Gao Ling, Li Xiao, Wang Dong-Bin, Du Mei-Lu, Xie Jin, Gao Xi-Yan
Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437.
School of Acupuncture-moxibustion and Tuina, Henan University of Traditional Chinese Medicine, Zhengzhou 450008; The Third Affiliated Hospital, Henan University of Traditional Chinese Medicine, Zhengzhou 450008.
Zhen Ci Yan Jiu. 2019 Apr 25;44(4):297-301. doi: 10.13702/j.1000-0607.170817.
To compare the clinical therapeutic effect of intensive moxibustion plus acupuncture and simple acupuncture therapy in the treatment of frozen shoulder so as to provide a reference for clinical practice.
A total of 60 patients with frozen shoulder were randomly divided into intensive moxibustion plus acupuncture group and simple acupuncture group (=30 per group). Acupoints Jianyu (LI15), Jianzhen (SI9), Jianliao (TE14), Tiaokou (ST38), Chengshan (BL57) and Ashi points (Extra) were punctured with filiform needles which were manipulated till the patients experienced feelings of soreness and distension in the local region, followed by retaining the needles for 40 min. For patients of the moxibustion plus acupuncture group, after acupuncture, an ignited moxa-stick segment was applied to the affected shoulder for 40-50 min. After the treatment, all patients were ordered to make a shoulder exercise (anteflexion, rear protraction, abduction and upthrow movements, etc.). The visual analogue scale (VAS) was used to assess the pain severity, and the Constant-Murley shoulder assessment scale (the total score is 100 points, including 15 points in pain severity and 20 points in daily living activities, 40 points in joint motion range, and 25 points in myodynamia) used to assess the functional state of the shoulder, and the "Standards for Diagnosis and Therapeutic Effect Evaluation of Diseases of Traditional Chinese Medicine"(1994) were employed to evaluate the therapeutic effect.
Following the treatment, intra-group comparison showed that the VAS score was significantly reduced in both groups in comparison with their own pre-treatment (<0.05), and the total scores of Constant-Murley scale, the scores of activities of daily living and active motion range, as well as the scores of pain integration and myodynamia, were all considerably increased in the two groups in comparison with their own pre-treatment (all <0.05). The therapeutic effect of the moxibustion plus acupuncture was significantly superior to that of the simple acupuncture in reducing VAS score and increasing total score of Constant-Murley scale, and scores of activities of daily living and active motion range, as well as the scores of pain integration (<0.05). Of the two 29 cases in the moxibustion plus acupuncture and simple acupuncture groups, 19 (65.52%) and 10 (34.48%) were cured, 8 (27.58%) and 12 (41.38%) experienced improvement, 2 (6.90%) and 7 (24.14%) were failed, with the effective rate being 93.10% and 75.86%, respectively. The therapeutic effective rate of the moxibustion plus acupuncture was evidently higher than that of the simple acupuncture (<0.05)..
The therapeutic effect of intensive moxibustion plus acupuncture is superior to that of simple acupuncture in improving symptoms of frozen shoulder in patients.
比较密集艾灸联合针刺与单纯针刺疗法治疗肩周炎的临床疗效,为临床实践提供参考。
将60例肩周炎患者随机分为密集艾灸联合针刺组和单纯针刺组(每组30例)。采用毫针针刺肩髃(LI15)、肩贞(SI9)、肩髎(TE14)、条口(ST38)、承山(BL57)及阿是穴(奇穴),行针至患者局部有酸麻胀感,留针40分钟。艾灸联合针刺组患者针刺后,将点燃的艾条段置于患侧肩部熏烤40 - 50分钟。治疗后,嘱所有患者进行肩部运动(前屈、后伸、外展及上举等动作)。采用视觉模拟评分法(VAS)评估疼痛程度,采用Constant-Murley肩关节评估量表(总分100分,其中疼痛程度15分,日常生活活动20分,关节活动范围40分,肌力25分)评估肩关节功能状态,并参照《中医病证诊断疗效标准》(1994年)评价疗效。
治疗后,组内比较显示,两组VAS评分均较治疗前显著降低(P<0.05),两组Constant-Murley量表总分、日常生活活动评分、主动活动范围评分以及疼痛积分和肌力评分均较治疗前显著提高(均P<0.05)。艾灸联合针刺组在降低VAS评分、提高Constant-Murley量表总分、日常生活活动评分、主动活动范围评分以及疼痛积分方面的疗效显著优于单纯针刺组(P<0.05)。艾灸联合针刺组和单纯针刺组各29例患者中,治愈分别为19例(65.52%)和10例(34.48%),好转分别为8例(27.58%)和12例(41.38%),未愈分别为2例(6.90%)和7例(24.14%),有效率分别为93.10%和75.86%。艾灸联合针刺组的治疗有效率明显高于单纯针刺组(P<0.05)。
密集艾灸联合针刺治疗肩周炎患者的疗效优于单纯针刺。