针刺与可的松注射治疗肩周炎的疗效对比

发布时间：2018-04-25 00:18

本文选题：电针 + 针灸　；参考：《南京中医药大学》2016年硕士论文

【摘要】：研究目的：比较单次可的松注射和三周针灸治疗对原发性肩周炎患者疼痛和功能受限的长期疗效。研究方法：41位患肩周炎超过三个月的患者被分入针灸治疗组和可的松治疗组。可的松治疗组,直接向肩肱关节囊内注射乙曲安奈德(2m1)或等渗生理盐水(2m1)和1%的利多卡因(2-3cc)的混合物40m1。针灸治疗组,连续三周每天施以电针,肩周局部取佈俞、肩毭、巨骨、臂佈、肩前和肩孊,远处取与患者对症的穴位,最后在肩周进行拔罐。两组均授以简单的自我锻炼,每日运动三次。进行基线评估及病情评估,病情评估分别于治疗前、治疗后即时(可的松注射后和针灸最后一次治疗)和治疗后12周进行。患者12周治疗后的肩关节疼痛和功能障碍评分(SPADI)作为主要评价指标。研究结果：治疗12周后,两组SPADI评分较治疗前的改变均有统计学意义(可的松组P=0.001,针刺组P=0.001)。尽管在治疗后12周时针刺组SPADI总分减少明显低于可的松组(P=0.025),但治疗后即时可的松组的SPADI总分减少明显低于针刺组(P0.001)。是因为治疗后即时至治疗后12周,可的松组SPADI评分上升19分,而针刺组却降低了2.5分。研究结论：可的松注射能迅速缓解肩周炎患者的局部疼痛,但长期疗效不佳(仍需进一步研究)。反复在同一部位进行注射会产生不良反应。施术正确,针灸就不会产生不良反应。针灸治疗肩周炎见效时间略长,也需要患者一周进行多次治疗,但此方法长期止痛的疗效远高于可的松。
[Abstract]:Objective: to compare the long-term effects of single cortisone injection and 3-week acupuncture therapy on pain and functional limitation in patients with primary shoulder periarthritis. Methods 41 patients with periarthritis of shoulder for more than 3 months were divided into acupuncture group and cortisone group. In the cortisone treatment group, the mixture of Acetamcinolone acetonide (2ml) or isotonic saline (2m1) and 1% lidocaine (2-3cc) was injected directly into the acromiohumeral capsule. In the acupuncture and moxibustion treatment group, electroacupuncture was given every day for three weeks, and local cupping was performed around the shoulder, the shoulder, the giant bone, the arm cloth, the shoulder front and the shoulder, and the acupoints in the distance to the patient. Finally, the cupping was carried out around the shoulder. Both groups were given simple self-exercise three times a day. Baseline assessment and assessment were performed before treatment, immediately after treatment (after cortisone injection and the last treatment with acupuncture) and 12 weeks after treatment. The pain and dysfunction of shoulder joint were evaluated by SPADII after 12 weeks treatment. Results: after 12 weeks of treatment, the SPADI scores in both groups were significantly different from those before treatment (P 0. 001 in cortisone group, P 0. 001 in acupuncture group). Although the total score of SPADI in the acupuncture group was significantly lower than that in the cortisone group at 12 weeks after treatment, the total SPADI score in the cortisone group was significantly lower than that in the acupuncture group (P 0.001). It was because the cortisone group increased its SPADI score by 19 points immediately after treatment and 12 weeks after treatment, while the acupuncture group decreased by 2.5 points. Conclusion: cortisone injection can quickly relieve local pain in patients with periarthritis of shoulder, but the long-term effect is not good (further study is needed. Repeated injections at the same site produce adverse reactions. If the technique is correct, acupuncture and moxibustion will not produce adverse reactions. Acupuncture and moxibustion treatment of shoulder periarthritis takes a long time and needs many times a week, but the long-term analgesic effect is much better than cortisone.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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