甘草附子汤超声穴位定向透入联合超声引导下肩关节腔注射消炎镇痛液治疗冻结肩的临床观察
高巍巍,曾杰,杨浩,王敏,胡小纲,邹德生
摘要(Abstract):
目的 观察甘草附子汤超声穴位定向透入联合超声引导下肩关节腔注射消炎镇痛液治疗冻结肩的临床疗效。方法 患者90例随机分为3组各30例,A组予甘草附子汤超声定向透入+超声引导下肩关节腔注射消炎镇痛液,B组予超声引导下肩关节腔注射消炎镇痛液,C组予甘草附子汤超声穴位定向透入。比较各组治疗前、治疗后不同时间点(治疗后1 d、1周、1个月)的视觉模拟量表(VAS)疼痛评分、肩关节功能CMS评分、超声评估腋下关节囊的厚度。结果 A组治疗后1周、1个月的VAS疼痛评分低于B组、C组(P <0.05);A组治疗后1个月的肩关节功能CMS评分均高于B组及C组(P <0.05);A组治疗后1个月的超声评估腋下关节囊的厚度均低于B组及C组(P <0.05)。结论 甘草附子汤超声穴位定向透入联合超声引导下肩关节腔注射消炎镇痛液,能更大程度发挥二者优势,可减少用药剂量,充分聚合中药温经散寒、祛风除湿及消炎镇痛液液压扩容、松解关节囊粘连和挛缩、改善肩关节的疼痛及功能障碍的作用。
关键词(KeyWords): 冻结肩;甘草附子汤;超声穴位定向透入;超声引导;肩关节腔注射
基金项目(Foundation): 成都中医药大学2019年度“杏林学者”医院专项
作者(Author): 高巍巍,曾杰,杨浩,王敏,胡小纲,邹德生
参考文献(References):
- [1] DE LA SERNA D,NAVARRO-LEDESMA S,ALAY?N F,et al. A comprehensive view of frozen shoulder:A mystery syndrome[J]. Front Med(Lausanne),2021,8:663703.
- [2]陈啸,黄竞敏,杨彤旭.冻结肩的中西医治疗研究进展[J].中国中西医结合外科杂志,2021,27(4):662-666.
- [3]郭璇妍,卢漫,贺凡丁,等.超声引导下关节腔注射联合关节囊扩张治疗冻结肩[J].中国医学影像技术,2018,34(7):1081-1084.
- [4]侯骁丹,陈智.运动针刀结合拉伸疗法治疗肩周炎冻结期临床研究[J].实用中医药杂志,2022,38(2):3.
- [5] ZAPPIA M,PIETTO FD,ALIPRANDI A,et al. Multi-modal imaging of adhesive capsulitis of the shoulder[J]. Insights into Imaging,2016,7(3):365-371.
- [6] WALTHER M,BLANKE F,WEHREN LV,et al. Frozen shoulder-comparison of different surgical treatment options[J]. Acta orthopaedica Belgica,2014,80(2):172-177.
- [7]唐梅,赵立春,徐敏,等.附子化学成分和药理作用研究进展[J].广西植物,2017,37(12):1614-1627.
- [8]李丽玲.中药超声透入疗法的研究进展[J].湖北中医杂志,2010,32(8):78-80.
- [9]项丽玲,苗明三.“有毒”中药外用安全性思考[J].中国中药杂志,2019,8(4):1710-1713.
- [10] YANG S,PARK DH,AHN SH,et al. Prevalence and risk factors of adhesive capsulitis of the shoulder after breast cancer treatment[J]. Supportive Care in Cancer,2017,25(4):1317-1322.
- [11] WANG W,SHI M,ZHOU C,et al. Effectiveness of corticosteroid injections in adhesive capsulitis of shoulder[J]. Medicine,2017,96(28):e7529.
- [12] RUTTEN MJ,COLLINS JM,MARESCH BJ,et al. Glenohumeral joint injection:a comparative study of ultrasound and fluoroscopically guided techniques before MR arthrography[J]. Eur Radiol,2009,19(3):722-730.
- [13] PRESTGAARD T,WORMGOOR ME,HAUGEN S,et al. Ultrasound-guided intra-articular and rotator interval corticosteroid injections in adhesive capsulitis of the shoulder:a double-blind,sham-controlled randomized study[J]. Pain,2015,156(9):1683-1691.
- [14] KURATANI K,TANAKA M,HANAI H,et al. Accuracy of shoulder joint injections with ultrasound guidance:Confirmed by magnetic resonance arthrography[J]. World J Orthop,2022,13(3):259-266.
- [15]蔡悦,梁红玉,王建立,等.甘草附子汤对佐剂性关节炎小鼠的治疗作用[J].中国实验方剂学杂志,2018,24(14):5.