周明

【摘要】 目的：探討与分析经筋推拿结合侧卧推扳复位手法治疗疼痛期肩关节周围炎的效果及机制。方法：选取2018年2月-2020年10月于本院诊治的124例疼痛期肩周炎患者，按照随机数字表法将其分为联合组和传统组，每组62例。传统组给予侧卧推扳复位手法治疗，联合组在传统组基础上给予经筋推拿治疗。比较两组疗效，治疗前后的肩关节后伸角度、VAS评分、β-内啡肽及前列腺素E2（PGE2）水平。结果：联合组总有效率为98.39%，高于传统组的88.71%，差异有统计学意义（P<0.05）。治疗前，两组肩关节后伸角度、VAS评分、β-内啡肽及PGE2水平比较，差异均无统计学意义（P>0.05）;治疗后，两组肩关节后伸角度均大于治疗前，VAS评分、β-内啡肽及PGE2水平均低于治疗前，且联合组肩关节后伸角度大于传统组，VAS评分、β-内啡肽及PGE2水平均低于传统组，差异均有统计学意义（P<0.05）。结论：经筋推拿结合侧卧推扳复位手法治疗疼痛期肩关节周围炎能缓解疼痛，改善患者的肩关节功能，抑制β-内啡肽及PGE2的释放，从而提高总体治疗效果。

【关键词】 经筋推拿 侧卧推扳复位 疼痛期 肩关节周围炎 β-内啡肽

The Efficacy and Mechanism Analysis of Meridian Massage Combined with Lateral Push-pull Manipulation in the Treatment of Periarthritis of Shoulder in Painful Period/ZHOU Ming. //Medical Innovation of China， 2021， 18（32）： 0-087

[Abstract] Objective： To investigate the efficacy and mechanism of meridian massage combined with lateral push-pull manipulation in the treatment of periarthritis of shoulder in painful period. Method： A total of 124 patients with periarthritis of shoulder in painful period treated in our hospital from February 2018 to October 2020 were selected， and they were divided into combined group and traditional group according to random number table method， 62 cases in each group. The traditional group was treated with lateral push-pull manipulation， and the combined group was treated with meridian massage on the basis of traditional group. The curative effect was compared between the two groups， shoulder extension angle， VAS scores， β-endorphin and prostaglandin E2 （PGE2） levels before and after treatment were compared between two groups. Result： The total effective rate of the combined group was 98.39%， which was higher than 88.71% of the traditional group， the difference was statistically significant （P<0.05）. Before treatment， there were no significant differences in shoulder extension angle， VAS scores， β-endorphin and PGE2 levels between two groups （P>0.05）; after treatment， the shoulder extension angle of both groups were larger than those before treatment， and the VAS scores， β-endorphin and PGE2 levels of both groups were lower than those before treatment， and the shoulder extension angle of the combined group was larger than that of the traditional group， and the VAS scores， β-endorphin and PGE2 levels of the combined group were lower than those of the traditional group， the differences were statistically significant （P<0.05）. Conclusion： The treatment of the periarthritis of shoulder in painful period with meridian massage combined with lateral push-pull manipulation can promote pain relief， improve the shoulder joint function of patients， and inhibit the release of β-endorphin and PGE2， thereby improve the overall therapeutic effect.

[Key words] Meridian massage Lateral push-pull manipulation Painful period Periarthritis of shoulder

β-endorphin

First-author’s address： Tieling Hospital of Traditional Chinese Medicine， Tieling 112000， China

doi：10.3969/j.issn.1674-4985.2021.32.021

肩关节周围炎（scapulohumeral periarthritis，SP）简称肩周炎，是肩关节滑膜囊、周围肌肉韧带、关节囊、肌腱等软组织损伤退变而引起的关节周围软组织的慢性炎症疾病[1]。肩周炎患者多表现为肩关节疼痛，患者多因肩关节疼痛来院就诊[2-3]。其病理表現为关节囊异常增厚改变及非细菌性炎性充血。肩周炎治疗的重点为减轻疼痛与功能的重建，但关节内注射与手术治疗都存在一定的不足。……