摘要
目的:探讨麻桂温经汤加味联合关节松动术治疗肩周炎血虚寒凝证的临床疗效以及对血流动力学和血清疼痛介质的影响。方法:筛选2016年7月至2018年7月在天津市宁河区医院诊治的肩周炎患者共有120例,按随机数字表法将患者分为对照组和观察组,每组60例。对照组患者接受关节松动术治疗,每日1次,口服塞来昔布胶囊。观察组在接受关节松动术治疗的基础采取麻桂温经汤加味内服,1剂/d,2次/d。两组患者连续治疗4周后,比较患者的主观疼痛程度McGill疼痛问卷(SF-MPQ)评分,肩关节活动度血流动力学变化,以及血清前列腺素E2(PGE2),P物质(SP),五羟色胺(5-HT)水平和临床疗效。结果:与本组治疗前比较,治疗4周后两组患者的视觉疼痛评分(VAS),现在疼痛状况(PPI),疼痛评级指数(PRI)评分明显降低,且观察组显著低于对照组(P<0.01),肩关节活动范围明显高于对照组(P<0.01);与本组治疗前比较,治疗4周后两组患者的红细胞沉降率(ESR),纤维蛋白原(Fb),全血黏度以及血清PGE2,SP,5-HT水平显著降低(P<0.01),且观察组显著优于对照组(P<0.01);观察组临床总有效率为96.61%(57/59),明显高于对照组的82.76%(48/58)(χ^2=4.685,P<0.05)。结论:麻桂温经汤加味联合关节松动术治疗肩周炎血虚寒凝证,能有效改善患者的疼痛、肩关节活动度,提高疗效,改善患者的血流动力学和下调疼痛介质PGE2,SP,5-HT水平可能与其疗效有关。
Objective:To explore the clinical efficacy of Magui Wenjingtang combined with joint mobilization in the treatment of periarthritis of the shoulder and the effect on hemodynamics and serum pain media.Method:A total of 120 patients with scapulohumeral periarthritis were enrolled in Tianjin Ninghe Hospital from July 2016 to July 2018.All cases were divided into control group and observation group,with 60 patients in each group.The control group received shoulder joint loosening operation(qd),and celecoxib capsules for oral administration.The observation group was treated with Magui Wenjingtang in addition to the shoulder joint loosening operation,1 dose/d,2 times/d.After 4 weeks of continuous treatment,the subjects were compared for the subjective pain level McGill Pain Questionnaire(SF-MPQ)score,shoulder mobility hemodynamic changes,and serum prostaglandin E2(PGE2),substance P(SP),serotonin(5-HT)level and clinical efficacy.Result:Compared with before treatment,visual pain score(VAS),current pain status(PPI),and pain rating index(PRI)scores of the two groups were significantly lower after 4 weeks of treatment,and those of the observation group was significantly lower than the control group(P<0.01).The range of shoulder joint activity was significantly higher than that of the control group(P<0.01),erythrocyte sedimentation rate(ESR),fibrinogen(Fb),whole blood viscosity and serum were compared between the two groups after 4 weeks of treatment and before treatment.The levels of PGE2,SP and 5-HT were significantly lower(P<0.01),and the observation group was significantly better than the control group(P<0.01).The total effective rate of the observation group was96.61%(57/59),which was significantly higher than 82.76%(48/58)of the control group(χ^2=4.685,P<0.05).Conclusion:Magui Wenjingtang combined with shoulder joint loosening operation in treating periarthritis of shoulder with syndrome of blood deficiency and cold coagulation can effectively improve the pain and shoulder joint mobility,increase the curative effect,and improve the hemodynamics,and down-regulatie pain mediator of PGE2,SP,5-HT,which may be related to the curative effect.
作者
贺延雷
雷芳
李强
田金辉
王旺
HE Yan-lei;LEI Fang;LI Qiang;TIAN Jin-hui;WANG Wang(Tianjin Ninghe Hospital,Tianjin 301500,China;People's Hospital of Hebei Medical University,Shijiazhuang 050011,China;Handan Central Hospital,Handan 056001,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2020年第10期63-68,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
河北省医学科学研究课题项目(20191830)。
关键词
麻桂温经汤
肩周炎
关节松动术
血虚寒凝证
Magui Wenjingtang
periarthritis of shoulder
joint loosening operation
syndrome of blood deficiency and cold coagulation
