[1]屠夏芸,汪萍,戚陈玉,等.经皮穴位电刺激联合持续被动运动治疗冻结肩的临床研究[J].中医正骨,2017,29(07):30-33.
 TU Xiayun,WANG Ping,QI Chenyu,et al.Clinical study on transcutaneous electrical acupoint stimulation combined with continuous passive motion for treatment of frozen shoulder[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(07):30-33.
点击复制

经皮穴位电刺激联合持续被动运动治疗冻结肩的临床研究()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年07期
页码:
30-33
栏目:
临床研究
出版日期:
2017-07-20

文章信息/Info

Title:
Clinical study on transcutaneous electrical acupoint stimulation combined with continuous passive motion for treatment of frozen shoulder
作者:
屠夏芸汪萍戚陈玉胡雪蓉赵友
浙江省新华医院,浙江 杭州 310005
Author(s):
TU XiayunWANG PingQI ChenyuHU XuerongZHAO You
Zhejiang Xinhua Hospital,Hangzhou 310005,Zhejiang,China
关键词:
肩凝症 经皮神经电刺激 运动疗法持续被动性 临床试验
Keywords:
Key words frozen shoulder transcutaneous electric nerve stimulation motion therapycontinuous passive clinical trial
摘要:
目的:观察经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)联合持续被动运动治疗冻结肩的临床疗效。方法:将符合要求的60例冻结肩患者随机分为2组,每组30例; 观察组采用TEAS联合持续被动运动治疗,对照组采用口服塞来昔布胶囊联合持续被动运动治疗。TEAS及持续被动运动均为隔日治疗1次,连续治疗8周; 口服塞来昔布胶囊,每日2次,每次0.2 g,连续服用8周。比较治疗前及治疗结束后2组患者的肩部疼痛视觉模拟量表(visual analogue scale,VAS)评分及肩关节外展上举、前屈上举、后伸活动度和牛津大学肩关节评分(Oxford shoulder score,OSS)。结果:治疗前2组患者的肩痛VAS评分及肩关节外展上举、前屈上举、后伸活动度和OSS评分比较,组间差异均无统计学意义[79.1°±9.6°,76.9°±10.5°,t=0.362,P=0.708; 51.3°±7.2°,50.7°±6.7°,t=0.268,P=0.833; 21.6°±4.8°,22.4°±5.2°,t=0.207,P=0.875;(49.2±2.7)分,(48.6±2.9)分,t=0.218,P=0.804]; 治疗结束后,2组患者的肩痛VAS评分和OSS评分均较治疗前降低[(5.1±0.3)分,(1.1±0.4)分,t=25.962,P=0.000;(5.2±0.5)分,(2.6±0.4)分,t=10.451,P=0.000;(49.2±2.7)分,(23.7±3.3)分,t=15.118,P=0.000;(48.6±2.9)分,(32.4±2.5)分,t=9.637,P=0.000],肩关节外展上举、前屈上举及后伸活动度均较治疗前增加(79.1°±9.6°,135.6°±8.7°,t=17.251,P=0.000; 76.9°±10.5°,120.9°±9.6°,t=16.078,P=0.000; 51.3°±7.2°,132.2°±9.1°,t=18.372,P=0.000; 50.7°±6.7°,103.5°±8.8°,t=14.215,P=0.000; 21.6°±4.8°,40.3°±3.4°,t=14.438,P=0.000; 22.4°±5.2°,32.4°±5.1°,t=8.917,P=0.000); 且观察组的肩痛VAS评分及OSS评分均低于对照组[(1.1±0.4)分,(2.6±0.4)分,t=3.021,P=0.000;(23.7±3.3)分,(32.4±2.5)分,t=2.769,P=0.000],肩关节外展上举、前屈上举及后伸活动度均大于对照组(135.6°±8.7°,120.9°±9.6°,t=2.893,P=0.000; 132.2°±9.1°,103.5°±8.8°,t=2.415,P=0.000; 40.3°±3.4°,32.4°±5.1°,t=2.862,P=0.000)。结论:TEAS联合持续被动运动治疗冻结肩,可以有效缓解肩部疼痛、增加肩关节活动度,综合疗效优于口服塞来昔布胶囊联合持续被动运动,值得临床推广应用。
Abstract:
ABSTRACT Objective:To observe the clinical curative effects of transcutaneous electrical acupoint stimulation(TEAS)combined with continuous passive motion(CPM)for treatment of frozen shoulder.Methods:Sixty patients with frozen shoulder were enrolled in the study and were randomly divided into observation group and control group,30 cases in each group.The patients in observation group were treated with combination therapy of