局部腧穴沖擊波治療粘連期瘀滯型肩關(guān)節(jié)周圍炎的臨床療效觀察

局部腧穴沖擊波治療粘連期瘀滯型肩關(guān)節(jié)周圍炎的臨床療效觀察摘要：目的：探討局部腧穴沖擊波治療粘連期瘀滯型肩關(guān)節(jié)周圍炎的臨床療效。方法：選取2018年10月至2019年10月在我院行局部腧穴沖擊波治療的80例粘連期瘀滯型肩關(guān)節(jié)周圍炎患者作為研究對(duì)象，隨機(jī)分為治療組和對(duì)照組，每組各40例。對(duì)照組采用傳統(tǒng)針刺、灸療方式治療，治療組在此基礎(chǔ)上加用局部腧穴沖擊波治療。比較兩組患者治療前后的VAS評(píng)分、肩活動(dòng)度及總有效率。結(jié)果：治療組比對(duì)照組VAS評(píng)分減少幅度更大，肩活動(dòng)度提高幅度更大，總有效率也更高（P<0.05）。結(jié)論：局部腧穴沖擊波治療粘連期瘀滯型肩關(guān)節(jié)周圍炎具有可行性和優(yōu)勢(shì)，可以提高患者治療效果和生活質(zhì)量。

關(guān)鍵詞：局部腧穴沖擊波；肩關(guān)節(jié)周圍炎；粘連期；瘀滯型；治療效果

Introduction：

肩關(guān)節(jié)周圍炎是一種以肩關(guān)節(jié)周圍炎癥反應(yīng)為主的綜合征，臨床表現(xiàn)為肩疼痛、僵硬和肌力下降。其中粘連期瘀滯型是其中一種較嚴(yán)重的類型，傳統(tǒng)治療方法效果欠佳。局部腧穴沖擊波是一種全新的治療方法，可以通過(guò)擾動(dòng)治療部位，促進(jìn)組織修復(fù)和再生。本研究旨在探討局部腧穴沖擊波治療粘連期瘀滯型肩關(guān)節(jié)周圍炎的臨床療效。

Materialsandmethods：

選取2018年10月至2019年10月在我院行局部腧穴沖擊波治療的80例粘連期瘀滯型肩關(guān)節(jié)周圍炎患者作為研究對(duì)象，隨機(jī)分為治療組和對(duì)照組，每組各40例。對(duì)照組采用傳統(tǒng)針刺、灸療方式治療，治療組在此基礎(chǔ)上加用局部腧穴沖擊波治療。比較兩組患者治療前后的VAS評(píng)分、肩活動(dòng)度及總有效率。

Results：

治療組比對(duì)照組VAS評(píng)分減少幅度更大，肩活動(dòng)度提高幅度更大，總有效率也更高（P<0.05）。

Conclusion：

局部腧穴沖擊波治療粘連期瘀滯型肩關(guān)節(jié)周圍炎具有可行性和優(yōu)勢(shì)，可以提高患者治療效果和生活質(zhì)量。本研究為臨床應(yīng)用提供了新的治療思路和方法。

Keywords：

局部腧穴沖擊波；肩關(guān)節(jié)周圍炎；粘連期；瘀滯型；治療效果Introduction：

Shoulderadhesivecapsulitisisasyndromecharacterizedbyinflammatoryreactionsaroundtheshoulderjoint,withclinicalsymptomsofshoulderpain,stiffness,andmuscleweakness.Amongthem,theadhesivestagnationtypeintheadhesionperiodisamoreseveretype,andtraditionaltreatmentmethodshavepoorefficacy.Localacupointshockwavetherapyisanewtreatmentmethodthatcanpromotetissuerepairandregenerationbydisturbingthetreatmentsite.Thisstudyaimstoexploretheclinicalefficacyoflocalacupointshockwavetherapyinthetreatmentofadhesivestagnationtypeshouldercapsulitis.

MaterialsandMethods：

EightypatientswithadhesivestagnationtypeshouldercapsulitiswhounderwentlocalacupointshockwavetherapyinourhospitalfromOctober2018toOctober2019wereselectedasthestudyobjects,andrandomlydividedintotreatmentgroupandcontrolgroup,with40casesineachgroup.Thecontrolgroupwastreatedwithtraditionalneedlepunctureandmoxibustiontherapy,andthetreatmentgroupaddedlocalacupointshockwavetherapyonthisbasis.TheVASscore,shouldermobilityandtotaleffectiverateofthetwogroupsofpatientsbeforeandaftertreatmentwerecompared.

Results：

ThetreatmentgrouphadagreaterreductioninVASscore,agreaterincreaseinshouldermobility,andahighertotaleffectiveratethanthecontrolgroup(P<0.05).

Conclusion：

Localacupointshockwavetherapyforadhesivestagnationtypeshouldercapsulitisisfeasibleandhasadvantages,whichcanimprovethetreatmenteffectandqualityoflifeofpatients.Thisstudyprovidesnewtreatmentideasandmethodsforclinicalapplication.

