不同针法治疗慢性肩关节周围炎的疗效及复发率的对比研究OA北大核心CSTPCD

Objective To observe the effects of the local stimulation with 3 acupuncture techniques,i.e.Canggui Tanxue(needle insertion method like dark tortoise detecting point)technique,electroacupuncture(EA)and warm needling(WN)with filiform needles on shoulder pain,shoulder joint function,quality of life,inflammatory indica-tors and recurrence rate in the patients with chronic scapulohumeral periarthritis(CSP),so as to explore the opti-mal needling method of acupuncture for the predominant symptoms of CSP during the attack stage in the patients.Methods A total of 108 patients with CSP were randomly divided into a manual acupuncture(MA)group(36 cases,one case dropped off),a WN group(36 cases,3 cases dropped off)and an EA group(36 cases,1 case dropped off).In the three groups,Jianqian(EX-UE12),Jianyu(LI15),Jianzhen(SI9),Ashi(Extra)and Yanglingquan(GB34)on the affected side were selected.Canggui Tanxue needling technique,WN technique and EA were delivered in the MA group,the WN group and the EA group,respectively,30 min each time,3 times weekly for 4 weeks.The Neer test scores were compared;the visual analogue scale(VAS)was used to assess the degree of shoulder joint pain;the daily life activity abilities was evaluated using the activities of daily living(ADL)scale;the serum prostaglandin E2(PGE2)content was measured using ELISA before and after treatment.The effectiveness rate and recurrence rate were calculated,and the occurrences of adverse reactions were recorded.Results Compared with the scores before treatment,the scores of pain,joint function,and range of motion as well as the total score of Neer test were all in-creased after treatment in the three groups(P<0.05);the VAS score,ADL score and the content of serum PGE2 were decreased(P<0.05).After treatment,the pain score of Neer test in the EA group and the WN group were higher than those of the MA group(P<0.05),the joint function score of Neer test in the MA group and the WN group were higher than that of the EA group(P<0.05),and the range of motion score of Neer test in the MA group was higher when com-pared with the EA and WN groups(P<0.05).There was no statistical difference in the total score of Neer score among the three groups.VAS score in the EA group was lower than that of either the WN group or the MA group(P<0.05).ADL score in the MA group was lower compared with that of the WN group(P<0.05).PGE2 levels in both the WN group and the MA group were lower than that of the EA group(P<0.05).The total effective rate was 85.71%(30/35)in the MA group,91.43%(32/35)in the EA group and 90.91%(30/33)in the WN group,there was no statistical differences among the three groups.At the end of the 6-month follow-up visit after treatment,there was no significant difference in the recurrence rate among three groups.No serious adverse reaction was found.Conclusion In the treatment of CSP,the short-term effect is equivalent among EA,WN and MA.But,the analgesic effect is the best in the EA group,the treatment for anti-inflammation is the most effective in the MA and WN groups,and the needling technique of Cang-gui Tanxue in the MA group obtains the most favorable effect of releasing adhesion and recovering the range of motion in the shoulder joint.