乌头汤联合针灸治疗寒湿凝滞型肩周炎疗效观察及对炎症因子的影响
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摘要
【目的】探讨乌头汤加减联合针灸治疗寒湿凝滞型肩周炎(冻结肩)患者的临床疗效及对转化生长因子β1、前列腺素E2及羟脯氨酸的影响。【方法】将102例寒湿凝滞型肩周炎患者随机分为试验组和对照组各51例,对照组采用针灸治疗,试验组在对照组的基础上加服乌头汤加减治疗,疗程1个月,观察2组患者的临床疗效、肩功能Constant-Mutley评分、疼痛程度及血液中转化生长因子β1、前列腺素E2和羟脯氨酸的水平。【结果】试验组的总有效率(96.1%)明显高于对照组(78.4%),差异有统计学意义(P<0.05);试验组的肩功能Constant-Mutley评分明显高于对照组,差异有统计学意义(P<0.05);试验组的疼痛程度中重度疼痛比例明显少于对照组,差异有统计学意义(P<0.05);试验组在降低转化生长因子β1、羟脯氨酸水平和升高前列腺素E2水平方面明显优于对照组,差异有统计学意义(P<0.05)。【结论】乌头汤加减联合针灸治疗寒湿凝滞型肩周炎患者可以实现消除水肿、镇痛、抗炎作用,并提高患者的肩功能。
Objective To explore the clinical effect of modified Wutou Decoction combined with acup-moxibustionfor the patients with Cold-damp stagnation and obstruction type of scapulohumeral periarthritis(frozen shoulder)and to observe the influence on the levels of transforming growth factor β1,prostaglandin E2 and hydroxyproline.Methods A total of 102 patients with cold-damp stagnation and obstruction type of scapulohumeral periarthritiswere enrolled into the trial. The patients were randomly divided into test group and control group,51 cases in eachgroup. The two groups were treated with acup-moxibustion, and additionally, the test group was treated withmodified Wutou Decoction orally, the treatment covering one month. The clinical effect, shoulder functionConstant-Mutley scores,pain degree and the blood levels of transforming growth factor β1,prostaglandin E2 andhydroxyproline were observed in the two groups. Results The total effective rate in the test group was 96.1%,apparently higher than 78.4% in the control group(P < 0.05). The Constant-Mutley scores of shoulder function inthe test group were apparently higher, and the proportions of moderate and severe pain in the test group wereapparently less than those in the control group(P < 0.05). Blood levels of transforming growth factor β1,prostaglandin E2 and hydroxyproline in the test group were apparently improved as compared with those in thecontrol group(P < 0.05). Conclusion Modified Wutou Decoction combined with acup-moxibustion exerts certaineffect on eliminating edema,relieving pain,counteracting inflammation and improving shoulder function of cold-damp stagnation and obstruction type of scapulohumeral periarthritis patients.
Objective To explore the clinical effect of modified Wutou Decoction combined with acup-moxibustionfor the patients with Cold-damp stagnation and obstruction type of scapulohumeral periarthritis(frozen shoulder)and to observe the influence on the levels of transforming growth factor β1,prostaglandin E2 and hydroxyproline.Methods A total of 102 patients with cold-damp stagnation and obstruction type of scapulohumeral periarthritiswere enrolled into the trial. The patients were randomly divided into test group and control group,51 cases in eachgroup. The two groups were treated with acup-moxibustion, and additionally, the test group was treated withmodified Wutou Decoction orally, the treatment covering one month. The clinical effect, shoulder functionConstant-Mutley scores,pain degree and the blood levels of transforming growth factor β1,prostaglandin E2 andhydroxyproline were observed in the two groups. Results The total effective rate in the test group was 96.1%,apparently higher than 78.4% in the control group(P < 0.05). The Constant-Mutley scores of shoulder function inthe test group were apparently higher, and the proportions of moderate and severe pain in the test group wereapparently less than those in the control group(P < 0.05). Blood levels of transforming growth factor β1,prostaglandin E2 and hydroxyproline in the test group were apparently improved as compared with those in thecontrol group(P < 0.05). Conclusion Modified Wutou Decoction combined with acup-moxibustion exerts certaineffect on eliminating edema,relieving pain,counteracting inflammation and improving shoulder function of cold-damp stagnation and obstruction type of scapulohumeral periarthritis patients.
引文
[1]徐晖.乌头汤加减内外兼治寒痹型膝骨性关节炎的临床疗效观察[J].云南中医中药杂志, 2015,36(12):39.
