group were administrated through acupuncture combined with massage manipulation.The analgesia effect,improvement of shoulder joint motion and the total curative effect of the patients were observed.Results：Ⅰ.On the aspect of pain degrees of shoulder joint：After the treatment,VAS scores of patients in the 2 groups were all lower than that before the treatment（t=42.730,P=0.000;t=30.156,P=0.000）,while VAS scores of treatment group decreased more significantly than those of control group（t=8.475,P=0.000）.Ⅱ.On the aspect of shoulder joint motion：After the treatment,Mallet scores of shoulder joint for the patients in the 2 groups were all lower than that before the treatment（t=22.254,P=0.000;t=19.486,P=0.000）,while Mallet scores of treatment group decreased more significantly than those of control group（t=4.841,P=0.000）.Ⅲ.On the aspect of total curative effect：the total curative effect of treatment group was better than that of control group（Z=-2.075,P=0.038）.Conclusion：The method of acupotomy combined with manipulation under brachial plexus anesthesia performs well on the treatment of frozen shoulder,it is worth popularizing in the clinic.