[超声引导下肌肉骨骼针刺治疗肩关节镜下肩袖缝合后肌筋膜疼痛综合征疗效分析]。

Q4 Medicine
Xiao Liang, Jing Wang, Xiao-Hui Xia, Hong-Tao Wang
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引用次数: 0

摘要

目的:比较超声引导下肌肉骨骼针灸治疗与放射体外冲击波治疗肩关节镜下肩袖缝合后肌筋膜疼痛综合征的临床疗效。方法:选取2021年6月至2022年4月收治的肩关节镜下肩袖缝合后肌筋膜疼痛综合征患者75例,根据治疗方法的不同分为肌肉骨骼超声组和体外冲击波组。肌肉骨骼超声组39例,男12例,女27例,年龄43 ~ 77岁,平均(56.33±9.45)岁,左侧11例,右侧28例,病程中位数为7.00(4.00,12.00)周,在肌肉骨骼超声指导下进行针灸治疗。体外冲击波组36例,男16例,女20例,年龄46 ~ 72岁,中位年龄(58.94±8.94)岁,左侧12例,右侧24例,病程平均5.50(4.00,8.00)周,行体外冲击波联合放疗。比较两组患者治疗前及治疗后1、3、6、12、24个月肩关节疼痛和功能改善情况,比较视觉模拟评分(VAS)和美国肩肘外科医生评分(ASES)。结果:两组患者随访24 ~ 27个月,平均(24.68±0.89)个月。随访期间无感染、血管神经损伤等并发症发生。治疗后6个月,肌肉骨骼超声组VAS(2.00±1.19)低于体外冲击波组(3.08±1.02),差异有统计学意义(p < 0.05)。治疗后3、6、12个月,肌肉骨骼超声组的as评分分别为(77.44±11.56)、(86.06±6.11)、(89.44±4.66)分,均高于体外冲击波组(55.23±12.76)、(58.10±10.25)、(84.03±7.36)分,差异均有统计学意义(p < 0.05)。结论:与放射性体外冲击波治疗相比,超声引导下肌肉骨骼针刺治疗肩关节镜下肩袖缝合后肌筋膜疼痛综合征的疼痛缓解更快,肩关节功能改善更快。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Analysis of rapeutic effect of musculoskeletal ultrasound-guided acupuncture for the treatment of myofascial pain syndrome after rotator cuff suture under shoulder arthroscopy].

Objective: To compare clinical efficacy of musculoskeletal ultrasound-guided acupuncture treatment and radiation extracorporeal shock wave therapy in myofascial pain syndrome after rotator cuff suture under shoulder arthroscopy.

Methods: From June 2021 to April 2022, 75 patients with myofascial pain syndrome after rotator cuff suture under shoulder arthroscopy were admitted and divided into musculoskeletal ultrasound group and extracorporeal shock wave group according to different treatment methods. There were 39 patients in musculoskeletal ultrasound group, including 12 males and 27 females, aged from 43 to 77 years old with an average of (56.33±9.45) years old;11 patients on the left side and 28 patients on the right side;the course of disease with a median of 7.00(4.00, 12.00) weeks;acupuncture treatment was performed under the guidance of musculoskeletal ultrasound. There were 36 patients in extracorporeal shock wave group, including 16 males and 20 females, aged from 46 to 72 years old with a median of (58.94±8.94) years old;12 patients on the left side and 24 patients on the right side;the course of disease with an average of 5.50(4.00, 8.00) weeks;extracorporeal shock wave therapy with radiation were performed. Visual analogue scale (VAS) and American shoulder and elbow surgeons score (ASES) were compared between two groups to evaluate improvement of shoulder joint pain and function before treatment and 1, 3, 6, 12, and 24 months after treatment.

Results: Both of two groups were followed up for 24 to 27 months with an average of (24.68±0.89) months. No complications such as infection and vascular and nerve injury occurred during follow-up period. At 6 months after treatment, VAS of musculoskeletal ultrasound group (2.00±1.19) was lower than that of extracorporeal shock wave group (3.08±1.02), and the difference was statistically significant (P<0.05). At 1, 3, 12 and 24 months after treatment, there were no statistically significant difference in VAS between two groups (P>0.05). At 3, 6 and 12 months after treatment, ASES scores of musculoskeletal ultrasound group were (77.44±11.56), (86.06±6.11), and (89.44±4.66) respectively, which were higher than those of extracorporeal shock wave group (55.23±12.76), (58.10±10.25), (84.03±7.36), the differences were statistically significant (P<0.05);there were no statistically significant difference in ASES between two groups at 1 and 24 months after treatment(P>0.05).

Conclusion: Musculoskeletal ultrasound-guided acupuncture treatment has advantages of faster pain relief and more rapid improvement of shoulder joint function for myofascial pain syndrome after rotator cuff suture under shoulder arthroscopy compared with radioactive extracorporeal shock wave therapy.

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