[2]李艳萍,杨峰,安琪.加味乌头汤加减治疗癌性疼痛效果观察[J].西部中医药,2018, 31(3):86.
[3]何勇,刘威,王大明,等.肩周炎疼痛机制研究进展[J].中国运动医学杂志,2016, 35(10):987.
[4] Lai X J,Hai J W,Yu X C,et al. Sharp-hook acupuncture(Feng Gou Zhen)for patients with periarthritis of shoulder:a randomized controlled Trial[J]. Evid-Based Compl Alt Med,2015,15(5):123.
[5]时德廷.风湿病的中西医诊治[M].北京:中国中医药出版社,1998.
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[7]赖雪燕,叶敏,祁冀,等.针灸治疗肩周炎的三大特色选穴方法[J].西部中医药,2014, 27(6):71.
[8]维敏,锁堂.应用乌头汤加减内服外敷治疗退行性膝关节炎临床探讨[J].中国中医基础医学杂志,2015,21(9):1136.
[9]梅罗阳,高岑,宋俊生.乌头汤及其加减方临床对照研究文献质量评价[J].河南中医,2015, 35(2):215.
[10]韩振翔,祁丽丽,禇立希,等.针灸结合主动功能锻炼分期治疗肩周炎方案的优选[J].中国针灸,2014,34(11):1067.
[11] Ye W. Chinese medicine packet plus wax therapy for periarthritis of the shoulder:study protocol for a multi-center,randomized controlled trial[J]. Clinical and Translational Degenerative Diseases,2016,23(15):25.
[12]袁红,陈榕,黄大鹏,等.平衡针灸对肩周炎模型兔转化生长因子β1、前列腺素E2、羟脯氨酸影响的实验研究[J].环球中医药,2015,8(1):42.
[13]温优良,李智,梁兴森,等.骶管注射对腰椎间盘突出症大鼠模型神经根局部炎症因子的影响[J].中国骨伤,2014,27(2):153.
[14] Li W,Lu N,Xu H,et al. Case control study of risk factors for frozen shoulder in China[J]. Int J Rheum Dis,2015,18(5):508.
[2]李艳萍,杨峰,安琪.加味乌头汤加减治疗癌性疼痛效果观察[J].西部中医药,2018, 31(3):86.
[3]何勇,刘威,王大明,等.肩周炎疼痛机制研究进展[J].中国运动医学杂志,2016, 35(10):987.
[4] Lai X J,Hai J W,Yu X C,et al. Sharp-hook acupuncture(Feng Gou Zhen)for patients with periarthritis of shoulder:a randomized controlled Trial[J]. Evid-Based Compl Alt Med,2015,15(5):123.
[5]时德廷.风湿病的中西医诊治[M].北京:中国中医药出版社,1998.
[6]唐宏亮,卢栋明,黎丽群,等.“肩三针”治疗肩周炎临床研究的系统评价[J].辽宁中医杂志,2015,42(5):933.
[7]赖雪燕,叶敏,祁冀,等.针灸治疗肩周炎的三大特色选穴方法[J].西部中医药,2014, 27(6):71.
[8]维敏,锁堂.应用乌头汤加减内服外敷治疗退行性膝关节炎临床探讨[J].中国中医基础医学杂志,2015,21(9):1136.
[9]梅罗阳,高岑,宋俊生.乌头汤及其加减方临床对照研究文献质量评价[J].河南中医,2015, 35(2):215.
[10]韩振翔,祁丽丽,禇立希,等.针灸结合主动功能锻炼分期治疗肩周炎方案的优选[J].中国针灸,2014,34(11):1067.
[11] Ye W. Chinese medicine packet plus wax therapy for periarthritis of the shoulder:study protocol for a multi-center,randomized controlled trial[J]. Clinical and Translational Degenerative Diseases,2016,23(15):25.
[12]袁红,陈榕,黄大鹏,等.平衡针灸对肩周炎模型兔转化生长因子β1、前列腺素E2、羟脯氨酸影响的实验研究[J].环球中医药,2015,8(1):42.
[13]温优良,李智,梁兴森,等.骶管注射对腰椎间盘突出症大鼠模型神经根局部炎症因子的影响[J].中国骨伤,2014,27(2):153.
[14] Li W,Lu N,Xu H,et al. Case control study of risk factors for frozen shoulder in China[J]. Int J Rheum Dis,2015,18(5):508.