桂枝附子汤加减联合中频导入治疗寒湿痹阻型肩周炎对功能康复的影响

发布时间：2018-04-12 21:08

本文选题：肩周炎 + 寒湿痹阻　；参考：《中国实验方剂学杂志》2017年03期

【摘要】：目的:探讨桂枝附子汤加减中频导入治疗寒湿痹阻型肩周炎的镇痛效应和对肩关节功能恢复的疗效及作用机制。方法:将136例患者按随机数字表法分为对照组和观察组,各68例。两组均参照指南进行肩部功能锻炼,对照组用中频电疗法,采用连续模式,20 min/次,1次/d,6次/周。观察组则采用桂枝附子汤加减中频导入,20 min/次,1次/d,6次/周。采用Mc Gill疼痛问卷(SF-MPQ)评价疼痛情况,采用Constant-Murley评分肩关节功能;日常活动评价采用美国肩与肘协会评分系统(ASES)肩关节功能评价量表,检测治疗前后血浆P物质(SP),白细胞介素-10(IL-10),肿瘤坏死因子-α(TNF-α),前列腺素E2(PGE2)水平;进行治疗前后寒湿痹阻证评分。结果:观察组临床疗效总有效率为95.31%,对照组为81.97%,观察组优于对照组(P0.05);治疗后观察组SF-MPQ的3个维度及总分均低于对照组(P0.01);治疗后观察组疼痛、日常生活活动、肩关节活动度和总分高于对照组(P0.01);治疗后观察组寒湿痹阻证评分低于对照组(P0.01);治疗后观察组SP,TNF-α,PGE2水平低于对照组,IL-10水平高于对照组(P0.01)。结论:在功能锻炼的基础上,采用附子汤加减中频导入治疗寒湿痹阻型肩周炎能进一步的减轻疼痛、改善寒湿痹阻症状,能增加关节活动度,改善关节功能,临床疗效显著且安全,其作用机制可能是通过调节炎症介质和下调SP和PGE2水平来实现。
[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- 伪 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- 伪 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.
【作者单位】：莱芜市人民医院;
【基金】：山东中医药科学技术项目(Z-2015-3-58-2)
【分类号】：R274.9

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