红花化瘀汤辅助肩关节镜手术对肩袖损伤患者肩关节功能及疼痛的影响
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摘要
目的:探究红花化瘀汤辅助肩关节镜手术对肩袖损伤患者肩关节功能及疼痛的影响。方法:选取2016年1月至2018年1月河北省沧州市中西医结合医院收治的肩袖损伤患者67例作为研究对象,按照随机数字表法分为对照组(n=33)和观察组(n=34),2组均进行肩关节镜下肩袖重建术。术后对照组给予常规西医治疗;观察组在对照组的基础上于术后2周内采用红花化瘀汤熏洗患处,熏洗4周。术后6周评价2组临床疗效,比较2组手术前后关节功能及疼痛情况。结果:术后6周观察组临床总有效率88. 24%,高于对照组的63. 64%(P <0. 05);与术前比较,术后4～6周2组患者疼痛、肩关节功能、主动向前屈曲活动、前屈力量、主观满意度评分均升高(均P <0. 05),且观察组显著高于对照组(P <0. 05);与术前比较,术后6周2组患者前屈、后伸、内旋、外旋各角度均显著增加(均P <0. 05),且观察组显著大于对照组(P <0. 05);与术前比较,术后2～6周2组患者肩关节VAS评分呈逐渐降低趋势(P <0. 05),且术后4、6周观察组肩关节VAS评分均显著低于对照组(均P <0. 05)。结论:红花化瘀汤辅助肩关节镜手术可显著改善肩袖损伤患者关节功能,缓解关节疼痛,疗效明显优于术后冰敷消肿治疗,值得临床推广应用。
Objective: To explore the effects of Honghua Huayu Decoction assisted shoulder arthroscopic surgery on shoulder joint function and pain in patients with rotator cuff injuries. Methods: A total of 67 patients with rotator cuff injuries admitted to,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2016 to January 2018 were selected,and divided into the control group( n = 33) and treatment group( n = 34) according to random number table method. Both 2 groups underwent shoulder arthroscopic rotator cuff reconstruction surgery,and control group received conventional western medicine after surgery. The affected part of patients in treatment group was fumigated with Honghua Huayu Decoction at 2 weeks after surgery on the basis of control group,which was fumigated with 4 weeks. The clinical efficacy in 2 groups after 6 weeks surgery was counted. The situation of joint function and pain in 2 groups before and after surgery were evaluated and compared. Results: The clinical total effective rate in treatment group 6 weeks after surgery was 88. 24%,which was higher than that 63. 64% in control group( P <0. 05). Compared with pre-surgery,the pain,shoulder joint function,active forward flexion,anteflexion power and subjective satisfaction scores from 4 weeks to 6 weeks after surgery increased( P < 0. 05). Treatment group was significantly higher than control group( P < 0. 05). Compared with pre-surgery,the angle of anteflexion,rear protraction,internal rotation and extorsion increased significantly 6 weeks after surgery in 2 groups( P < 0. 05),and treatment group was significantly higher than control group( P <0. 05). The joint of VAS scores 2 weeks to 6 weeks after surgery decreased in 2 groups( P < 0. 05),and treatment group was significantly lower than control group 4 weeks,6 weeks after surgery compared with pre-surgery( P < 0. 05). Conclusion: Honghua Huayu Decoction assisted shoulder arthroscopic surgery can significantly improve the joint function of patients with rotator cuff injuries,alleviate joint pain. The efficacy is significantly better than that of conventional western medicine,which is worthy of clinical application.
