关节腔注射、运动疗法联合中药熏洗治疗粘连期肩周炎的临床观察

目的 探讨关节腔注射、运动疗法联合中药熏洗治疗粘连期肩周炎的临床疗效。方法 将90例粘连期肩周炎患者随机分为对照组和治疗组，每组45例。对照组采取关节腔注射联合运动疗法治疗，治疗组在此基础上加用中药熏洗治疗，疗程为2周。治疗前后采用视觉模拟量表（visual analogue scale，VAS）评价肩关节疼痛程度，采用肩关节功能Melle评分量表及肩关节活动度评价肩关节活动度和功能，并观察两组临床疗效。结果 治疗后两组患者VAS评分、Melle评分均较治疗前降低（P＜0.05）；两组Melle评分差值比较，差异有统计学意义（P＜0.05）。治疗后两组患者的肩关节外展、内旋、外旋活动度均较治疗前增加（P＜0.05）；治疗组患者肩关节外展、内旋、外旋活动度升高值均显著高于对照组（P＜0.05）。两组临床疗效分布比较，差异有统计学意义（P＜0.05）。结论 两种治疗方案均能减轻肩关节疼痛，改善肩关节功能，关节腔注射、运动疗法联合中药熏洗对粘连期肩周炎的疗效优于关节腔注射联合运动疗法，能更好地改善肩关节功能和活动度。

Clinical Effect of Intra-articular Injection and Exercise Therapy Combined with Traditional Chinese Medicine Fumigation and Washing in Treatment of Adhesion-Stage Shoulder Periarthritis

Objective To investigate the clinical effect of intra-articular injection and exercise therapy combined with traditional Chinese medicine (TCM) fumigation and washing in the treatment of adhesion-stage shoulder periarthritis. Methods A total of 90 patients with adhesion-stage shoulder periarthritis were randomly divided into control group and treatment group, with 45 patients in each group. The patients in the control group were treated with intra-articular injection and exercise therapy, and those in the treatment group were treated with TCM fumigation and washing in addition to the treatment in the control group; the course of treatment was 2 weeks for both groups. Before and after treatment, Visual Analog Scale (VAS) was used to evaluate the degree of shoulder pain, the Melle score for shoulder function and range of motion (ROM) of shoulder joint were used to evaluate the ROM and function of shoulder joint, and clinical outcome was compared between the two groups. Results After treatment, both groups had significant reductions in VAS score and Melle score (P<0.05), and there was no significant difference in the change in Melle score between the two groups (P<0.05). After treatment, both groups had significant increases in the ROMs of shoulder joint abduction, intorsion, and extorsion (P<0.05), and the treatment group had significantly greater increases than the control group (P<0.05). There was no significant difference in the distribution of clinical outcomes between the two groups (P<0.05). Conclusion Both treatment regimens can reduce shoulder pain and improve shoulder function. Intra-articular injection and exercise therapy combined with TCM fumigation and washing have a better clinical effect than intra-articular injection and exercise therapy in the treatment of adhesion-stage shoulder periarthritis and can better improve the function and range of motion of shoulder joint.