桂枝附子汤加减联合中频导入治疗寒湿痹阻型肩周炎对功能康复的影响

娄飞; 蒋翠蕾; 张建东; 周莹

doi:10.13422/j.cnki.syfjx.2017030165

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桂枝附子汤加减联合中频导入治疗寒湿痹阻型肩周炎对功能康复的影响

临床 | 更新时间：2024-01-04

- 桂枝附子汤加减联合中频导入治疗寒湿痹阻型肩周炎对功能康复的影响
- Effect of Modified Guizhi Fuzi Tang Combined with Intermediate Frequency Induction Therapy in Treating Scapulohumeral Periarthritis with Cold Dampness
- 中国实验方剂学杂志 2017年23卷第3期页码：165-169
- 作者机构：
- 作者简介：
- 基金信息：
  
  山东中医药科学技术项目（Z-2015-3-58-2）
- DOI：10.13422/j.cnki.syfjx.2017030165
  中图分类号： R274.9
- 纸质出版日期：2017
- 稿件说明：
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娄飞, 蒋翠蕾, 张建东, 等. 桂枝附子汤加减联合中频导入治疗寒湿痹阻型肩周炎对功能康复的影响[J]. 中国实验方剂学杂志, 2017,23(3):165-169.

LOU Fei, JIANG Cui-lei, ZHANG Jian-dong, et al. Effect of Modified Guizhi Fuzi Tang Combined with Intermediate Frequency Induction Therapy in Treating Scapulohumeral Periarthritis with Cold Dampness[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(3): 165-169.
娄飞, 蒋翠蕾, 张建东, 等. 桂枝附子汤加减联合中频导入治疗寒湿痹阻型肩周炎对功能康复的影响[J]. 中国实验方剂学杂志, 2017,23(3):165-169. DOI： 10.13422/j.cnki.syfjx.2017030165.

LOU Fei, JIANG Cui-lei, ZHANG Jian-dong, et al. Effect of Modified Guizhi Fuzi Tang Combined with Intermediate Frequency Induction Therapy in Treating Scapulohumeral Periarthritis with Cold Dampness[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(3): 165-169. DOI： 10.13422/j.cnki.syfjx.2017030165.

摘要

目的：探讨桂枝附子汤加减中频导入治疗寒湿痹阻型肩周炎的镇痛效应和对肩关节功能恢复的疗效及作用机制。方法：将136例患者按随机数字表法分为对照组和观察组，各68例。两组均参照指南进行肩部功能锻炼，对照组用中频电疗法，采用连续模式，20 min/次，1次/d，6次/周。观察组则采用桂枝附子汤加减中频导入，20 min/次，1次/d，6次/周。采用McGill疼痛问卷（SF-MPQ）评价疼痛情况，采用Constant-Murley评分肩关节功能；日常活动评价采用美国肩与肘协会评分系统（ASES）肩关节功能评价量表，检测治疗前后血浆P物质（SP），白细胞介素-10（IL-10），肿瘤坏死因子-α（TNF-α），前列腺素E2（PGE2）水平；进行治疗前后寒湿痹阻证评分。结果：观察组临床疗效总有效率为95.31%，对照组为81.97%，观察组优于对照组（P<0.05）；治疗后观察组SF-MPQ的3个维度及总分均低于对照组（P<0.01）；治疗后观察组疼痛、日常生活活动、肩关节活动度和总分高于对照组（P<0.01）；治疗后观察组寒湿痹阻证评分低于对照组（P<0.01）；治疗后观察组SP，TNF-α，PGE2水平低于对照组，IL-10水平高于对照组（P<0.01）。结论：在功能锻炼的基础上，采用附子汤加减中频导入治疗寒湿痹阻型肩周炎能进一步的减轻疼痛、改善寒湿痹阻症状，能增加关节活动度，改善关节功能，临床疗效显著且安全，其作用机制可能是通过调节炎症介质和下调SP和PGE2水平来实现。

Abstract

Objective: To discuss the analgesic effect of modified Guizhi Fuzi Tang combined with intermediate frequency induction therapy in treating scapulohumeral periarthritis with cold dampness

and the mechanism of action on recovery of shoulder joint function. Method: One hundred and thirty-six patients were randomly divided into control group (68 cases) and observation group (68 cases) by random number table. Both groups took shoulder functional exercise according to guide. Patients in control group were also provided intermediate frequency induction therapy in continuous mode

20 min/time

1 time/day

6 times/week. And patients in observation group were also given modified Guizhi Fuzi Tang combined with intermediate frequency induction therapy

20 min/time

1 time/day

6 times/week. Pain was evaluated by MeGill Pain Questionnaire (SF-MPQ). Shoulder joint function was scored by Constant-Murley. Daily activities were evaluated by American Shoulder and Elbow Surgeons' Form (ASES) shoulder joint function evaluation scale. Before and after treatment

levels of substance P (SP)

interleukin-10 (IL-10)

tumor necrosis factor-α (TNF-α)

prostaglandin E2 (PGE2) were detected. And cold dampness was scored. Result: The total rate of clinical effect in observation group was 95.31%

which was higher than 81.97% in control group (P<0.05). The three dimensions of SF-MPQ and the total score and cold dampness in observation group were lower than those in control group (P<0.01). And scores of pain

activities of daily living and range of motion and the total scores in observation group were higher than those in control group (P<0.01). After treatment

levels of SP

TNF-α and PGE2 were lower than those in control group (P<0.01)

and level of IL-10 was higher than that in control group (P<0.01). Conclusion: In addition to functional exercise

modified Guizhi Fuzi Tang combined with intermediate frequency induction therapy can relieve pain

ameliorate cold dampness

improve function of joint and joint range of motion

and the mechanism of action may be regulating inflammatory mediators and reducing levels of SP and PGE2.

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