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基层医疗中肩胛上神经阻滞治疗肩周炎的随机试验。

Suprascapular nerve block for the treatment of frozen shoulder in primary care: a randomized trial.

作者信息

Jones D S, Chattopadhyay C

机构信息

Wrightington Hospital, Wigan.

出版信息

Br J Gen Pract. 1999 Jan;49(438):39-41.

Abstract

BACKGROUND

Frozen shoulder is a common problem in general practice, but its treatment is difficult since none of the currently used therapies are proven to be effective.

AIM

To assess the effectiveness of suprascapular nerve block to relieve pain and improve range of movement, and its suitability for use in primary care. This small study by a single practitioner aims to justify a larger multicentred trial.

METHOD

A randomized trial of 30 patients to compare a single suprascapular nerve block with a course of intra-articular injections. Patients' pain levels and ranges of movement were assessed over a 12-week period.

RESULTS

Suprascapular nerve block produced a faster and more complete resolution of pain and restoration of range of movement than a series of intra-articular injections. These differences were confirmed by statistical analysis using the Mann-Whitney U-test (P < 0.01 for pain levels and P < 0.05 for range of abduction and external rotation.)

CONCLUSIONS

This study suggests that suprascapular nerve block is a safe and effective treatment for frozen shoulder in primary care, and justifies a larger multicentred trial using independent blinded assessment. Such a study should include a third group treated by suprascapular nerve block without steroid; a more comprehensive assessment of patient debility.

摘要

背景

肩周炎是全科医疗中的常见问题,但由于目前所采用的治疗方法均未被证实有效,其治疗存在困难。

目的

评估肩胛上神经阻滞缓解疼痛及改善活动范围的有效性,以及其在基层医疗中的适用性。这项由单一从业者开展的小型研究旨在为规模更大的多中心试验提供依据。

方法

对30例患者进行随机试验,比较单次肩胛上神经阻滞与关节内注射疗程的效果。在12周内评估患者的疼痛程度和活动范围。

结果

与一系列关节内注射相比,肩胛上神经阻滞能更快、更完全地缓解疼痛并恢复活动范围。使用曼-惠特尼U检验进行的统计分析证实了这些差异(疼痛程度P<0.01,外展和外旋活动范围P<0.05)。

结论

本研究表明,肩胛上神经阻滞是基层医疗中治疗肩周炎的一种安全有效的方法,为采用独立盲法评估的更大规模多中心试验提供了依据。这样的研究应包括第三组接受无类固醇肩胛上神经阻滞治疗的患者;对患者虚弱状况进行更全面的评估。

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