目的:观察关节腔注射联合"经筋"手法治疗早中期冻结肩的临床疗效及安全性.方法:选择62例早中期冻结肩患者,按照治疗方法不同分为观察组和对照组,每组31例.对照组予以口服美洛昔康片,外用温性经筋通贴膏、经筋通凝胶剂,观察组予以关节腔注射联合"经筋"手法治疗,分别于治疗前后比较疼痛视觉模拟量表(visual analogue score,VAS)评分、肩痛和功能指数(shoulder pain and function in-dex,SPADI)、Fugl-Meyer肩关节活动范围量表评分和Constant-Murley肩功能评分,并对临床疗效及不良反应进行评价.结果:治疗后,两组VAS、SPADI评分较治疗前降低(P＜0.01),Fugl-Meyer及Constant-Murley评分均较治疗前降低(P＜0.01);且观察组与对照组比较,差异有统计学意义(P＜0.05);随着时间的变化,两组VAS及Fugl-Meyer评分无明显变化,但观察组SPADI及Constant-Murley评分在治疗后3个月时与治疗后1周时比较,差异有统计学意义(P＜0.05).观察组SPADI及Constant-Murley评分总有效率均高于对照组,但差异无统计学意义(P＞0.05).观察组不良事件发生率[22.6%(7/31)]低于对照组[45.2%(14/31)](P＜0.05).结论:关节腔注射联合"经筋"手法治疗早中期冻结肩疗效明显,安全性好.
Observation on the Therapeutic Effects of Joint Cavity Injection Combined with "Meridian-sinew" Manipulation in the Treatment of Frozen Shoulder in the Early to Middle Stage
Objective:To observe the clinical effects and the safety of joint cavity injection combined with"meridian-sinew"manipulation in the treatment of frozen shoulder in the early to middle stage.Methods:Sixty-two patients with frozen shoulder in the early to middle stage were selected and divided into observation group and control group according to different treatment methods,with 31 patients in each group.The control group took Meloxicam tablets orally,and used warm meridian-sinew-unobstructing plaster and meridian-sinew-unobstructing gel externally,while the observation group accepted joint cavity injection and meridian-sinew manipulation,to compare the visual analogue score(VAS),shoulder pain and disability index(SPADI),Fugl-Meyer shoulder range of motion scale,and Constant-Murley shoulder function score before and after the treatment respectively,to assess the clinical effects and adverse reaction.Results:After treatment,the VAS and SPADI scores of the two groups were lower than those before treatment(P＜0.01),and the Fugl-Meyer and Constant-Murley scores were lower than those before treatment(P＜0.01);and the difference between the observation group and the control group was statistically significant(P＜0.05);with the change of time,there was no significant change of the VAS and Fugl-Meyer scores of the two groups,but when the SPADI and Constant-Murley scores of the observation group after three months of the treatment were compared with these after one week of the treatment,the difference had statistical meaning(P＜0.05).The total effective rate of SPADI and Constant-Murley score in the observation group was higher than that in the control group,but the difference was not statistically significant(P＞0.05).The incidence of adverse events[22.6%(7/31)]in the observation group was lower than that[45.2%(14/31)]in the control group(P＜0.05).Conclusion:Joint cavity injection combined with"meridian-sinew"manipulation in the treatment of frozen shoulder in the early and middle stages could obtain noticeable clinical effects with good safety.
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