中藥熏洗配合肩關(guān)節(jié)鏡下松解術(shù)治療凍結(jié)期肩周炎的臨床研究
發(fā)布時(shí)間：2018-08-11 13:06
【摘要】：目的:肩關(guān)節(jié)周?chē)资且环N骨科常見(jiàn)疾病,以肩周疼痛、活動(dòng)障礙等癥狀為其特點(diǎn)。該疾病發(fā)病率高、病程長(zhǎng),引起了臨床的廣泛關(guān)注,但對(duì)其有效治療方案仍存在爭(zhēng)議。本文探討中藥熏洗法結(jié)合肩關(guān)節(jié)鏡下松解手術(shù)治療凍結(jié)期肩周炎的臨床療效,找到治療該病有效、安全的治療途徑,為臨床治療提供依據(jù)。方法:2014年12月到2016年12月,病人來(lái)源為符合納入標(biāo)準(zhǔn)的80例凍結(jié)期肩周炎的患者,隨機(jī)分為兩組:治療組40例,運(yùn)用中藥熏洗結(jié)合肩關(guān)節(jié)鏡下松解手術(shù);對(duì)照組40例,僅僅使用肩關(guān)節(jié)鏡下松解手術(shù),不給予中藥熏洗療法。分析治療前后兩組肩部疼痛主觀評(píng)分、CMS、肩關(guān)節(jié)活動(dòng)度,評(píng)定兩組治療方案的綜合療效。全數(shù)實(shí)驗(yàn)數(shù)據(jù)采用SPSS17.0統(tǒng)計(jì)軟件給予分析。結(jié)果:1.VAS評(píng)分術(shù)后2周,兩組患者治療后VAS評(píng)分較治療前均明顯降低,且差異有統(tǒng)計(jì)學(xué)意義,(P0.05)。術(shù)后6周,對(duì)比兩組組間VAS評(píng)分有統(tǒng)計(jì)學(xué)差異,(P0.05)。術(shù)后3月,兩組組間VAS評(píng)分無(wú)統(tǒng)計(jì)學(xué)差異,(P0.05)。說(shuō)明治療組在緩解近期疼痛方面優(yōu)于對(duì)照組。2.肩關(guān)節(jié)CMS評(píng)分術(shù)后2周,對(duì)兩組患者進(jìn)行CMS評(píng)分比較,兩組相對(duì)于治療前均有統(tǒng)計(jì)學(xué)差異,(P0.05)。術(shù)后6周,對(duì)比兩組CMS評(píng)分有統(tǒng)計(jì)學(xué)差異,(P0.05)。術(shù)后3月,對(duì)比兩組CMS評(píng)分有統(tǒng)計(jì)學(xué)差異,(P0.05)。說(shuō)明治療組在改善肩關(guān)節(jié)功能的近期、遠(yuǎn)期療效均優(yōu)于對(duì)照組。3.肩關(guān)節(jié)ROM的分析術(shù)后兩周,對(duì)兩組患者進(jìn)行ROM比較,兩組相對(duì)于治療前均有統(tǒng)計(jì)學(xué)差異,(P0.05)。術(shù)后6周,對(duì)比兩組ROM有統(tǒng)計(jì)學(xué)差異,(P0.05)。術(shù)后3月,對(duì)比兩組ROM評(píng)分有統(tǒng)計(jì)學(xué)差異,(P0.05)。說(shuō)明術(shù)后配合中藥熏洗治療可以明顯增加肩關(guān)節(jié)活動(dòng)度。4.療效綜合評(píng)定術(shù)后6周及術(shù)后3月對(duì)兩組療效經(jīng)Radit檢驗(yàn),治療組的愈顯率明顯高于對(duì)照組,P0.05,差異具有統(tǒng)計(jì)學(xué)意義,說(shuō)明治療組在治療凍結(jié)期肩周炎方面的近期、遠(yuǎn)期療效均優(yōu)于對(duì)照組。結(jié)論:研究證明,肩關(guān)節(jié)鏡下松解手術(shù)具有微創(chuàng)、軟組織損傷小、松解精準(zhǔn)、術(shù)后恢復(fù)快等優(yōu)點(diǎn)。中藥熏洗可使藥物有效成分直達(dá)病所,操作方便,毒副作用小,對(duì)凍結(jié)期肩周炎患者術(shù)后疼痛、肩關(guān)節(jié)活動(dòng)度、肩關(guān)節(jié)功能均有明顯改善。中藥熏洗配合肩關(guān)節(jié)鏡下松解手術(shù)治療凍結(jié)期肩周炎的近遠(yuǎn)期療效均優(yōu)于單純采用肩關(guān)節(jié)鏡下松解手術(shù)治療,適合臨床推廣及運(yùn)用。
[Abstract]:Objective: periarthritis of shoulder is a common orthopedic disease characterized by shoulder pain and dyskinesia. The disease has a high incidence and a long course, which has attracted wide attention in clinical practice, but its effective treatment is still controversial. This paper discusses the clinical effect of fumigation and washing combined with shoulder arthroscopy in the treatment of frozen scapulohumeral periarthritis, and finds an effective and safe way to treat the disease, which provides the basis for clinical treatment. Methods: from December 2014 to December 2016, 80 patients with frozen scapulohumeral periarthritis were randomly divided into two groups: treatment group (n = 40), treated group (n = 40) and control group (n = 40). Only use shoulder arthroscopy release surgery, do not give Chinese medicine fumigation therapy. The subjective score of shoulder pain and the range of shoulder motion were analyzed before and after treatment. All experimental data were analyzed by SPSS17.0 software. Results 1. The VAS scores of the two groups were significantly lower than those before treatment 2 weeks after treatment, and the difference was statistically significant (P0.05). Six weeks after the operation, there was statistical difference in VAS score between the two groups (P0.05). Three months after operation, there was no significant difference in VAS score between the two groups (P0.05). It shows that the treatment group is superior to the control group in relieving short-term pain. 2. Two weeks after the shoulder joint CMS score, the two groups of patients were compared with the CMS score, the two groups compared to the treatment before the statistical difference (P0.05). Six weeks after operation, there was a statistical difference in CMS scores between the two groups (P0.05). 3 months after operation, compared with the two groups of CMS scores were statistically different (P0.05). The results showed that the long-term effect of the treatment group was better than that of the control group in improving the function of shoulder joint in the short-term. The analysis of shoulder joint ROM two weeks after operation, the two groups of patients were compared with ROM, the two groups were compared with the treatment before the statistical difference (P0.05). Six weeks after the operation, compared with the two groups, there was a statistical difference in ROM (P0.05). 3 months after operation, compared with the two groups of ROM scores were statistically different (P0.05). The results showed that the combination of fumigation and washing with traditional Chinese medicine after operation could obviously increase the range of shoulder motion. 