遠道剌治療肩關節周圍炎及功能

Clinical Study about Treatment of Frozen Shoulder and Functions all the Way to Improve the Stab

陳良杰(Liang-Chieh Chen) ； Suhe Li

《傳統醫學雜誌》 25卷1期 (2014/10) Pp. 17-61

摘要

目的本課題是中醫理論的指導下，通過臨床試驗，觀察遠道針剌治療肩關節周圍炎的臨床療效，為治療肩周炎找到更好的方法，為患者減輕痛苦，恢復關節的活動功能。方法將符合條件的60例患者隨機分為治療組和對照組，每組30例。分別採用遠道針剌法與局部針剌法治療2個療程，選用肩關節疾患成績判定標準評價療效。評價內容包括疼痛、肩關節功能、肩關節治動範圍。肩關節量表有專門的醫務人員評價填寫。分別在首次治療前後治療2個療程後進行評價。結果治療組與對照組患者的性別、年齡構成及患側、病情輕重、中醫分型等指標經過統計學檢驗，無差異（P＞0.05），具有可比性。治療前，治療組與對照組疼痛、功能、活動範圍及總評分分別經過統計學檢驗，無差異（P＞0.05），具有可比性。在經過兩個療程的治療後，其中治療組臨床治癒4例，顯效8例，有效14例，無效4例，總有效率為86.67%；對照組臨床治癒3例，顯效8例，有效12例，無效7例，總有效率為76.67%。經統計學檢驗，兩組療效無差異（P＞0.05），提示兩種治療方法療效相當。治療後，治療組和對照組疼痛、功能、活動範圍及總評分分別與治療前進行比較，發現其各組的評分均明顯高於治療前，差異有統計學意義（P＜0.05）。提示遠道取穴針剌法與局部取穴針剌法均能緩解肩部疼痛，改善功能，恢後活動範圍。兩組患者治療後相互比較，發現在緩解疼痛與改善功能方面的差異無統計學意義（P＞0.05）；而在恢後活動範圍方面，治療組明顯好於對照組，差異有統計學意義（P＜0.05），提示治療組在恢復肩關節活動範圍方面優於對照組。結論本研究結果提示：兩種治療方法對肩周炎均有明確的療效，均能有效地緩解疼痛，改善功能，恢復活動範圍，但在恢復活動範圍方面，遠道取穴針剌法效果優於局部取穴針剌法，說明遠道針剌法能更有效的恢復關節的活動範圍。

關鍵字

遠道針剌法 ； 局部針剌法 ； 肩周圍關節炎

並列摘要

Objective: This project is under the guidance of traditional Chinese medicine theory, through clinical trials, acupuncture shoulder all the way around the observation of the clinical effect of inflammation, for the treatment of frozen shoulder to find a better way for patients to relieve pain and restore jointmobility. Method: The conditions of 60 patients were randomly divided into treatment group and control group, n=30. Were used to come all the way and local acupuncture acupuncture treatment for 2 courses, the choice of performance criteria of shoulder disorders evaluated. Evaluation included pain, shoulder function, shoulder range of motion. Shoulder scale evaluation of a dedicated medical personnel only. Respectively, before treatment and treatment in the first 2 months after treatment were evaluated. Results: Treatment group and control group with sex, age composition and the lateral, severity, type and other indicators of TCM through statistical tests, no significant difference (P＞ 0.05), comparable. Before treatment, the treatment group and the control of pain, function, range and total scores were through the statistical test, no significant difference (P＞ 0.05), comparable. After two courses of treatment, the treatment group were clinically cured four cases, effective in 8 cases, effective in 14 cases, 4 cases, the total effective rate was 86.67%; the control group were clinically cured three cases, effective in 8 cases, effective 12 cases 7 cases, total effective rate was 76.67%. The statistical test, no significant difference between two groups (P＞ 0.05), suggest a considerable effect of two treatment methods. After the treatment group and control group pain, function, range and total scores were compared with those before treatment and found scores of each group were significantly higher than before treatment, the difference was statistically significant (P ＜0.05). Tip all the way and the local acupoints acupuncture acupoints acupuncture can relieve shoulder pain and improve function and restore range of motion. Comparison between two groups of patients after treatment was found in pain relief and improved function of the difference was not statistically significant (P＞ 0.05); while in the recovery range, the treatment group was significantly better than the control group, the difference was statistically significant (P ＜0.05), suggesting that the treatment group in terms of recovery of shoulder range of activities than thecontrol group had a better effect. Conclusion: The results suggest that: the two treatments have clear effects on the frozen shoulder, can effectively relieve pain and improve function, recovery activities, but in the scope of restoration activities, all the way better than the local acupuncture acupuncture, indicating all the way acupuncture is more effective recovery of shoulder range of avtivities.

並列關鍵字

All the way acupuncture ； local acupuncture ； frozen shoulder