作　　者： (王新昌）; (郝连升）; (陈健）;

机构地区： 山东省聊城市中医医院,山东聊城252004

出　　处： 《中医正骨》 2017年第8期36-38,41,共4页

摘　　要： 目的:观察放散式体外冲击波联合关节腔注射和功能锻炼治疗肩周炎的临床疗效。方法:将126例肩周炎患者随机分为2组,63例采用放散式体外冲击波联合关节腔注射和功能锻炼治疗(联合治疗组),63例采用关节腔注射联合功能锻炼治疗(关节腔注射组)。放散式体外冲击波治疗,2周1次,共治疗4次;关节腔注射采用玻璃酸钠注射液和曲安奈德注射液,每周1次,共治疗4次;功能锻炼,每天3~5次,共治疗30 d。分别采用视觉模拟量表(visual analogue scale,VAS)和肩关节评价量表评定患者的肩关节疼痛程度和总体疗效。结果:治疗前2组患者的肩关节疼痛VAS评分比较,差异无统计学意义(t=1.761,P=0.953);治疗结束后2组患者的VAS评分均减小[(7.08±2.04)分,(2.62±0.92)分,t=3.726,P=0.021;(7.15±1.87)分,(3.15±1.02)分,t=2.854,P=0.031],联合治疗组的VAS评分低于关节腔注射组(t=2.794,P=0.031)。治疗前2组患者的肩关节综合评分比较,差异无统计学意义(t=1.642,P=0.735);治疗结束后2组患者的肩关节综合评分均增大[(45.80±10.52)分,(87.27±4.54)分,t=3.826,P=0.023;(46.95±11.09)分,(73.63±3.86)分,t=2.971,P=0.034],联合治疗组的肩关节综合评分高于关节腔注射组(t=2.014,P=0.039)。结论:采用放散式体外冲击波联合关节腔注射和功能锻炼治疗肩周炎疗效确切,效果优于关节腔注射联合功能锻炼。 Objective：To observe the clinical curative effect of divergent type extracorporeal shock wave（ ESW） therapy combined with intra - articular injection and functional exercises in the treatment of periarthritis humeroscapularis, n,etllods ： One hundred and twenty - six patients with periarthritis humeroscapularis were randomly divided into 2 groups, 63 cases in each group. The patients were treated with combination therapy of divergent type ESW therapy and intra- articular injection and functional exercises （combination therapy group）and combination therapy of intra - articular injection and functional exercises （ intra - articular injection group） respectively. The divergent type ESW therapy was performed once 2 weeks for consecutive 4 times, and the intra - articular injection of sodium hyaluronate and triamcinolo- ne acetonide was performed once a week for consecutive 4 times, and the functional exercises was performed 3 - 5 times a day for consecu- tive 30 days. The shoulder pain degree and the total clinical curative effects were evaluated by using visual analogue scale（VAS） and shoul- der rating scale respectively. Results ： There was no statistical differences in shoulder pain VAS scores between the 2 groups before the treat- ment （ t = 1. 761, P = 0. 953 ）. The VAS scores decreased in both of the 2 groups after the end of the treatment （7.08 ＋/- 2.04 vs 2.62 ＋/- 0.92 points, t = 3. 726, P = 0. 021 ;7.15 ＋/- 1.87 vs 3.15 ＋/- 1.02 points, t = 2. 854,P = 0.031 ）, and the VAS scores were lower in com- bination therapy group compared to intra- articular injection group（ t =2. 794 ,P =0. 031 ）. There was no statistical differences in shoulder comprehensive scores between the 2 groups before the treatment （ t = 1. 642, P = 0. 735 ）. The shoulder comprehensive scores increased in both of the 2 groups after the end of the treatment（45.80 ＋/- 10.52 vs 87.27 ＋/-4.54 points, t = 3. 826,P = 0. 023 ;46.95 ＋/- 11.09 vs 73.63 ＋/-3.86 points ,t = 2. 971 ,P=0. 034） ,

关 键 词： 肩凝症 肩周炎 注射 关节内 透明质酸 曲安奈德 高能量冲击波 功能锻炼 临床试验