[1]孙旗,姜孟家,王淑斌,等.针刺疗法预防肱骨近端骨折内固定术后肩关节功能障碍的临床研究[J].中医正骨,2016,28(04):29-32.
　SUN Qi,JIANG Mengjia,WANG Shubin,et al.A clinical study of acupuncture therapy for prevention of shoulder dysfunction after internal fixation of proximal humeral fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):29-32.
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针刺疗法预防肱骨近端骨折内固定术后肩关节功能障碍的 临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年04期
页码:
29-32
栏目:
临床研究
出版日期:
2016-04-20

文章信息/Info

Title:
A clinical study of acupuncture therapy for prevention of shoulder dysfunction after internal fixation of proximal humeral fractures
作者:
孙旗; 姜孟家; 王淑斌; 郑晨颖; 贾育松
北京中医药大学东直门医院,北京 100700
Author(s):
SUN Qi; JIANG Mengjia; WANG Shubin; ZHENG Chenying; JIA Yusong
Dongzhimen hospital of Beijing University of Traditional Chinese Medicine,Beijing 100700,China
关键词:
肱骨骨折;  肩骨折;  针刺疗法;  电刺激疗法;  临床试验
Keywords:
humeral fractures;  shoulder fractures;  acupuncture therapy;  electric stimulation therapy;  clinical trial
摘要:
目的:观察针刺疗法预防肱骨近端骨折内固定术后肩关节功能障碍的临床疗效。方法:将符合要求的44例肱骨近端骨折患者随机分为2组,行切开复位内固定术。自术后1 d起,指导患者进行肩关节功能锻炼。术后2周切口愈合后,在功能锻炼基础上分别采用针刺疗法(24例)和中频电疗法(20例)治疗,均每周治疗3次,连续治疗12周。分别于术后1周、12周、24周行X线检查,观察骨折愈合情况。比较2组患者术前及术后1周、4周、12周和24周的改良Constant-Murley肩关节功能评分,改良评分=健侧肩关节功能评分-患侧肩关节功能评分。结果:X线检查显示,术后1周骨折复位及内固定满意; 术后12周骨折线模糊,有骨痂形成; 术后24周骨折均达到骨性愈合。手术前后不同时间点改良Constant-Murley评分比较,差异有统计学意义,存在时间效应(F=3428.676,P=0.000); 2组患者改良Constant-Murley评分比较,组间差异有统计学意义,存在分组效应(F=-2.195,P=0.029); 术前及术后1周2组患者的改良Constant-Murley评分比较,组间差异均无统计学意义[(87.4±6.8)分,(89.1±7.3)分,t=0.799,P=0.429;(83.7±4.7)分,(81.2±4.1)分,t=1.842,P=0.073]; 术后4周、12周和24周,针刺治疗组的改良Constant-Murley评分均低于中频电疗组[(51.7±4.9)分,(65.4±4.5)分,t=-9.611,P=0.000;(17.6±2.0)分,(34.7±2.7)分,t=-24.281,P=0.000;(9.7±1.5)分,(17.9±1.6)分,t=-17.514,P=0.000]; 时间因素和分组因素存在交互效应(F=10.000,P=0.001)。结论:针刺疗法可以有效预防肱骨近端骨折内固定术后肩关节功能障碍,其效果优于中频电疗法,可以作为一种辅助方法进行推广应用。
Abstract:
Objective:To observe the preventative effect of acupuncture therapy on shoulder dysfunction after internal fixation of proximal humeral fractures.Methods:Forty-four patients with proximal humeral fractures enrolled in the study were randomly divided into 2 groups and were treated with open reduction internal fixation.Shoulder functional exercises were performed with guidance from doctors since 1 day after the treatment.Moreover,the patients were treated with acupuncture therapy(24 cases)and medium frequency electrotherapy(20 cases)respectively after the operative incision healing at 2 weeks after the surgery,3 times a week for consecutive 12 weeks.The X-ray examination were performed at 1,12 and 24 weeks after the surgery,and the fracture healing were observed.The improved Constant-Murley shoulder scores were compared between the 2 groups before the surgery and at 1,4,12 and 24 weeks after the surgery.The improved scores were equal to the difference of scores between uninjured shoulder and injured shoulder.Results:The X-ray examination showed(1)the fracture reduction and internal fixation were satisfactory at 1 week after the surgery;(2)the fracture lines were fuzzy and the bony callus were found at 12 weeks after the surgery;(3)the bone union were achieved at 24 weeks after the surgery.There was statistical difference in the improved Constant-Murley scores between different timepoints,in other words,there was time effect(F=3428.676,P=0.000).There was statistical difference in the improved Constant-Murley scores between the 2 groups,in other words,there was group effect(F=-2.195,P=0.029).There was no statistical difference in the improved Constant-Murley scores between the 2 groups before the surgery and at 1 week after the surgery(87.4+/-6.8 vs 89.1+/-7.3 points,t=0.799,P=0.429; 83.7+/-4.7 vs 81.2+/-4.1 points,t=1.842,P=0.073).The improved Constant-Murley scores were lower in acupuncture therapy group compared to medium frequency electrotherapy group at 4,12 and 24 weeks after the surgery(51.7+/-4.9 vs 65.4+/-4.5 points,t=-9.611,P=0.000; 17.6+/-2.0 vs 34.7+/-2.7 points,t=-24.281,P=0.000; 9.7+/-1.5 vs 17.9+/-1.6 points,t=-17.514,P=0.000).There was interaction between time factor and grouping factor(F=10.000,P=0.001).Conclusion:The acupuncture therapy can effectively prevent shoulder dysfunction after internal fixation of proximal humeral fractures,and its curative effect is better than that of medium frequency electrotherapy,so it is worthy of popularizing in clinic as an auxiliary method.

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备注/Memo:
通讯作者:姜孟家 E-mail:578869773@qq.com
更新日期/Last Update: 2016-08-30