目的 观察火针联合董氏奇穴针刺治疗肩袖损伤的临床疗效及对关节功能及血清前列腺素E2(prostaglandin E2,PGE2)和转化生长因子-β1(transforming growth factor-β1,TGF-β1)的影响.方法 将100 例肩袖损伤患者随机分为对照组(50 例)和观察组(50 例).对照组予以电针联合董氏奇穴针刺治疗,观察组予以火针联合董氏奇穴针刺治疗.检测视觉模拟量表(visual analog scale,VAS)和美国加利福尼亚大学洛杉矶分校(University of California,Los Angeles,UCLA)肩关节评分、肩关节活动度(range of motion,ROM)及血清PGE2和TGF-β1 水平.结果 观察组总有效率高于对照组(P＜0.05).治疗后及4周随访时,两组VAS评分及血清PGE2和TGF-β1 水平均低于治疗前(P＜0.05),且观察组均低于对照组(P＜0.05);两组UCLA肩关节评分和肩关节ROM均高于治疗前(P＜0.05),且观察组均高于对照组(P＜0.05).4 周随访时,两组VAS评分、UCLA肩关节评分、肩关节ROM及血清PGE2 和TGF-β1 水平与治疗后比较差异无统计系意义(P＞0.05).治疗后血清PGE2、TGF-β1水平与VAS评分呈正相关,与UCLA肩关节评分呈负相关.结论 火针和电针联合董氏奇穴针刺治疗肩袖损伤均可缓解疼痛、改善肩关节功能,但火针优于电针,其机制可能与降低血清PGE2和TGF-β1水平有关.
Observations on the efficacy of fire needling plus acupuncture at Dong's extraordinary points for rotator cuff injury and its effect on joint function and serum PGE2 and TGF-β1
Objective To observe the clinical efficacy of fire needling plus acupuncture at Dong's extraordinary points for rotator cuff injury and its effect on joint function and serum prostaglandin E2(PGE2)and transforming growth factor-β1(TGF-β1).Methods One hundred patients with rotator cuff injury were randomized to a control group(50 cases)and an observation group(50 cases).The control group received electroacupuncture plus acupuncture at Dong's extraordinary points and the observation group,fire needling plus acupuncture at Dong's extraordinary points.The Visual Analog Scale(VAS)score,the University of California,Los Angeles(UCLA)shoulder rating scale score and shoulder range of motion(ROM)were recorded and serum PGE2 and TGF-β1 levels were measured.Results The total efficacy rate was higher in the observation group than in the control group(P＜0.05).At the end of treatment and the 4-week follow-up,the VAS score and serum PGE2 and TGF-β1 levels decreased in the two groups compared with before(P＜0.05)and were lower in the observation group than in the control group(P＜0.05);the UCLA shoulder rating scale score and shoulder ROM increased in the two groups compared with before(P＜0.05)and were higher in the observation group than in the control group(P＜0.05).At the 4-week follow-up,the VAS score,the UCLA shoulder rating scale score,shoulder ROM and serum PGE2 and TGF-β1 levels had no statistically significant differences in the two groups compared with at the end of treatment(P＜0.05).Serum PGE2 and TGF-β1 levels at the end of treatment had a positive correlation with the VAS score and a negative correlation with the UCLA shoulder rating scale score.Conclusions Fire needling or electroacupuncture plus acupuncture at Dong's extraordinary points can relieve the pain and improve shoulder joint function in treating rotator cuff injury but fire needling is better than electroacupuncture.Its mechanism may be related to decreasing serum PGE2 and TGF-β1 levels in the patients with rotator cuff injury.
Fire needlingDong's extraordinary pointsElectroacupunctureRotator cuff injuryPainJoint functionProstaglandin E2Transforming growth factor-β1
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