李娜　罗湘筠

[關键词] 肩周炎急性期;腕踝针;镇痛;VAS评分;血清P物质

[中图分类号] R246.9          [文献标识码] B          [文章编号] 1673-9701（2021）14-0139-03

Analgesia efficacy of wrist-ankle acupuncture on acute stage of scapulohumeral periarthritis and its impacts on serum substance P

LI Na1   LUO Xiangyun2

1.Hunan University of Chinese Medicine， Changsha   410000， China; 2.Department of Acupuncture and Moxibustion， the Third Affiliated Hospital of Hunan University of Chinese Medicine， Zhuzhou   412000， China

[Abstract] Objective To observe and analyze the clinical efficacy of pain improvement of wrist-ankle acupuncture on acute stage of scapulohumeral periarthritis and the changes of serum substance P in vivo. Methods A total of 62 patients with acute stage of scapulohumeral periarthritis admitted to our department were randomLy selected， and they were divided into the treatment group（n=31） and the control group（n=31） according to the random number table method. The control group was treated with diclofenac sodium sustained-release capsule，while the treatment group was treated with lidocaine and stellate ganglion block combined with wrist-ankle acupuncture. Both groups were treated with active and passive functional exercise in continuous treatment for 4 weeks. The clinical efficacy， visual analogue scale （VAS） and changes of serum substance P were compared between the two groups. Results ①After the treatment， the total clinical efficacy rate of the treatment group was 100.00%， and there was statistically significant difference from 77.42% of the control group （χ2=4.348， P<0.05）. ②After 4 weeks of treatment， the VAS of the treatment group was （2.07±0.44） points， and there was statistically significant difference from （8.24±1.52） points before treatment（P<0.05）. The VAS of the control group after treatment was （4.22±0.65） points， and there was statistically significant difference from （8.36±1.14） points before treatment （P<0.05）. After treatment， the VAS score of the treatment group was lower than that of the control group， with statistically significant difference（P<0.05）. ③After 4 weeks of treatment， the concentration of substance P in the treatment group was （33.07±6.74） pg/mL， and there was statistically significant difference from （69.24±7.52）pg/mL before treatment （P<0.05）. The concentration of substance P in the control group after treatment was （40.22±6.65） pg/mL， and there was statistically significant difference from （70.36±8.02） pg/mL before treatment （P<0.05）. After treatment， the concentration of substance P in the treatment group was lower than that in the control group， with statistically significant difference（P<0.05）. Conclusion Wrist-ankle acupuncture is safe and effective in treating scapulohumeral periarthritis and improving pain symptoms.

[Key words] Acute stage of scapulohumeral periarthritis; Wrist-ankle acupuncture; Analgesia; VAS score; Serum substance P

肩周炎是一种以肩关节疼痛，功能活动障碍为主要临床症状的肩关节疾患，其主要发病原因多由各种急慢性损伤导致肩关节周围软组织退变、关节囊及周围韧带、肌腱发生急慢性特异性炎症导致[1-2]。其临床发病人群女性多于男性，且多发生于50岁左右，故又称为“五十肩”。肩周炎急性期发作伴随着剧烈疼痛，关节活动受限，肩关节周围相关肌肉痙挛等严重影响日常生活。目前临床上针对肩周炎急性期的止痛手段多种多样，如口服非甾体药物，局部封闭治疗，针灸推拿、理疗等，但这些治疗方法均有一定的局限性。本研究采用腕踝针治疗肩关节周围炎，其止痛效果准确有效，取得满意的疗效，现报道如下。

1 资料与方法

1.1 一般资料

随机选取2019年1月至2020年1月于我科就诊的肩周炎急性期患者62例，其中男23例，女39例，年龄45～68岁，平均（51.2±10.1）岁;将患者随机分为治疗组与对照组，每组各31例，其中治疗组男12例，女19例，平均年龄（52.32 ±11.29）岁，VAS评分（8.24±1.52）分，P物质水平（69.24±7.52）pg/mL;对照组女20例，男11例，平均年龄（50.11±9.78）岁，VAS评分（8.36±1.14），P物质水平（70.36±8.02）pg/mL。两组患者年龄、性别、VAS评分、P物质水平等比较，差异无统计学意义（P>0.05），具有可比性。

1.1.1 纳入标准[3]  ①符合肩关节周围炎的诊断标准，且疼痛症状明显，处于急性期者;②年龄40～75岁;③近期未服用治疗疼痛相关药物者;④经本院医学伦理委员会同意，签署知情同意书并配合治疗者。

1.1.2 排除标准[4]  ①有明确外伤史等导致……