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针刀治疗肩周炎:1例病例报告

Acupotomy for adhesive capsulitis of the shoulder: A case report.

作者信息

Hu Zehao, Huang Qiuxuan, Li Zhanxin

机构信息

Shantou Hospital of Traditional Chinese Medicine, Guangzhou University of Traditional Chinese Medicine, Shantou, China.

Graduate School of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China.

出版信息

Medicine (Baltimore). 2025 Aug 22;104(34):e44115. doi: 10.1097/MD.0000000000044115.

DOI:10.1097/MD.0000000000044115
PMID:40859541
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12384796/
Abstract

RATIONALE

Adhesive capsulitis of the shoulder (ACS) is a pathological condition characterized by chronic inflammation and fibrosis of the glenohumeral joint capsule and surrounding soft tissues, leading to capsular adhesion and stiffness. Its hallmark clinical manifestations include progressive pain and restricted active/passive range of motion. Acupotomy therapy, which integrates traditional Chinese meridian tendon theory with modern biomechanical principles, achieves minimally invasive adhesion release and biomechanical balance restoration. This article presents a successfully treated case of adhesive shoulder capsulitis using acupotomy.

PATIENT CONCERNS

The patient, a 52-year-old male, presented with persistent pain in the left shoulder accompanied by restricted joint mobility and evident muscle atrophy.

DIAGNOSES

The patient was diagnosed with ACS on November 15, 2024.

INTERVENTIONS

Acupotomy was performed to release adhesions in the glenohumeral joint capsule, coracohumeral ligament, and periarticular muscle groups, followed by postoperative joint mobilization and resistance training.

OUTCOMES

Therapeutic outcomes were evaluated using range of motion, Visual Analog Scale (VAS) for pain, and imaging studies. Immediately after treatment, passive abduction improved to 150° with the VAS score decreasing from 7 to 5; at the 6-week follow-up, active abduction had recovered to 160° with the VAS score stabilized at 2.

LESSONS

Acupotomy therapy provides a safe and effective solution for moderate-to-severe frozen shoulder through its stepwise intervention protocol of "adhesion release-dynamic stabilization-functional remodeling," which restores shoulder biomechanical homeostasis in a minimally invasive manner.

摘要

理论依据

肩周炎(ACS)是一种病理状态,其特征为盂肱关节囊及周围软组织的慢性炎症和纤维化,导致关节囊粘连和僵硬。其标志性临床表现包括进行性疼痛和主动/被动活动范围受限。针刀疗法将中医经络肌腱理论与现代生物力学原理相结合,实现微创粘连松解和生物力学平衡恢复。本文介绍了一例使用针刀成功治疗肩周炎的病例。

患者情况

患者为一名52岁男性,出现左肩持续性疼痛,伴有关节活动受限和明显的肌肉萎缩。

诊断

该患者于2024年11月15日被诊断为肩周炎。

干预措施

进行针刀治疗以松解盂肱关节囊、喙肱韧带和关节周围肌肉群的粘连,术后进行关节活动和抗阻训练。

结果

使用活动范围、视觉模拟疼痛量表(VAS)和影像学检查评估治疗效果。治疗后立即观察到,被动外展改善至150°,VAS评分从7分降至5分;在6周随访时,主动外展恢复至160°,VAS评分稳定在2分。

经验教训

针刀疗法通过“粘连松解-动态稳定-功能重塑”的逐步干预方案,为中重度冻结肩提供了一种安全有效的解决方案,以微创方式恢复肩部生物力学稳态。

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本文引用的文献

1
Factors associated with frozen shoulder in adults: a retrospective study.成人冻结肩相关因素的回顾性研究。
BMC Musculoskelet Disord. 2024 Jun 26;25(1):493. doi: 10.1186/s12891-024-07614-8.
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Adhesive Capsulitis.粘连性肩关节囊炎。
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Association between adhesive capsulitis and thyroid disease: a meta-analysis.粘连性肩关节囊炎与甲状腺疾病的相关性:一项荟萃分析。
J Shoulder Elbow Surg. 2023 Jun;32(6):1314-1322. doi: 10.1016/j.jse.2023.01.033. Epub 2023 Mar 4.
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In different shoulder pathologies, three different treatments can be performed with one needle under ultrasound guidance: technical advice.在不同的肩部病变中,在超声引导下用一根针可进行三种不同的治疗:技术建议。
Med Ultrason. 2021 Feb 18;23(1):115-116. doi: 10.11152/mu-2885.
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The puzzling pathophysiology of frozen shoulders - a scoping review.肩周炎令人费解的病理生理学——一项范围综述
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[Acupoint position and manipulation of needle knife treating shoulder bi syndrome].针刀治疗肩周炎的穴位定位与操作
Zhongguo Zhen Jiu. 2016 Mar;36(3):299-302.
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Diabetes mellitus and accompanying hyperlipidemia are independent risk factors for adhesive capsulitis: a nationwide population-based cohort study (version 2).糖尿病和伴随的高脂血症是粘连性肩关节囊炎的独立危险因素:一项全国范围内基于人群的队列研究(第 2 版)。
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