4. Comprehensive evaluation of curative effect 6 weeks after operation and 3 months after operation, Radit test showed that the effective rate of treatment group was significantly higher than that of control group (P0.05), the difference was statistically significant, indicating that the treatment group in the treatment of frozen period shoulder periarthritis in the near future. The long-term curative effect was better than the control group. Conclusion: the results show that the arthroscopic release of shoulder has the advantages of minimally invasive, soft tissue injury, accurate release and quick postoperative recovery. Fumigation and washing of Chinese medicine can make the active components of medicine direct to the sick place, the operation is convenient, the toxic side effect is small, and the pain, the range of motion of shoulder joint and the function of shoulder joint of frozen period shoulder periarthritis patients after operation are obviously improved. The short-term and long-term curative effect of fumigation and washing combined with shoulder arthroscopy in the treatment of frozen shoulder periarthritis is better than that of shoulder arthroscopy alone, so it is suitable for clinical popularization and application.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R686
本文編號(hào)：2177077
[Abstract]:Objective: periarthritis of shoulder is a common orthopedic disease characterized by shoulder pain and dyskinesia. The disease has a high incidence and a long course, which has attracted wide attention in clinical practice, but its effective treatment is still controversial. This paper discusses the clinical effect of fumigation and washing combined with shoulder arthroscopy in the treatment of frozen scapulohumeral periarthritis, and finds an effective and safe way to treat the disease, which provides the basis for clinical treatment. Methods: from December 2014 to December 2016, 80 patients with frozen scapulohumeral periarthritis were randomly divided into two groups: treatment group (n = 40), treated group (n = 40) and control group (n = 40). Only use shoulder arthroscopy release surgery, do not give Chinese medicine fumigation therapy. The subjective score of shoulder pain and the range of shoulder motion were analyzed before and after treatment. All experimental data were analyzed by SPSS17.0 software. Results 1. The VAS scores of the two groups were significantly lower than those before treatment 2 weeks after treatment, and the difference was statistically significant (P0.05). Six weeks after the operation, there was statistical difference in VAS score between the two groups (P0.05). Three months after operation, there was no significant difference in VAS score between the two groups (P0.05). It shows that the treatment group is superior to the control group in relieving short-term pain. 2. Two weeks after the shoulder joint CMS score, the two groups of patients were compared with the CMS score, the two groups compared to the treatment before the statistical difference (P0.05). Six weeks after operation, there was a statistical difference in CMS scores between the two groups (P0.05). 3 months after operation, compared with the two groups of CMS scores were statistically different (P0.05). The results showed that the long-term effect of the treatment group was better than that of the control group in improving the function of shoulder joint in the short-term. The analysis of shoulder joint ROM two weeks after operation, the two groups of patients were compared with ROM, the two groups were compared with the treatment before the statistical difference (P0.05). Six weeks after the operation, compared with the two groups, there was a statistical difference in ROM (P0.05). 3 months after operation, compared with the two groups of ROM scores were statistically different (P0.05). The results showed that the combination of fumigation and washing with traditional Chinese medicine after operation could obviously increase the range of shoulder motion. 4. Comprehensive evaluation of curative effect 6 weeks after operation and 3 months after operation, Radit test showed that the effective rate of treatment group was significantly higher than that of control group (P0.05), the difference was statistically significant, indicating that the treatment group in the treatment of frozen period shoulder periarthritis in the near future. The long-term curative effect was better than the control group. Conclusion: the results show that the arthroscopic release of shoulder has the advantages of minimally invasive, soft tissue injury, accurate release and quick postoperative recovery. Fumigation and washing of Chinese medicine can make the active components of medicine direct to the sick place, the operation is convenient, the toxic side effect is small, and the pain, the range of motion of shoulder joint and the function of shoulder joint of frozen period shoulder periarthritis patients after operation are obviously improved. The short-term and long-term curative effect of fumigation and washing combined with shoulder arthroscopy in the treatment of frozen shoulder periarthritis is better than that of shoulder arthroscopy alone, so it is suitable for clinical popularization and application.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R686
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