Keywords：

Localacupointshockwavetherapy;shouldercapsulitis;adhesivestagnation;efficacyDiscussion：

Shouldercapsulitisisacommondisorderoftheshoulderjoint,andadhesivestagnationisoneofitscommontypes.Manymethodshavebeenusedtotreatadhesivestagnationtypeshouldercapsulitis,includingphysiotherapy,manualtherapy,andmedications.However,thetreatmenteffectisnotsatisfactory,andtherecurrencerateishigh.Therefore,itisnecessarytoexplorenewtreatmentideasandmethods.

Inrecentyears,localacupointshockwavetherapyhasbeenwidelyusedinthetreatmentofmusculoskeletaldisorders,suchasplantarfasciitis,tenniselbow,andtendinitis.Shockwavetherapycanpromotetissuerepair,reduceinflammation,relievepain,andimprovejointfunction.Moreover,shockwavetherapyisnon-invasive,safe,andhasfewadverseeffects.Therefore,itisapromisingtreatmentforadhesivestagnationtypeshouldercapsulitis.

Inthisstudy,wefoundthatlocalacupointshockwavetherapycansignificantlyimprovetheclinicalsymptomsandjointfunctionofpatientswithadhesivestagnationtypeshouldercapsulitis.TheASscoreandshouldermobilityofthetreatmentgroupweresignificantlyhigherthanthoseofthecontrolgroup.Moreover,thetotaleffectiverateofthetreatmentgroupwashigherthanthatofthecontrolgroup.Theseresultsindicatethatlocalacupointshockwavetherapyiseffectiveinthetreatmentofadhesivestagnationtypeshouldercapsulitis.

Themechanismoflocalacupointshockwavetherapyinthetreatmentofshouldercapsulitismayberelatedtothefollowingaspects.First,shockwavetherapycanpromotetissuerepairandregenerationbystimulatingstemcellsandgrowthfactors.Second,shockwavetherapycanpromotemicrocirculationandreduceinflammationbyincreasingtheproductionofnitricoxideandreducingthereleaseofpro-inflammatorycytokines.Third,shockwavetherapycanrelievepainbyreducingnervesensitizationandincreasingthethresholdofpainreceptors.Fourth,shockwavetherapycanimprovejointfunctionbyincreasingthemobilityandelasticityofsofttissuesandstimulatingtheformationofnewcollagenfibers.

Inconclusion,localacupointshockwavetherapyisafeasibleandeffectivetreatmentforadhesivestagnationtypeshouldercapsulitis.Ithasadvantagesinimprovingclinicalsymptoms,jointfunction,andqualityoflifeofpatients.However,thisstudyhassomelimitations,suchasarelativelysmallsamplesizeandashortfollow-upperiod.Therefore,morestudieswithlargersamplesizesandlongerfollow-upperiodsareneededtoconfirmthelong-termefficacyandsafetyoflocalacupointshockwavetherapyInadditiontothelimitationsmentionedabove,thereareseveralotheraspectsthatneedtobefurtherexploredinthefutureresearchoflocalacupointshockwavetherapyforadhesivestagnationtypeshouldercapsulitis.

Firstly,theoptimaltreatmentregimenoflocalacupointshockwavetherapyneedstobefurtherstudied.Inthisstudy,patientsreceivedthreesessionsofshockwavetherapyeveryweekforfourweeks.Thistreatmentregimenwaseffectiveinimprovingtheclinicalsymptomsandjointfunctionofpatients.However,theoptimalnumberofsessions,theintervalbetweensessions,andtheintensityofshockwavetherapyneedtobefurtherexplored.Inaddition,thecombinationofothertreatments,suchasphysicaltherapyandmedications,withlocalacupointshockwavetherapyneedstobestudiedaswell.

Secondly,themechanismunderlyingthetherapeuticeffectoflocalacupointshockwavetherapyforadhesivestagnationtypeshouldercapsulitisneedstobefurtherelucidated.Itisbelievedthatshockwavetherapycanpromoteangiogenesisandneovascularization,inducethereleaseofgrowthfactorsandcytokines,andactivatetissuerepairprocesses.However,thespecificmechanismsunderlyingthetherapeuticeffectoflocalacupointshockwavetherapyonshouldercapsulitisremainunclear.Futurestudiesusinganimalmodelsandcellculturesystemsmayhelptouncovertheunderlyingmechanism.

Thirdly,thesafetyoflocalacupointshockwavetherapyneedstobefurtherevaluated.Inthisstudy,noseriousadverseeventswerereportedduringorafterthetreatment.However,thelong-termsafetyoflocalacupointshockwavetherapyneedstobeevaluatedinlargerandlonger-termstudies.Inaddition,theeffectofshockwavetherapyonnearbytissues,suchasnervesandbloodvessels,needstobefurtherexploredtoensurethesafetyofthistreatment.

Insummary,localacupointshockwavetherapyisapromisingtreatmentforadhesivestagnationtypeshouldercapsulitis.Futurestudiesshould