针刀联合手法松解治疗粘连性肩周炎的临床研究

发布时间：2018-05-04 21:50

本文选题：针刀 + 手法松解　；参考：《济南大学》2016年硕士论文

【摘要】：目的运用针刀技术联合手法松解的治疗手段,以传统针灸推拿的治疗方法做对照,通过治疗前后各项肩关节功能活动的评分比较,评价不同方法的临床疗效,探究针刀联合手法松解治疗粘连性肩周炎的疗效及作用机制。方法将90例肩关节周围炎患者随机分为两组,试验组45例采用针刀联合手法松解治疗,对照组45例采用传统针灸推拿治疗。根据“全国第二届肩周炎学术研讨会”上制定的诊断标准进行诊断和评定疗效,采用疼痛视觉模拟评分法(Visual Analogue Score,VAS)评估患者肩关节疼痛程度,采用调整后的Constant-Murley肩关节功能评分(CMS),包括日常功能活动(ADL)、肩关节活动度(ROM)、肌力(MMT),对患肩部治疗前及治疗一定时间后进行肩关节功能活动量化评分。分析患者治疗前后临床症状指标的变化,包括:VAS评分及肩关节各项功能活动评分,计算出各组有效率。应用SPSS统计分析软件作数据分析。结果1.治疗后,两组患者的VAS、ADL、ROM、MMT等各项评分均较治疗前有优化,组内差异比较具有统计学意义(p0.05)。2.治疗后,两组患者在VAS、ADL、ROM的评分对比上,组间差异具有统计学意义(p0.05),试验组在评分改善上优于对照组。3.治疗后两组患者在MMT评分的比较上,无显著性差异(p0.05)。4.临床疗效上,试验组治愈32例,好转8例,无效3例,有效率93.02%;对照组治愈25例,好转11例,无效6例,有效率85.71%。两组之间的疗效差异具有统计学意义(p0.05),试验组疗效优于对照组。结论1、针刀技术联合手法松解治疗粘连性肩周炎疗效肯定,且优于传统针灸推拿疗法。2、针刀技术可有效松解肩周炎患者患周组织的粘连和挛缩,刺激局部神经和改善微循环代谢,减轻炎症反应。在此基础上,手法松解可增加松解粘连的效果。二者联合能大幅度地改善患者的活动受限、疼痛的临床症状,提高患者生活质量。
[Abstract]:Objective to evaluate the clinical efficacy of different methods by comparing the scores of shoulder joint function before and after treatment with the traditional acupuncture and massage therapy. To explore the therapeutic effect and mechanism of acupuncture knife combined with manual release in the treatment of adherent shoulder periarthritis. Methods 90 patients with periarthritis of shoulder were randomly divided into two groups: the experimental group (n = 45) was treated with acupuncture and knife combined with manual release, and the control group (n = 45) was treated with traditional acupuncture and massage. According to the diagnostic criteria established in the second National Symposium on Periarthritis of shoulder, the curative effect was evaluated. Visual Analogue score was used to evaluate the degree of shoulder pain. The modified Constant-Murley functional score was used to evaluate the shoulder function before and after treatment, including daily functional activities, shoulder motion and muscle strength. The changes of clinical symptom indexes before and after treatment were analyzed, including the score of VAS and the score of functional activities of shoulder joint. The effective rate of each group was calculated. SPSS statistical analysis software was used for data analysis. Result 1. After treatment, the scores of VASA ADL rom MMT in the two groups were optimized as compared with those before treatment, and the difference was statistically significant (P 0.05). 2. After treatment, the scores of VAS-ADLL ROM in the two groups were compared, the difference between the two groups was statistically significant (p0.05), and the improvement of the scores in the experimental group was better than that in the control group (.3.) After treatment, there was no significant difference in MMT score between the two groups (p 0.05. 4). In clinical effect, 32 cases were cured, 8 cases were improved, 3 cases were ineffective, and the effective rate was 93.02% in the experimental group, while in the control group, 25 cases were cured, 11 cases were improved, 6 cases were ineffective, and the effective rate was 85.71%. The difference of curative effect between the two groups was statistically significant (p 0.05), and the curative effect of the experimental group was better than that of the control group. Conclusion 1. The treatment of adherent shoulder periarthritis with needle knife technique combined with manipulation is effective and superior to that of traditional acupuncture and massage therapy. The needle knife technique can effectively relieve the adhesion and contracture of periarthritis of shoulder tissue. Stimulate the local nerves and improve the metabolism of microcirculation, reduce inflammation. On this basis, manual release can increase the effect of loosening adhesion. The combination of the two can significantly improve the patient's limited activity, pain clinical symptoms and improve the patient's quality of life.
【学位授予单位】：济南大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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