摘要
目的 探讨常氏三绝联合肩关节腔清洗治疗粘连期肩周炎的疗效及红外热成像病变区温度变化情况。方法 选取郑州市中医院2023年2月-2024年2月期间收治的粘连期肩周炎患者120例,以随机数字表法分为对照组和试验组,各60例。对照组给予40 mL 0.9%生理盐水中加0.5 mL曲安奈德注射液和3 mL 2%盐酸利多卡因注射液所得混合液进行肩关节腔清洗治疗,试验组在对照组的基础上给予常氏三绝疗法,2组均持续治疗1个疗程。比较2组治疗1个疗程后的疗效,治疗前和1个疗程后的疼痛程度[视觉模拟评分法(VAS)]、肩关节功能[Constant-Murley评分(CMS)]、肩关节活动度、炎症相关指标水平[单核细胞趋化蛋白-1(MCP-1)、转化生长因子-β(TGF-β)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)],治疗前和治疗1周、1个疗程后的红外热成像病变区温度和治疗期间的不良反应。结果 治疗1个疗程后,总有效率试验组为91.67%,高于对照组的76.67%(P<0.05)。较治疗前,2组治疗1个疗程后的VAS评分及血清MCP-1、TNF-α、IL-6水平降低,且试验组较对照组更低(P<0.05);2组CMS评分,肩关节内旋、外旋、外展、内收、后伸活动度及血清TGF-β水平升高,且试验组较对照组更高(P<0.05)。较治疗前,2组治疗1周、1个疗程后的红外热成像病变区温度降低,较治疗1周后,2组治疗1个疗程后的红外热成像病变区温度降低,且试验组1个疗程后的红外热成像病变区温度较对照组更低(P<0.05)。治疗期间,试验组和对照组均未出现明显过敏、胃肠道反应等情况。结论 粘连期肩周炎患者应用常氏三绝联合肩关节腔清洗治疗可减轻机体炎症反应和疼痛程度,并可降低红外热成像病变区温度,进而有利于改善肩关节功能和肩关节活动度,提高疗效,且安全性良好。
Objective To investigate the efficacy of Chang's triple therapy combined with shoulder cavity cleaning in the treatment of frozen shoulder in adhesion stage and the temperature changes in the lesion area on infrared thermography.Methods A total of 120 patients with adhesive frozen shoulder admitted to the Zhengzhou Hospital of Traditional Chinese Medicine from February 2023 to February 2024 were selected and divided into a control group and a pilot group using the randomized numerical table method,with 60 patients in each group.The control group was given 40 mL of 0.9%normal saline,0.5 mL of triamcinolone acetonide injection and 3 mL of 2%lidocaine hydrochloride injection to clean the shoulder joint cavity,while the pilot group was given the Chang's triple therapy on the basis of the control group,and both groups were continuously treated for one course.The efficacy after one course of treatment,and the pain degree[Visual Analog Scale(VAS)],shoulder function[Constant-Murley Score(CMS)],shoulder mobility,inflammation-related indexes[monocyte chemotactic protein-1(MCP-1),transforming growth factor-β(TGF-β),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]before and after one course of treatment,infrared thermography lesion area temperature before and after one week and one course of treatment,and adverse reactions during treatment were compared between the two groups.Results After one course of treatment,the total effective rate was 91.67%in the pilot group,higher than 76.67%in the control group(P<0.05).Compared with before treatment,the scores of VAS and levels of serum MCP-1,TNF-α,IL-6 were lower in the two groups after one course of treatment,and lower in the pilot group than in the control group(P<0.05),while the scores of CMS,shoulder internal,external rotation,abduction,adduction,posterior extension mobility,and level of serum TGF-βwere higher in the two groups,and higher in the pilot group than in the control group(P<0.05).Compared with before treatment,the temperature of the infrared thermography lesion area in the two groups was decreased after one week and one course of treatment,while compared with after one week of treatment,the temperature of the infrared thermography lesion area in the two groups was decreased after one course of treatment,and the temperature in the pilot group after one course of treatment was was lower than that in the control group(P<0.05).During the treatment period,no obvious allergies or gastrointestinal reactions were observed in both the pilot and control groups.Conclusion The application of Chang's triple therapy combined with the shoulder cavity cleaning treatment in patients with adhesive frozen shoulder can reduce the body's inflammatory response and pain degree,and can lower the temperature of the lesion area on infrared thermography,which in turn is conducive to the improvement of shoulder joint function and shoulder joint mobility,and improves the therapeutic efficacy,and has good safety.
作者
杨元平
康献勇
翟俊玲
王筱锋
YANG Yuanping;KANG Xianyong;ZHAI Junling;WANG Xiaofeng(Zhengzhou Hospital of Traditional Chinese Medicine,Zhengzhou 450000,China)
出处
《吉林中医药》
2025年第8期946-950,共5页
Jilin Journal of Chinese Medicine
基金
2023年度河南省中医药科学研究专项课题(2023ZY2152)。
关键词
肩周炎
粘连期
常氏三绝
肩关节腔清洗
疗效
红外热成像
frozen shoulder
adhesion stage
Chang's triple therapy
shoulder cavity cleaning
efficacy
infrared thermography
