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多学科团队中西医结合在接受关节镜手术的肩袖损伤患者中的应用。

Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery.

作者信息

Cao Di-Ping, Yin Lei, Wang Yi-Fei, Liu Bing-Li

机构信息

Department of Orthopedics, The Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China.

出版信息

World J Clin Cases. 2024 Jul 6;12(19):3767-3775. doi: 10.12998/wjcc.v12.i19.3767.

Abstract

BACKGROUND

Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries (RCIs). Although this procedure has certain clinical advantages, it requires rehabilitation management interventions to ensure therapeutic efficacy.

AIM

To investigate the effect of integrated traditional Chinese medicine and Western medicine (TCM-WM) under the multidisciplinary team (MDT) model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs.

METHODS

This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024. They were divided into a control group ( = 48) that received routine rehabilitation treatment and an experimental group ( = 52) that received TCM-WM under the MDT model (, acupuncture, TCM traumatology and orthopedics, and rehabilitation). The results of the Constant-Murley Shoulder Score (CMS), Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), muscular strength evaluation, and shoulder range of motion (ROM) assessments were analyzed.

RESULTS

After treatment, the experimental group showed significantly higher CMS scores in terms of pain, functional activity, shoulder joint mobility, and muscular strength than the baseline and those of the control group. The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group. In addition, the experimental group showed significantly enhanced muscular strength (forward flexor and external and internal rotator muscles) and shoulder ROM (forward flexion, abduction, and lateral abduction) after treatment compared with the control group.

CONCLUSION

TCM-WM under the MDT model improved shoulder joint function, relieved postoperative pain, promoted postoperative functional recovery, and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.

摘要

背景

关节镜下肩袖修复术是治疗肩袖损伤(RCI)的一种常见外科手术。尽管该手术具有一定的临床优势,但仍需要康复管理干预措施以确保治疗效果。

目的

探讨多学科团队(MDT)模式下中西医结合对接受关节镜下RCI手术患者术后恢复的影响。

方法

本研究纳入了2021年6月至2024年5月期间在上海中医药大学附属第七人民医院接受关节镜下肩袖修复术治疗RCI的100例患者。将他们分为对照组(n = 48),接受常规康复治疗;以及实验组(n = 52),接受MDT模式下的中西医结合治疗(包括针灸、中医骨伤科和康复治疗)。分析了Constant-Murley肩关节评分(CMS)、视觉模拟量表(VAS)、肩痛和功能障碍指数(SPADI)、肌肉力量评估以及肩关节活动范围(ROM)评估的结果。

结果

治疗后,实验组在疼痛、功能活动、肩关节活动度和肌肉力量方面的CMS评分显著高于基线水平及对照组。实验组的VAS和SPADI评分也显著低于基线水平及对照组。此外,与对照组相比,治疗后实验组的肌肉力量(前屈肌、外旋肌和内旋肌)和肩关节ROM(前屈、外展和外旋)显著增强。

结论

MDT模式下的中西医结合改善了接受关节镜下肩袖修复术的RCI患者的肩关节功能,减轻了术后疼痛,促进了术后功能恢复,并有助于肌肉力量和肩关节ROM的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a5/11235447/5a78bea41d13/WJCC-12-3767-g001.jpg

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