TEAS and CPM,and the patients in control group were treated with combination therapy of oral application of celecoxib capsules and CPM.Both TEAS and CPM were performed every other day for consecutive 8 weeks,and the celecoxib capsules were taken twice a day for consecutive 8 weeks,0.2 g at a time.The shoulder pain visual analogue scale(VAS)scores,the range of motion(ROM)of shoulder(abduction-raising,anteflexion-raising and backward extension)and Oxford shoulder score(OSS)were recorded and compared between the 2 groups before the treatment and after the end of the treatment.Results:There was no statistical difference in shoulder pain VAS scores,ROM of shoulder(abduction-raising,anteflexion-raising and backward extension)and OSS scores between the 2 groups before the treatment(79.1+/-9.6 vs 76.9+/-10.5 degrees,t=0.362,P=0.708; 51.3+/-7.2 vs 50.7+/-6.7 degrees,t=0.268,P=0.833; 21.6+/-4.8 vs 22.4+/-5.2 degrees,t=0.207,P=0.875; 49.2+/-2.7 vs 48.6+/-2.9 points,t=0.218,P=0.804).The shoulder pain VAS scores and OSS scores decreased in both of the 2 group after the end of the treatment compared to pre-treatment(5.1+/-0.3 vs 1.1+/-0.4 points,t=25.962,P=0.000; 5.2+/-0.5 vs 2.6+/-0.4 points,t=10.451,P=0.000; 49.2+/-2.7 vs-------------------- 23.7+/-3.3 points,t=15.118,P=0.000; 48.6+/-2.9 vs 32.4+/-2.5 points,t=9.637,P=0.000),while the ROM of shoulder(abducent aforenamed,anteflexed aforenamed and rear protraction)increased in both of the 2 group after the end of the treatment compared to pre-treatment(79.1+/-9.6 vs 135.6+/-8.7 degrees,t=17.251,P=0.000; 76.9+/-10.5 vs 120.9+/-9.6 degrees,t=16.078,P=0.000; 51.3+/-7.2 vs 132.2+/-9.1 degres,t=18.372,P=0.000; 50.7+/-6.7 vs 103.5+/-8.8 degrees,t=14.215,P=0.000; 21.6+/-4.8 vs 40.3+/-3.4 degrees,t=14.438,P=0.000; 22.4+/-5.2 vs 32.4+/-5.1 degrees,t=8.917,P=0.000).The shoulder pain VAS scores and OSS scores were lower in observation group compared to control group(1.1+/-0.4 vs 2.6+/-0.4 points,t=3.021,P=0.000; 23.7+/-3.3 vs 32.4+/-2.5 points,t=2.769,P=0.000),while the ROM of shoulder(abducent aforenamed,anteflexed aforenamed and rear protraction)were greater in observation group compared to control group(135.6+/-8.7 vs 120.9+/-9.6 degrees,t=2.893,P=0.000; 132.2+/-9.1 vs 103.5+/-8.8 degrees,t=2.415,P=0.000; 40.3+/-3.4 vs 32.4+/-5.1 degrees,t=2.862,P=0.000)after the end of the treatment.Conclusion:The therapy of TEAS combined with CPM can effectively relieve the shoulder pain and increase the shoulder ROM in the treatment of frozen shoulder,and its comprehensive curative effect is better than that of oral application of celecoxib capsules combined with CPM,so it is worthy of popularizing in clinic.

