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目的 探讨肌骨超声引导下针刀定点松解在粘连性肩关节囊炎瘀滞证治疗中的效果及安全性。方法 纳入粘连性肩关节囊炎瘀滞证患者共120例（2021年1月2022年6月），采取随机数字表法分为对照组和观察组，每组60例，对照组采取传统解剖定位法针刀松解，观察组采取肌骨超声引导下针刀定点松解，每周1次，治疗4周。分别观察两组临床疗效及并发症，并比较治疗前后Constant肩关节量表评分、疼痛视觉模拟评分法（VAS）评分、红细胞沉降率（ESR）、血清C反应蛋白（CRP）变化。结果 治疗4周后，两组Constant肩关节量表评分均较治疗前提升，疼痛VAS评分、ESR、血清CRP水平均较治疗前下降，且观察组Constant肩关节量表评分高于对照组，疼痛VAS评分、ESR、血清CRP水平低于对照组（P<0.05）。观察组临床总有效率96.67%(58/60)相较于对照组86.67%(52/60)更高（P<0.05）。两组并发症发生率比较差异无统计学意义（P>0.05）。结论 肌骨超声引导下针刀定点松解对粘连性肩关节囊炎瘀滞证临床疗效好，可改善肩关节活动功能、缓解疼痛、降低炎性因子水平，且安全性较好。
Abstract：Objective To investigate the efficacy and safety of musculoskeletal ultrasound-guided fixed-point release with needle-knife in the treatment of adhesive capsulitis with blood stasis syndrome. Methods A total of 120 patients with adhesive capsulitis with blood stasis syndrome were enrolled from January 2021 to June 2022. According to the random number table method, they were divided into control group and observation group, with 60 patients in each group.The control group was treated with traditional anatomical positioning method and fixed-point release with needle-knife, and the observation group was treated with musculoskeletal ultrasound-guided fixed-point release with needle-knife, once a week for 4 weeks. The clinical effect and complications of the two groups were observed, and the changes of Constant shoulder scale score, visual analogue scale(VAS) score, erythrocyte sedimentation rate(ESR) and serum C reactive protein(CRP)before and after treatment were compared. Results At 4 weeks after treatment, the scores of Constant shoulder scale in the two groups were higher than those before treatment, while the VAS pain score, ESR and serum CRP levels were lower than those before treatment; the Constant shoulder scale score in the observation group was higher than that in the control group, while the VAS pain score, ESR and serum CRP levels were lower than those in the control group(P<0.05). The total clinical effective rate of the observation group was 96.67%(58/60), which was higher than 86.67%(52/60) of the control group(P<0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Musculoskeletal ultrasound-guided fixed-point release with needle-knife has a good clinical effect on adhesive shoulder capsulitis with blood stasis syndrome, which can improve shoulder joint function, relieve pain, reduce inflammatory factor levels, and has good safety.
[1]邹欢,曾飞,叶立祥,等.粘连性肩关节囊炎治疗研究进展[J].中国疼痛医学杂志,2023,29(2):127-132.
[2]邓秦喆,高洁,张东升,等.粘连性肩关节囊炎患者喙肱韧带MR测量研究[J].实用放射学杂志,2023,39(5):786-789.
[3]潘伟汉,颜显毅,曹兴泽,等.关节镜松解联合PRP治疗粘连性肩关节囊炎近期疗效分析[J].实用骨科杂志,2025,31(3):245-248,252.
[4] PARK S K, JUNG M S, PARK J Y, et al. Calcific periarthritis of the hand showing a variable disease course[J].J Rheum Dis,2025,32(1):66-67.
[5]朱俐.基于肌骨超声技术量化评价太极推拿治疗肩周炎的临床疗效[D].武汉:湖北中医药大学,2020.
[6] STONEHAM A, POON P, HIRNER M, et al. Intraoperative‘space suits’ do not reduce periprosthetic joint infections in shoulder arthroplasty.[J]. Bone Jt Open, 2024,5(10):894-897.
[7]熊琴,乌日娜,张砚,等.超声引导下闭合复位治疗青少年鼻骨骨折临床疗效观察[J].山东医药,2024,64(31):65-67.
[8] TAMURA Y, MAEDA N, KOMIYA M, et al. Muscle synergy of the periarticularis shoulder muscles during a wheelchair propulsion motion for wheelchair basketball[J].Appl Sci, 2024,14(20):9292.
[9]薄存菊,刘晓明,刘勇坚,等.超声引导下肩胛上神经联合腋神经阻滞治疗粘连性肩关节囊炎的临床观察[J].中国疼痛医学杂志,2024,30(5):377-383.
[10]李曰文,戴国钢,王一,等.郑氏中医非手术治疗粘连性肩关节囊炎疗效观察[J].辽宁中医药大学学报,2023,25(12):179-183.
[11]邢瑞林,连龙虎,刘艳艳,等.超声引导下细针改良针刀在粘连性肩关节囊炎伴滑囊积液治疗中的价值[J].中国医药导报,2023,20(31):163-166.
[12]王璐,于歌,陈亚平.神经肌肉控制训练治疗粘连性肩关节囊炎的效果[J].中国康复理论与实践,2022,28(5):616-620.
[13]霍存举,吴国华,江海波.骨科疾病临床诊疗技术[M].北京:中国医药科技出版社,2016:166-168.
