摘要
Abstract
Objective: To observe the clinical efficacy and mechanism of local anaesthesia by dynamic contralateral meridian needling Hegu (LI4) in treating periarthritis of shoulder during adhesion stage. Methods: 60 patiens with periarthritis of shoulder during adhesion stage were randomly divided into the observation group (n =30) and the control group (n = 30). The observation group was treated with moxibustion, mountain burning fire method, and bloodletting puncture with cupping; the points chosen for moxibustion in the observation group were Dazhui (GV14), Jianyu (LI15), Jianliao (TE14), Jianzhen (SI9), Jianqian and Ashi points; LI4 was applied with mountain burning fire method and dynamic contralateral meridian needling method of local anaesthesia. The control group was the same as the observation group except for the dynamic contralateral meridian needling. The two groups were treated once every other day for 10 times. The degree of shoulder movement in each direction, pain rating index (PRI), and visual analogue score (VAS) were observed in the two groups before and after the treatment. MRI test was carried out in the observation group to detect the changes of the edema volume, synovial fluid volume and joint capsule thickness of the key muscle ligament of the shoulder before and after the treatment. The expressions of IL-6, IL-10, TNF-α, and β-EP in peripheral blood, as well as the clinical efficacy were evaluated in the two groups. Results: The clinical recovery rate of the observation group was 93. 33％ (28/30) after the treatment, which was superior to 3. 33％ (1/30) of the control group (P ＜ 0. 01). The degrees of shoulder movements and the pain scores (PRI, VAS) were improved after the treatment compared to those before the treatment in the two groups (P ＜ 0. 01, P ＜ 0. 05); of which, the observation group was better than the control group (P ＜ 0. 01). The edema volume, synovial fluid volume and joint capsule thickness of the key muscle ligament of the shoulder were significantly reduced after the treatment in the observation group (P ＜ 0. 05). The expression levels of IL-6, IL-10 and TNF-α were significantly lower after the treatment than those before the treatment in the observation group (P ＜ 0. 01); there was statistical differences when compared to the control group (P ＜ 0. 05). The expression level of β-EP in the observation group is higher after the treatment than that before the first operation (P ＜ 0. 05); there was statistical differences when compared to the control group (P ＜ 0. 05). Conclusion: The local anaesthesia of dynamic contralateral meridian needling LI4 is an effective way to treat periarthritis of shoulder during adhesion period, which can reduce the edema of muscle and ligament of shoulder joint, reduce synovial fluid accumulation, and eliminate inflammation of joint capsule. It may be related to the reduction of IL-6, IL-10 and TNF-α, as well as be related to the increase of β-EP expression.关键词
肩关节周围炎/针刺麻醉/巨刺/IL-6/IL-10/TNF-α/β-EPKey words
Periarthritis of shoulder/Acupuncture anesthesia/Contralateral meridian needling/IL-6/IL-10/TNF-α/β-EP分类
医药卫生
