标题：腕踝针联合穴位按摩治疗肩周炎临床观察

      作者：郑喜，王素芳，李仁心秀    宝鸡市中医医院针灸科风湿病专科，陕西 宝鸡 721000

      卷次： 2020年31卷11期

      【摘要】 目的 观察腕踝针联合穴位按摩治疗肩周炎的临床疗效。方法 选取2017年6月至2018年12月于宝鸡市中医医院针灸风湿病专科治疗的96例肩周炎患者作为研究对象，按照随机数表法将其分为观察组和对照组，每组48例。对照组患者使用穴位按摩治疗，观察组患者使用腕踝针结合穴位按摩治疗，两组患者均治疗两周。比较两组患者的临床疗效，以及治疗前、治疗2周后的肩关节功能[Constant-Murlev肩关节功能评分量表(CMS)]、血清相关因子[血清转化生长因子-β1 (TGF-β1)、前列腺素E2 (PGE2)、缓激肽(BK)]水平及生活质量[世界卫生组织生活质量测定量表简表(WHOQOL-BREF)]评分的差异。结果 观察组患者的临床治疗总有效率为95.83%，明显高于对照组的81.25%，差异有统计学意义(P<0.05)；治疗2周后，观察组患者CMS中的疼痛、日常活动、肩关节活动度、客观评定的力量测试及总评分分别为(8.76±3.32)分、(14.62±4.32)分、(26.86±7.51)分、(15.02±2.65)分、(65.05±8.36)分，明显高于对照组的(7.11±3.35)分、(11.25±4.24)分、(23.16±6.55)分、(13.42±4.53)分、(58.97±8.62)分，差异均有统计学意义(P<0.05)；治疗两周后，观察组患者WHOQOL-BREF评分中的生理领域、心理领域、社会关系领域、环境领域、自身生活质量及自身健康状况评分分别为(16.26±2.71)分、(16.73±2.11)分、(17.26±2.27)分、(17.63±2.49)分、(3.62±0.68)分、(3.41±0.76)分，明显高于对照组的(13.88±2.06)分、(13.98±2.17)分、(14.13±2.66)分、(14.09±2.34)分、(3.19±0.83)分、(3.12±0.57)分，差异均有统计学意义(P<0.05)；治疗 2周后，观察组患者的TGF-β1、PGE2及BK水平分别为(52.13±5.42) ng/mL、(71.25±9.21) ng/mL、(8.19±1.03) ng/mL，明显低于对照组的(64.21±5.13) ng/mL、(89.93±5.39) ng/mL、(12.33±0.56) ng/mL，差异均有统计学意义(P<0.05)。结论 腕踝针联合穴位按摩治疗肩周炎能有效改善患者肩关节活动度，降低炎性反应，提高生活质量，临床治疗疗效显著。
      【关键词】 腕踝针；穴位按摩；肩周炎；疗效；肩关节功能
      【中图分类号】 R684.3 【文献标识码】 A 【文章编号】 1003—6350（2020）11—1425—04

Clinical efficacy of wrist-ankle acupuncture combined with acupoint massage in the treatment of periarthritis ofshoulder.
ZHENG Xi, WANG Su-fang, LIREN Xin-xiu. Department of Rheumatology Specialist, Acupuncture andMoxibustion, Baoji Hospital of Traditional Chinese Medicine, Baoji 721000, Shaanxi, CHINA
【Abstract】 Objective To observe the clinical efficacy of wrist-ankle acupuncture combined with acupoint mas-sage in the treatment of periarthritis of shoulder. Methods Ninety-six patients with periarthritis of shoulder treated inDepartment of Rheumatology Specialist, Acupuncture and Moxibustion, Baoji Hospital of Traditional Chinese Medicinefrom June 2017 to December 2018 were selected as study subjects. According to the random number table method, theywere divided into observation group and control group, with 48 patients in each group. The patients in control groupwere treated with acupoint massage, while the patients in observation group were given wrist-ankle acupuncture com-bined with acupoint massage, both for 2 weeks. The clinical efficacy, and shoulder joint function (Constant-Murlevshoulder joint function score scale [CMS]), serum-related factors (serum transforming growth factor-β1 [TGF-β1]), pros-taglandin E2 [PGE2], bradykinin [BK]) and quality of life score (World Health Organization Quality of Life MeasurementScale [WHOQOL-BREF]) before treatment and after 2 weeks of treatment were compared between the two groups.Results The total effective rate of clinical treatment in the observation group was significantly higher than that in con-trol group (95.83% vs 81.25%, P<0.05). After 2 weeks of treatment, the scores of pain, daily activities, shoulder joint mo-bility, objectively assessed strength test, and total score of CMS were (8.76±3.32) points, (14.62±4.32) points, (26.86±7.51) points, (15.02±2.65) points, and (65.05±8.36) points in observation group, which were significantly higher than(7.11±3.35) points, (11.25±4.24) points, (23.16±6.55) points, (13.42±4.53) points, and (58.97±8.62) points in the controlgroup (P<0.05). After 2 weeks of treatment, the scores of physiological field, psychological field, social relationshipfield, environmental field, own quality of life and own health status of WHOQOL-BREF scale were (16.26±2.71) points,(16.73±2.11) points, (17.26±2.27) points, (17.63±2.49) points, (3.62±0.68) points, and (3.41±0.76) points in observationgroup, which were significantly higher than (13.88±2.06) points, (13.98±2.17) points, (14.13±2.66) points, (14.09±2.34) points, (3.19±0.83) points, and (3.12±0.57) points in the control group (P<0.05). After 2 weeks of treatment, thelevels of TGF-β1, PGE2, and BK were (52.13±5.42) ng/mL, (71.25±9.21) ng/mL, and (8.19±1.03) ng/mL in the observa-tion group, which were significantly lower than (64.21±5.13) ng/mL, (89.93±5.39