肌骨超声引导下PRP肩袖间隙注射治疗冻结肩的临床疗效及机制研究
Study on the Clinical Eeffect and Mechanism of the Treatment of Frozen Shoulder by Injecting PRP Into the Rota-tor Cuff Space Under the Guidance of MSKUS
郑苏 1王刚 1赵磊 1解嘉阳 2谢谨 1郭爽1
作者信息
- 1. 十堰市太和医院·湖北医药学院附属医院医务处,湖北 十堰 442000
- 2. 湖南中医药大学,湖南 长沙 410200
- 折叠
摘要
目的:观察肌骨超声(MSKUS)引导下富血小板血浆(PRP)肩袖间隙注射治疗冻结肩的临床疗效,并探讨其机制.方法:60 例冻结肩患者随机分为对照组和治疗组,每组各 30 例,治疗组采取PRP 注射治疗,对照组采取倍他米松+9%氯化钠溶液注射治疗.治疗 2 个疗程后,比较两组患者Constant-Murley肩关节功能评分、肩周后方关节囊厚度(PCT)、盂肱距离(GHD)和TNF-α、IL-6 含量及临床疗效等.结果:治疗后两组患者Constant-Mur-ley肩关节功能评定疼痛、ADL、ROM、MMT评分较治疗前均有提升(P＜0.05),且治疗组改善更明显(P＜0.05).两组患者TNF-α和IL-6 含量较治疗前均有所降低(P＜0.05),且治疗组降低更明显(P＜0.05).两组患者治疗后PCT均降低,GHD均提高,较治疗前差异有统计学意义(P＜0.05),且治疗组改善更明显(P＜0.05).治疗组总有效率为 96.6%,对照组总有效率为 93.1%,差异有统计学意义(P＜0.05).结论:MSKUS引导下PRP肩袖间隙注射治疗冻结肩,可减轻患者疼痛,改善肩关节功能,提高临床疗效,可能与调节TNF-α、IL-6 含量水平,修复PCT和GHD组织损伤有关.
Abstract
Objective To observe the clinical effect of platelet-rich plasma(PRP)injection into rotator cuff space guided by musculo-skeletal ultrasound(MSKUS)in the treatment of frozen shoulder,and to explore its mechanism.Methods 60 cases of frozen shoulder patients were randomly divided into a control group and a treatment group,with 30 cases in each group.The treatment group received PRP injection therapy,while the control group received betamethasone+9%sodium chloride solution injection therapy.After two courses of treatment,the Constant-Murley shoulder joint function scores,pos-terior capsular thickness(PCT),glenohumeral distance(GHD),TNF-α,IL-6 levels,and clinical efficacy were com-pared between the two groups.Results After treatment,both groups of patients showed improvements in Constant-Murley shoulder joint function assessment scores for pain,ADL,ROM,and MMT compared to before treatment(P＜0.05),with more significant improvements observed in the treatment group(P＜0.05).The levels of TNF-α and IL-6 in both groups decreased after treatment compared to before treatment(P＜0.05),with a more significant decrease observed in the treat-ment group(P＜0.05).Both groups of patients showed a decrease in PCT and an increase in GHD after treatment,with sta-tistically significant differences compared to before treatment(P＜0.05),and the improvement was more significant in the treatment group(P＜0.05).The total effective rate was 96.6%in the treatment group and 93.1%in the control group,with a statistically significant difference(P＜0.05).Conclusion The treatment of frozen shoulder with PRP under the guidance of MSKUS can relieve the pain,improve the function of shoulder joint and improve the clinical effect,which may be associ-ated with regulating TNF-α and IL-6 levels,repairing PCT and GHD tissue damage.
关键词
肌骨超声/富血小板血浆/冻结肩/Constant-Murley肩关节功能评定/肩周后方关节囊厚度/盂肱距离/肿瘤坏死因子-α/白细胞介素-6Key words
Musculoskeletal ultrasound/Platelet-rich plasma/Frozen shoulder/Constant Murley shoulder function as-sessment/Posterior capsule thickness/Glenoid-brachial distance/Tumor necrosis factors-α/Interleukin-6引用本文复制引用
基金项目
湖北省卫生健康委中医科研项目(ZY2021Q015)
福建中医药大学临床专项校管项目(XB2021232)
福建中医药大学临床专项校管项目(XB2021233)
出版年
2024
国家科技期刊平台
NSTL
万方数据