摘要
目的观察经皮穴位电刺激联合肩胛上神经阻滞治疗肩周炎的疗效。方法收集山西大医院疼痛科2017年4月至2018年6月收治的肩周炎患者90例,年龄18~65岁,性别不限,采用随机数字表法分为经皮穴位电刺激组(TEAS组)、肩胛上神经阻滞联合"安慰剂"穴位电刺激组(SJT组)、肩胛上神经阻滞联合真穴位电刺激组(SZT组),各组30例。其中TEAS组进行穴位电刺激(电流强度15~25 mA),SZT组同时进行肩胛上神经阻滞与穴位电刺激(电流强度15~25 mA),SJT组进行肩胛上神经阻滞与穴位电刺激(电流强度5 mA,起安慰剂作用)。采用单盲第三方评价的方法,以美国肩肘协会评分系统(ASES)观察记录各组患者治疗前及开始治疗后第1、3、5、7、9、11日和第2疗程结束时的镇痛效果(视觉模拟评分,VAS)与生活功能评分(ADL)。结果各组患者治疗后不同时点VAS评分均较治疗前降低(P均<0.05),生活功能评分与肩关节功能评分均较治疗前升高(P均<0.05);与TEAS组和SJT组比较,SZT组患者在治疗后各时点的VAS评分均较低(P均<0.05),生活功能与肩关节功能评分较高(P均<0.05)。两个疗程结束后,SZT组患者的满意度均较TEAS组与SJT组高(P均<0.05)。结论经皮穴位电刺激联合肩胛上神经阻滞治疗肩周炎疗效确切,且易于被患者接受。
Objective To observe the efficacy of transcutaneous electrical acupoint stimulation(TEAS)combined with suprascapular nerve block in the treatment of patients with scapulohumeral periarthritis.Methods Ninety patients with scapulohumeral periarthritis,age 18-65 years old,both sexes,admitted in department of Pain Medicine,Shanxi Dayi Hospital from April 2017 to June 2018 and were divided into 3 groups(n=30)by a random number table as transcutaneous electrical acupoint stimulation group(group TEAS),suprascapular nerve block plus sham TEAS group(group SJT)and suprascapular nerve block plus TEAS group(group SZT).The patients were treated with transcutaneous electrical acupoint stimulation(group TEAS,current intensity 15-25 mA),sham suprascapular nerve block as placebo plus TEAS(group SJT,current intensity 5 mA)and suprascapular nerve block plus TEAS(group SZT,current intensity 15-25 mA)respectively.Treatment was once every 2 days,6 times for a course,and a total of two courses for all patients.Pain score and the shoulder joint function were observed and recorded by visual analogue scale(VAS)and American shoulder and elbow surgeons form(ASES)respectively before the treatment,and at 1 day,3 days,5 days,7 days,9 days,11 days after the treatment,and at the end of the second course.The patients'satisfaction was observed at the end of treatment courses.Results VAS was decreased and ASES was increased in all three groups after the treatment(all P<0.05).Compared with group TEAS,VAS was decreased and ASES was increased in group SZT after the treatment(all P<0.05).Compared with group SJT,VAS was decreased and ASES was increased in group SZT after the treatment(all P<0.05).At the end of two courses treatment,patients'satisfaction was higher in group SZT than that in group TEAS and group SJT(all P<0.05).Conclusion Transcutaneous electrical acupoint stimulation combined with suprascapular nerve block has better effects in the treatment of patients with scapulohumeral periarthritis and high compliance for the patients.
作者
王海燕
王慧
韩冲芳
杨文曲
张卫卫
王祥
Wang Haiyan;Wang Hui;Han Chongfang;Yang Wenqu;Zhang Weiwei;Wang Xiang(Department of Anesthesiology,Shanxi Dayi Hospital,Taiyuan City,Shanxi Province 030032,China)
出处
《实用疼痛学杂志》
2019年第6期428-432,共5页
Pain Clinic Journal
关键词
针刺穴位
神经传导阻滞
经皮神经电刺激
肩胛上神经
肩关节
关节周围炎
Acupuncture points
Nerve block
Transcutaneous electric nerve stimulation
Suprascapular nerve
Shoulder joint
Periarthritis