Objective: To explore the effects of Honghua Huayu Decoction assisted shoulder arthroscopic surgery on shoulder joint function and pain in patients with rotator cuff injuries. Methods: A total of 67 patients with rotator cuff injuries admitted to,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2016 to January 2018 were selected,and divided into the control group( n = 33) and treatment group( n = 34) according to random number table method. Both 2 groups underwent shoulder arthroscopic rotator cuff reconstruction surgery,and control group received conventional western medicine after surgery. The affected part of patients in treatment group was fumigated with Honghua Huayu Decoction at 2 weeks after surgery on the basis of control group,which was fumigated with 4 weeks. The clinical efficacy in 2 groups after 6 weeks surgery was counted. The situation of joint function and pain in 2 groups before and after surgery were evaluated and compared. Results: The clinical total effective rate in treatment group 6 weeks after surgery was 88. 24%,which was higher than that 63. 64% in control group( P <0. 05). Compared with pre-surgery,the pain,shoulder joint function,active forward flexion,anteflexion power and subjective satisfaction scores from 4 weeks to 6 weeks after surgery increased( P < 0. 05). Treatment group was significantly higher than control group( P < 0. 05). Compared with pre-surgery,the angle of anteflexion,rear protraction,internal rotation and extorsion increased significantly 6 weeks after surgery in 2 groups( P < 0. 05),and treatment group was significantly higher than control group( P <0. 05). The joint of VAS scores 2 weeks to 6 weeks after surgery decreased in 2 groups( P < 0. 05),and treatment group was significantly lower than control group 4 weeks,6 weeks after surgery compared with pre-surgery( P < 0. 05). Conclusion: Honghua Huayu Decoction assisted shoulder arthroscopic surgery can significantly improve the joint function of patients with rotator cuff injuries,alleviate joint pain. The efficacy is significantly better than that of conventional western medicine,which is worthy of clinical application.
引文
[1]聂博渊,杨朝晖.肩袖损伤的治疗进展[J].医学综述,2014,20(13):2384-2386.
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[3]庄泽,卢华定,陈郁鲜,等.肩袖损伤后单排与双排缝合方法比较的Meta分析[J].中国组织工程研究,2014,18(29):4742-4751.
[4]邱志新,窦荣花,郝有志,等.红花化瘀汤结合针刺治疗中风后肩手综合征的临床研究[J].世界中医药,2016,11(9):1769-1772.
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[8]Mihata T,Mcgarry M H,Ishihara Y,et al.Biomechanical Analysis of Articular-Sided Partial-Thickness Rotator Cuff Tear and Repair[J].American Journal of Sports Medicine,2015,43(2):439-446.
[9]Faulkner N D,Getelman M H,Burns J P,et al.Regarding“Meta-analysis comparing single-row and double-row repair techniques in the arthroscopic treatment of rotator cuff tears”[J].Journal of Shoulder and Elbow Surgery,2014,23(9):e223-e225.
[10]邱志新,窦荣花,郝有志,等.中风后肩手综合征患者应用红花化瘀汤结合针刺治疗的效果分析[J].陕西中医,2016,37(10):1323-1324.
[11]叶锐,张光彩,吴林,等.中医综合疗法治疗慢性肩关节周围炎临床研究[J].中医学报,2017,32(10):1985-1988.
[12]杨明煜,朱红坤,胡边,等.温针灸结合手法治疗对肩袖损伤患者血清C反应蛋白及肿瘤坏死因子的影响[J].湖北中医药大学学报,2017,19(4):97-100.
[13]张玉明,张秀芳,张明,等.肩部强化训练结合中药熏蒸在改善脑卒中患者肩痛的疗效观察[J].中国康复,2017,32(2):123-125.
[14]黄成龙,潘界恩,蔡震海,等.关节镜下缝线桥技术治疗老年创伤性肩关节脱位合并肩袖损伤的疗效评价[J].中国内镜杂志,2016,22(6):35-39.
[15]高东梅,郝龙,田雪.肩三针注射术配合中药熏蒸、推拿等治疗肩周炎136例[J].陕西中医,2017,38(7):965-966.
[16]闵重函,周瑛,荆琳,等.手法加中药熏蒸对前交叉韧带断裂重建术后膝关节功能康复的病例对照研究[J].中国骨伤,2016,29(5):397-403.