参考文献/References:

[1] 苏瑾,王平,刘爱峰.三维动态牵伸回旋手法对冻结期冻结肩患者体表红外热像的影响[J].中医正骨,2015,27(7):11-14.
[2] FABIS J,RZEPKA R,FABIS A,et al.Shoulder proprioception-lessons we learned from idiopathic frozen shoulder[J].BMC Musculoskelet Disord,2016,17:123.
[3] 赵明宇,杨超凡,赵启,等.“筋滞骨错”理论指导下手法治疗黏连期肩凝症[J].中医正骨,2016,28(4):57-58.
[4] 中华医学会.临床诊疗指南·物理医学与康复分册[M].北京:人民卫生出版社,2005:68-69.
[5] 蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005:123-124.
[6] TUTON D,BARBE C,SALMON JH,et al.Transcultural validation of the Oxford Shoulder Score for the French-speaking population[J].Orthop Traumatol Surg Res,2016,102(5):555-558.
[7] 赖雪燕,叶敏,祁冀,等.针灸治疗肩周炎的三大特色选穴方法[J].西部中医药,2014,27(6):71-73.
[8] 李晓声.经皮穴位电刺激复合腰硬联合麻醉在下肢骨科手术中镇静镇痛应用观察[J].辽宁中医药大学学报,2016,18(2):193-195.
[9] FENG X,YE T,WANG Z,et al.Transcutaneous acupoint electrical stimulation pain management after surgical abortion:A cohort study[J].Int J Surg,2016,30:104-108.
[10] 李邦伟,高宏,马睿杰,等.经皮穴位电刺激联合温针灸治疗腰椎间盘突出症疗效评价[J].浙江中医药大学学报,2014,38(7):900-901.
[11] 谢晶军,王丹,方剑乔.不同经穴经皮穴位电刺激对大鼠痛阈及血压调节效应的比较[J].中华中医药杂志,2015,30(11):4144-4146.
[12] 王立萍,梁洁,王玉,等.经皮穴位电刺激对食管癌根治术患者围术期促炎因子的释放及胰岛素抵抗的影响[J].临床麻醉学杂志,2016,32(7):707-708.
[13] 尹正录,孟兆祥,林舜艳,等.穴位电刺激对高龄患者术后认知功能及炎性因子的影响[J].中华针灸电子杂志,2015,4(4):159-163.
[14] JIANG SH,TU WZ,ZOU EM,et al.Neuroprotective effects of different modalities of acupuncture on traumatic spinal cord injury in rats[J].Evid Based Complement Alternat Med,2014,2014:431580.
[15] 张云霄,陈冀衡,万有,等.针药复合麻醉对胸腔镜肺癌根治术患者术后镇痛效果的影响[J].中国疼痛医学杂志,2015,21(3):206-209.
[16] 韩济生.针刺镇痛:共识与质疑[J].中国疼痛医学杂志,2017,17(1):9-13.
[17] 鄂立红,文业华.持续被动运动治疗肩周炎的疗效观察[J].中国实用医药,2016,11(23):95-96.

相似文献/References:

[1]苏瑾,王平,刘爱峰.三维动态牵伸回旋手法对冻结期冻结肩患者 体表红外热像的影响[J].中医正骨,2015,27(07):11.
 SU Jin,WANG Ping,LIU Aifeng.Influence of three-dimensional dynamic drafting and convolution manipulation on body surface infrared thermal imaging in patients with frozen shoulder during frozen period[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):11.
[2]王史潮,吴云刚,徐仲翔,等.综合疗法治疗创伤性肩关节周围炎[J].中医正骨,2015,27(04):52.
[3]赵明宇,杨超凡,赵启,等.“筋滞骨错”理论指导下手法治疗黏连期肩凝症[J].中医正骨,2016,28(04):57.
[4]孙 飞.臭氧水关节腔冲洗配合穴位注射治疗肩周炎34例[J].中医正骨,2016,28(10):67.
[5]管亦坚,程朝晖,梁一民.水针刀联合玻璃酸钠关节腔注射治疗肩周炎的临床研究[J].中医正骨,2016,28(11):13.
 GUAN Yijian,CHENG Zhaohui,LIANG Yimin.Clinical study on hydro-acupuncture knife therapy combined with intra-articular injection of sodium hyaluronate in the treatment of periarthritis humeroscapularis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(07):13.
[6]郑英慧,卢启贵.无痛手法松解联合鸡尾酒疗法和功能锻炼治疗重度肩周炎[J].中医正骨,2016,28(11):66.
[7]李正祥,王海梁,易文静,等.松解三法联合功能锻炼治疗黏连期肩周炎的临床研究[J].中医正骨,2017,29(06):35.
 LI Zhengxiang,WANG Hailiang,YI Wenjing,et al.Clinical study on manipulative release combined with functional exercises for treatment of adhesion-stage periarthritis humeroscapularis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(07):35.
[8]王新昌,郝连升,陈健.放散式体外冲击波联合关节腔注射和功能锻炼治疗肩周炎的临床研究[J].中医正骨,2017,29(08):36.
 WANG Xinchang,HAO Liansheng,CHEN Jian.Clinical study on divergent type extracorporeal shock wave therapy combined with intra-articular injection and functional exercises in the treatment of periarthritis humeroscapularis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(07):36.
[9]梁永瑛,郭艳明,周帅亮,等.经皮穴位电刺激联合常规康复疗法在全膝关节置换术后早期康复中的应用[J].中医正骨,2017,29(10):35.
 LIANG Yongying,GUO Yanming,ZHOU Shuailiang,et al.Application of transcutaneous electric acupoint stimulation combined with conventional rehabilitation therapy to early rehabilitation after total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(07):35.
[10]吴国林,陈红卫,季向荣,等.放射式体外冲击波运动靶点治疗肩关节周围炎的临床研究[J].中医正骨,2018,30(05):10.
 WU Guolin,CHEN Hongwei,JI Xiangrong,et al.A clinical study of radial type extracorporeal shockwave acting on moving targets for treatment of periarthritis of shoulder[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(07):10.

备注/Memo

备注/Memo:
通讯作者:赵友 E-mail:274509294@qq.com
更新日期/Last Update: 2017-12-29