张锦　杨红梅

[摘 要] 目的：分析冲击波结合关节松动术治疗肩周炎的临床效果。方法：选取我院2013年5月—2015年5月收治的120例肩周炎患者，按照随机原则分为观察组及对照组，各60例，均予关节松动术治疗，观察组在此基础上加用冲击波治疗。比较两组患者视觉模拟评分（VAS）、肩关节疼痛与功能障碍指数（SPADI）变化，并依据肩关节活动度（ROM）变化评价其临床疗效。结果：两组患者治疗后VAS评分均显著降低，观察组降低更为明显，差异有统计学意义（P<0.05）。两组患者治疗2疗程后SPADI均显著下降，观察组下降更为明显，差异有统计学意义（P<0.05）。观察组临床有效率为95.0%，显著高于对照组的76.7%，差异有统计学意义（P<0.05）。结论：冲击波结合关节松动术能够进一步缓解肩周炎患者疼痛、促进肩关节功能的早期恢复。

[关键词] 冲击波；关节松动术；肩周炎；疗效

中图分类号：R684.3 文献标识码：B 文章编号：2095-5200（2016）05-120-03

[Abstract] Objective： To analyze the clinical effect of the combination of shock wave and joint mobilization in the treatment of scapulohumeral periarthritis. Methods： 120 cases of scapulohumeral periarthritis patients in our hospital from May 2013 to May 2015 were randomly divided into observation group and control group， 60 cases in each group， were all treated with joint mobilization therapy； observation group was given shock wave therapy based on joint mobilization therapy. The visual analogue scale （VAS）， shoulder pain and disability index （SPADI） were compared between the two groups， and the clinical effect was evaluated according to the changes of the range of motion （ROM）. Results： After treatment， the VAS scores of the two groups were both significantly decreased， the observation group decreased more significantly， the difference was statistically significant （P<0.05）. The two groups of patients after treatment of 2 courses of SPADI were significantly decreased， the observation group decreased more significantly， the difference was statistically significant （P<0.05）. The clinical effective rate of the observation group was 95%， significantly higher than that of the control group （76.7%）， the difference was statistically significant （P<0.05）. Conclusions： The combination of shock wave and joint mobilization can further relieve pain， and promote the early recovery of shoulder joint function in patients with scapulohumeral periarthritis.

[Key words] shock wave； joint mobilization； scapulohumeral periarthritis； curative effect

肩周炎占肩部疾病的42%[1]，其引发的肩部疼痛、功能障碍等临床表现给患者带来了较大痛苦，严重者肩关节广泛压痛可放射至颈部、肘部，并出现三角肌萎缩，生活质量受到明显影响[2]。解除疼痛、改善关节挛缩、缓解运动障碍是肩周炎治疗的基本原则，关节松动术主要参照关节生物力学原理，通过关节面上微小运动促进关节液的产生和流动；冲击波是近年来新兴的一种关节慢性疼痛治疗方案，在四肢骨关节疾病的治疗中亦受到了广泛关注[3]。为了解冲击波结合关节松动术治疗肩周炎的疗效，进行了前瞻性研究，现报道如下。

1 资料与方法

1.1 病例资料

选取我院2013年5月—2015年5月收治参照中国肩关节周围炎指南制定的相关标准确诊粘连型肩周炎[4] 患者120例，以随机原则分为观察组及对照组，各60例。两组患者年龄、病程、性别、发病位置等一般临床资料比较，差异无统计学意义（P>0.05），具有可比性。本……