[17]亓建.中药熏蒸治疗膝关节镜术后肿痛的临床研究[D].北京:北京中医药大学,2014:27.
[18]高萍,任万雷.中药熏蒸疗法在关节疼痛性疾病中的应用概况[J].国际中医中药杂志,2017,39(11):1054-1056.
[19]任咏梅,张琲珏.中药熏蒸疗法配合气压弹道式冲击波治疗肩周炎30例[J].陕西中医,2017,38(4):482-483.
[2]Killian M L,Cavinatto L M,Ward S R,et al.Chronic Degeneration Leads to Poor Healing of Repaired Massive Rotator Cuff Tears in Rats[J].American Journal of Sports Medicine,2015,43(10):2401-2410.
[3]庄泽,卢华定,陈郁鲜,等.肩袖损伤后单排与双排缝合方法比较的Meta分析[J].中国组织工程研究,2014,18(29):4742-4751.
[4]邱志新,窦荣花,郝有志,等.红花化瘀汤结合针刺治疗中风后肩手综合征的临床研究[J].世界中医药,2016,11(9):1769-1772.
[5]韦贵康.中医筋伤学[M].上海:上海科技出版社,2002:26-30.
[6]Dodson CC,Kitay A,Verma NN,et al.The long-trem outcome of recurrent defects after rotator cuff repair[J].Am J Sports Med,2010,38(1):35-39.
[7]凌耀光,项征,陶日东,等.关节镜辅助小切口治疗肩袖损伤疗效分析[J].安徽医学,2016,37(3):318-320.
[8]Mihata T,Mcgarry M H,Ishihara Y,et al.Biomechanical Analysis of Articular-Sided Partial-Thickness Rotator Cuff Tear and Repair[J].American Journal of Sports Medicine,2015,43(2):439-446.
[9]Faulkner N D,Getelman M H,Burns J P,et al.Regarding“Meta-analysis comparing single-row and double-row repair techniques in the arthroscopic treatment of rotator cuff tears”[J].Journal of Shoulder and Elbow Surgery,2014,23(9):e223-e225.
[10]邱志新,窦荣花,郝有志,等.中风后肩手综合征患者应用红花化瘀汤结合针刺治疗的效果分析[J].陕西中医,2016,37(10):1323-1324.
[11]叶锐,张光彩,吴林,等.中医综合疗法治疗慢性肩关节周围炎临床研究[J].中医学报,2017,32(10):1985-1988.
[12]杨明煜,朱红坤,胡边,等.温针灸结合手法治疗对肩袖损伤患者血清C反应蛋白及肿瘤坏死因子的影响[J].湖北中医药大学学报,2017,19(4):97-100.
[13]张玉明,张秀芳,张明,等.肩部强化训练结合中药熏蒸在改善脑卒中患者肩痛的疗效观察[J].中国康复,2017,32(2):123-125.
[14]黄成龙,潘界恩,蔡震海,等.关节镜下缝线桥技术治疗老年创伤性肩关节脱位合并肩袖损伤的疗效评价[J].中国内镜杂志,2016,22(6):35-39.
[15]高东梅,郝龙,田雪.肩三针注射术配合中药熏蒸、推拿等治疗肩周炎136例[J].陕西中医,2017,38(7):965-966.
[16]闵重函,周瑛,荆琳,等.手法加中药熏蒸对前交叉韧带断裂重建术后膝关节功能康复的病例对照研究[J].中国骨伤,2016,29(5):397-403.
[17]亓建.中药熏蒸治疗膝关节镜术后肿痛的临床研究[D].北京:北京中医药大学,2014:27.
[18]高萍,任万雷.中药熏蒸疗法在关节疼痛性疾病中的应用概况[J].国际中医中药杂志,2017,39(11):1054-1056.
[19]任咏梅,张琲珏.中药熏蒸疗法配合气压弹道式冲击波治疗肩周炎30例[J].陕西中医,2017,38(4):482-483.