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1.天津市宁河区医院,天津 301500
2.河北医科大学 附属人民医院,石家庄 050011
3.邯郸市中心医院,河北 邯郸 056001
*贺延雷,硕士,主治医师,从事骨科研究工作,Tel:022-69114281,E-mail:hellee@126.com
收稿日期:2019-11-29,
网络出版日期:2020-02-07,
纸质出版日期:2020-05-20
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贺延雷, 雷芳, 李强, 等. 麻桂温经汤加味联合关节松动术治疗肩周炎血虚寒凝证的临床观察[J]. 中国实验方剂学杂志, 2020,26(10):63-68.
Yan-lei HE, Fang LEI, Qiang LI, et al. Clinical Efficacy of Magui Wenjingtang Combined with Shoulder Joint Loosening Operation in Treating Periarthritis of Shoulder with Syndrome of Blood Deficiency and Cold Coagulation[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(10): 63-68.
贺延雷, 雷芳, 李强, 等. 麻桂温经汤加味联合关节松动术治疗肩周炎血虚寒凝证的临床观察[J]. 中国实验方剂学杂志, 2020,26(10):63-68. DOI: 10.13422/j.cnki.syfjx.20201024.
Yan-lei HE, Fang LEI, Qiang LI, et al. Clinical Efficacy of Magui Wenjingtang Combined with Shoulder Joint Loosening Operation in Treating Periarthritis of Shoulder with Syndrome of Blood Deficiency and Cold Coagulation[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(10): 63-68. DOI: 10.13422/j.cnki.syfjx.20201024.
目的:
2
探讨麻桂温经汤加味联合关节松动术治疗肩周炎血虚寒凝证的临床疗效以及对血流动力学和血清疼痛介质的影响。
方法:
2
筛选2016年7月至2018年7月在天津市宁河区医院诊治的肩周炎患者共有120例,按随机数字表法将患者分为对照组和观察组,每组60例。对照组患者接受关节松动术治疗,每日1次,口服塞来昔布胶囊。观察组在接受关节松动术治疗的基础采取麻桂温经汤加味内服,1剂/d,2次/d。两组患者连续治疗4周后,比较患者的主观疼痛程度McGill疼痛问卷(SF-MPQ)评分,肩关节活动度血流动力学变化,以及血清前列腺素E
2
(PGE
2
),P物质(SP),五羟色胺(5-HT)水平和临床疗效。
结果:
2
与本组治疗前比较,治疗4周后两组患者的视觉疼痛评分(VAS),现在疼痛状况(PPI),疼痛评级指数(PRI)评分明显降低,且观察组显著低于对照组(
P
<
0.01),肩关节活动范围明显高于对照组(
P
<
0.01);与本组治疗前比较,治疗4周后两组患者的红细胞沉降率(ESR),纤维蛋白原(Fb),全血黏度以及血清PGE
2
,SP,5-HT水平显著降低(
P
<
0.01),且观察组显著优于对照组(
P
<
0.01);观察组临床总有效率为96.61%(57/59),明显高于对照组的82.76%(48/58)(
χ
2
=4.685,
P
<
0.05)。
结论:
2
麻桂温经汤加味联合关节松动术治疗肩周炎血虚寒凝证,能有效改善患者的疼痛、肩关节活动度,提高疗效,改善患者的血流动力学和下调疼痛介质PGE
2
,SP,5-HT水平可能与其疗效有关。
Objective:
2
To explore the clinical efficacy of Magui Wenjingtang combined with joint mobilization in the treatment of periarthritis of the shoulder and the effect on hemodynamics and serum pain media.
Method:
2
A total of 120 patients with scapulohumeral periarthritis were enrolled in Tianjin Ninghe Hospital from July 2016 to July 2018.All cases were divided into control group and observation group
with 60 patients in each group. The control group received shoulder joint loosening operation (
qd
)
and celecoxib capsules for oral administration. The observation group was treated with Magui Wenjingtang in addition to the shoulder joint loosening operation
1 dose/d
2 times/d. After 4 weeks of continuous treatment
the subjects were compared for the subjective pain level McGill Pain Questionnaire (SF-MPQ) score
shoulder mobility hemodynamic changes
and serum prostaglandin E
2
(PGE
2
)
substance P (SP)
serotonin (5-HT) level and clinical efficacy.
Result:
2
Compared with before treatment
visual pain score (VAS)
current pain status (PPI)
and pain rating index (PRI) scores of the two groups were significantly lower after 4 weeks of treatment
and those of the observation group was significantly lower than the control group (
P
<
0.01). The range of shoulder joint activity was significantly higher than that of the control group (
P
<
0.01)
erythrocyte sedimentation rate (ESR)
fibrinogen (Fb)
whole blood viscosity and serum were compared between the two groups after 4 weeks of treatment and before treatment. The levels of PGE
2
SP and 5-HT were significantly lower (
P
<
0.01)
and the observation group was significantly better than the control group (
P
<
0.01). The total effective rate of the observation group was 96.61%(57/59)
which was significantly higher than 82.76% (48/58) of the control group(
χ
2
=4.685
P
<
0.05).
Conclusion:
2
Magui Wenjingtang combined with shoulder joint loosening operation in treating periarthritis of shoulder with syndrome of blood deficiency and cold coagulation can effectively improve the pain and shoulder joint mobility
increase the curative effect
and improve the hemodynamics
and down-regulatie pain mediator of PGE
2
SP
5-HT
which may be related to the curative effect.
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