本文選題：肩周炎 + 寒濕痹阻��； 參考：《中國實驗方劑學(xué)雜志》2017年03期

【摘要】：目的:探討桂枝附子湯加減中頻導(dǎo)入治療寒濕痹阻型肩周炎的鎮(zhèn)痛效應(yīng)和對肩關(guān)節(jié)功能恢復(fù)的療效及作用機制。方法:將136例患者按隨機數(shù)字表法分為對照組和觀察組,各68例。兩組均參照指南進行肩部功能鍛煉,對照組用中頻電療法,采用連續(xù)模式,20 min/次,1次/d,6次/周。觀察組則采用桂枝附子湯加減中頻導(dǎo)入,20 min/次,1次/d,6次/周。采用Mc Gill疼痛問卷(SF-MPQ)評價疼痛情況,采用Constant-Murley評分肩關(guān)節(jié)功能;日�；顒釉u價采用美國肩與肘協(xié)會評分系統(tǒng)(ASES)肩關(guān)節(jié)功能評價量表,檢測治療前后血漿P物質(zhì)(SP),白細胞介素-10(IL-10),腫瘤壞死因子-α(TNF-α),前列腺素E2(PGE2)水平;進行治療前后寒濕痹阻證評分。結(jié)果:觀察組臨床療效總有效率為95.31%,對照組為81.97%,觀察組優(yōu)于對照組(P0.05);治療后觀察組SF-MPQ的3個維度及總分均低于對照組(P0.01);治療后觀察組疼痛、日常生活活動、肩關(guān)節(jié)活動度和總分高于對照組(P0.01);治療后觀察組寒濕痹阻證評分低于對照組(P0.01);治療后觀察組SP,TNF-α,PGE2水平低于對照組,IL-10水平高于對照組(P0.01)。結(jié)論:在功能鍛煉的基礎(chǔ)上,采用附子湯加減中頻導(dǎo)入治療寒濕痹阻型肩周炎能進一步的減輕疼痛、改善寒濕痹阻癥狀,能增加關(guān)節(jié)活動度,改善關(guān)節(jié)功能,臨床療效顯著且安全,其作用機制可能是通過調(diào)節(jié)炎癥介質(zhì)和下調(diào)SP和PGE2水平來實現(xiàn)。
[Abstract]:Objective: to investigate the analgesic effect and mechanism of midfrequency infusion of Guizhi Fuzi decoction in the treatment of shoulder periarthritis with cold and dampness arthralgia.Methods: 136 patients were randomly divided into control group (n = 68) and observation group (n = 68).The two groups were given shoulder function exercise according to the guidelines, while the control group was treated with intermediate frequency electrotherapy, and the control group was treated with continuous mode of 20 min/ / 1 / d 6 times / week.In the observation group, Guizhi Aconitum decoction was used to introduce 20 min/ times per day / week.Mc Gill pain questionnaire (SF-MPQ) was used to evaluate the pain, Constant-Murley was used to evaluate the shoulder function, and the American shoulder and elbow association scale was used to evaluate the daily activities.The plasma levels of substance P, IL-10, TNF- 偽 and PGE2 were measured before and after treatment, and the scores of cold and dampness obstruction syndrome were evaluated before and after treatment.Results: the total effective rate of clinical efficacy was 95.31 in the observation group and 81.97 in the control group, which was superior to that in the control group, and the three dimensions and total scores of SF-MPQ in the observation group were lower than those in the control group after treatment.The range of motion and total score of shoulder joint were higher than that of control group (P 0.01), the score of cold dampness obstruction syndrome in observation group was lower than that of control group (P 0.01), and the level of SPN TNF- 偽 PGE2 in observation group was lower than that in control group (P 0.01).Conclusion: on the basis of functional exercise, the treatment of shoulder periarthritis with cold and dampness arthralgia can further alleviate the pain, improve the symptom of cold and dampness arthralgia, increase the range of joint motion and improve the function of the joint.The clinical efficacy is significant and safe, which may be achieved by regulating inflammatory mediators and down-regulating SP and PGE2 levels.
【作者單位】： 萊蕪市人民醫(yī)院;
【基金】：山東中醫(yī)藥科學(xué)技術(shù)項目(Z-2015-3-58-2)
【分類號】：R274.9

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