Study on the effect of extracorporeal shock wave on pain and inflammatory factor levels in patients with shoulder periarthritis
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摘要:
目的 分析体外冲击波治疗肩关节周围炎的疗效及对患者疼痛与炎症因子水平的改善作用。 方法 选取绍兴市越城区人民医院骨科2019年1月—2020年1月收治的肩关节周围炎患者120例，根据不同治疗方案分为A组与B组各60例，A组应用玻璃酸钠肩关节腔注射治疗，B组应用玻璃酸钠肩关节腔注射联合电磁式体外冲击波治疗，比较2组患者临床疗效、疼痛程度、肩关节功能、肩关节活动度以及炎症因子水平。 结果 治疗后, B组的总有效率(93.33%)高于A组(78.33%)，B组的VAS评分[(2.21±0.72)分]低于A组[(4.19±1.04)分]，Constant-Murley评分[(70.76±5.89)分]高于A组[(64.22±6.15)分]。治疗后，B组肩关节外展、前屈、后伸的活动度(133.12°±7.25°、137.81°±8.27°、40.06°±3.15°)均大于A组(108.43°±6.87°、102.54°±7.82°、33.82°±2.90°)。治疗后，B组的白介素-6、肿瘤坏死因子-α水平[(47.93±4.01)ng/L、(11.02±1.76)ng/L]低于A组[(56.61±3.27)ng/L、(18.21±2.05)ng/L]，均P < 0.05。 结论 体外冲击波治疗肩关节周围炎的疗效确切，可明显减轻患者疼痛，改善肩关节功能，增加肩关节活动度，减轻炎症反应，临床总有效率高，有助于患者尽早康复。 Abstract:Objective To analyze the efficacy of extracorporeal shock wave (ESW) in the treatment of scapulohumeral periarthritis and the improvement of pain and inflammatory factors. Methods A total of 120 patients with shoulder periarthritis in the Department of Orthopedics of our hospital from January 2019 to January 2020 were selected. According to different treatment plans, they were divided into group A and group B with 60 cases each. Group A was treated with sodium hyaluronate injection in the shoulder joint cavity, and group B were used sodium hyaluronate injection in the shoulder joint cavity combined with electromagnetic extracorporeal shock wave therapy. The clinical efficacy, pain degree, shoulder joint function, shoulder joint range of motion and inflammatory factor levels were compared between the two groups. Results After treatment, the total effective rate of group B (93.33%) was higher than that of group A (78.33%), the VAS score of group B [(2.21±0.72) points] was lower than that of group A [(4.19±1.04) points], and the Constant-Murley score[(70.76±5.89) points] was higher than that of group A [(64.22±6.15) points]. After treatment, the range of movement of shoulder joint abduction, flexion and extension (133.12°±7.25°, 137.81°±8.27°, 40.06°±3.15°) of group B was greater than that of group A (108.43°±6.87°, 102.54°±7.82°, 33.82°±2.90°). After treatment, the levels of interleukin-6 and tumor necrosis factor-α in group B [(47.93±4.01) ng/L, (11.02±1.76) ng/L] were lower than those in group A [(56.61±3.27) ng/L, (18.21±2.05)ng/L], all P < 0.05. Conclusion ESW treatment of shoulder periarthritis has a definite effect, which can significantly reduce the pain of patients, improve shoulder joint function, increase shoulder joint mobility, reduce inflammation, and have a high clinical total effective rate, which can help patients recover as soon as possible. -
表 1 2组肩关节周围炎患者临床疗效比较(例)
组别 例数 治愈 显效 有效 无效 总有效[例(%)] A组 60 10 18 19 13 47(78.33) B组 60 17 23 16 4 56(93.33) 注：2组总有效率比较，χ2=5.551，P=0.018。 
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表 2 2组肩关节周围炎患者VAS评分比较(x ±s，分)
组别 例数 治疗前 治疗后 A组 60 7.14±0.53 4.19±1.04 B组 60 7.20±0.50 2.21±0.72 t值 0.638 12.125 P值 0.262 ＜0.001
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表 3 2组肩关节周围炎患者Constant-Murley评分比较(x ±s，分)
组别 例数 治疗前 治疗后 A组 60 40.45±5.76 64.22±6.15 B组 60 40.40±5.69 70.76±5.89 t值 0.048 5.949 P值 0.481 ＜0.001
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表 4 2组肩关节周围炎患者肩关节活动度对比(x ±s，°)
组别 例数 外展 前屈 后伸 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 A组 60 65.23±6.34 108.43±6.87 42.43±6.13 102.54±7.82 13.65±2.26 33.82±2.90 B组 60 65.20±6.39 133.12±7.25 42.38±6.15 137.81±8.27 13.60±2.28 40.06±3.15 t值 0.026 19.148 0.045 24.003 0.121 11.289 P值 0.490 ＜0.001 0.482 ＜0.001 0.452 ＜0.001
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表 5 2组肩关节周围炎患者炎症因子水平比较(x ±s，ng/L)
组别 例数 白介素-6 肿瘤坏死因子-α 治疗前 治疗后 治疗前 治疗后 A组 60 82.54±6.15 56.61±3.27 26.23±2.76 18.21±2.05 B组 60 82.29±6.12 47.93±4.01 26.30±2.73 11.02±1.76 t值 0.223 12.994 0.140 20.613 P值 0.412 ＜0.001 0.445 ＜0.001
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