[14]国家中医药管理局.中医病证诊断疗效标准[S].南京：南京大学出版社,1994:190-191.
[15] LAPNER P, NAM D, CHEEMA A, et al. Diagnostic accuracy of pre-operative percutaneous synovial biopsy and aspirate compared with open biopsy for prosthetic shoulder infections[J].J Shoulder Elbow Surg, 2025,34(2):441-448.
[16] COGAN C J, PATEL M, IANNOTTI J P, et al. Diagnosis of shoulder periprosthetic joint infection with atypical wounds:a case series of 12 patients[J].Seminars in Arthroplasty:JSES,2024,34(3):807-812.
[17] ENTEZARI V, HO C J, SAHOO S, et al. Early radiographic and clinical outcomes of primary short stem anatomic total shoulder arthroplasty with a peripherally enhanced fixation glenoid:a multicenter study[J].Seminars in Arthroplasty:JSES,2024,34(3):533-544.
[18] LEE J H, PARK H S, PARK S H, et al. Pharmacoacupuncture for the treatment of frozen shoulder:a systematic review and metaanalysis of randomized controlled trials[J].Curr Pain Headache Rep, 2024,28(12):1365-1386.
[19]李晓凡,封云松,余红军,等.粘连性肩关节囊炎与喙肱韧带的MRI研究[J].中国现代医学杂志,2020,30(21):58-62.
[20] SANTORO A, DEBERNARDIS D, CHEN R, et al. Surgical fixation of periprosthetic humeral shaft fracture about a short-stem anatomic total shoulder arthroplasty with a proximal humeral locking plate:surgical technique and report of 3 cases[J].JSES Rev Rep Tech, 2024,4(3):573-577.
[21] SCHOELL K, CRABB R, SIMPSON E, et al. Preoperative corticosteroid injections are associated with a higher periprosthetic infection rate following primary total shoulder arthroplasty:a systematic review and meta-analysis[J].J Shoulder Elbow Surg, 2024,33(12):2734-2742.
[22] PAREL P M, AGARWAL A R, RAMESH A, et al. Increased risk of 90-day deep surgical site infection and periprosthetic joint infection following total shoulder arthroplasty in psoriasis patients[J].Seminars in Arthroplasty:JSES, 2024,34(2):348-353.
[23] XU J, REN D, LIU F, et al. Molecular mechanism of the influence of related genes expression in synovium tissue around shoulder joint of secondary frozen shoulder model rats on angiogenesis[J].Cell Mol Biol(Noisy-le-grand), 2024,70(5):263-269.
[24]戴朝秦,应松铁,杨麒磊,等.脉冲枪胸椎松动术对粘连性肩关节囊炎的疗效影响[J].中国康复医学杂志,2023,38(7):995-997.
[25]张学广,刘尧,王米,等.超声引导下臭氧水注射治疗粘连性肩关节囊炎的临床效果观察[J].国际麻醉学与复苏杂志,2021,42(9):907-911.
[26]白杨,宏亚丽,陈波,等.针灸治疗粘连性肩关节囊炎临床研究核心结局指标集的构建方法[J].中国针灸,2023,43(6):701-705.
[27]郭向飞,柯海,陈平,等.针刺内麻点联合氟比洛芬酯在粘连性肩关节囊炎术后镇痛的疗效观察[J].中国疼痛医学杂志,2023,29(7):550-553.
[28]白杨,宏亚丽,王薇,等.滞动针针刺肌筋膜激痛点对粘连性肩关节囊炎患者局部软组织结构和温度的影响[J].中医杂志,2022,63(13):1256-1264.
[29]苏睿,李航,王奇,等.体外冲击波联合银质针治疗糖尿病合并粘连性肩关节囊炎的临床研究[J].中国疼痛医学杂志,2021,27(3):221-224.
[30]王利锋,黄姝变,赵鹏.当归四逆汤加减联合体外冲击波治疗粘连性肩关节囊炎疗效观察[J].现代中西医结合杂志,2021,30(22):2477-2481.
[31]杨森林,万权.超声引导下多次肩袖间隙糖皮质激素注射治疗疼痛期粘连性肩关节囊炎的短期疗效[J].中国疼痛医学杂志,2022,28(5):379-383.
[32]唐伟伟,邹云鹤,李端芳,等.基于红外热像引导冲击波治疗慢性粘连性肩关节囊炎的随机对照试验[J].中国疼痛医学杂志,2020,26(4):297-300.
[33]俞晓杰,郝丹丹,高强,等.超声引导肩胛上神经阻滞联合盂肱关节类固醇注射治疗粘连性肩关节囊炎[J].中国介入影像与治疗学,2020,17(9):538-542.
[34]王拓,张朝跃,周天宝,等.手法松解结合关节镜下松解治疗粘连性肩关节囊炎[J].中国骨与关节损伤杂志,2021,36(7):739-740.
基本信息:
DOI：
中图分类号:R246.9
引用信息:
[1]刘太,李胜吾,王标等.肌骨超声引导下针刀定点松解治疗粘连性肩关节囊炎瘀滞证的临床疗效及并发症观察[J].临床误诊误治,2025,38(12):108-112.
基金信息:
四川省中医药管理局科学技术研究专项课题（2020LC0183）