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[1]孫旗,姜孟家,王淑斌,等.針刺療法預防肱骨近端骨折內固定術后肩關節(jié)功能障礙的臨床研究[J].中醫(yī)正骨,2016,28(04):29-32.
　SUN Qi,JIANG Mengjia,WANG Shubin,et al.A clinical study of acupuncture therapy for prevention of shoulder dysfunction after internal fixation of proximal humeral fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):29-32.
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針刺療法預防肱骨近端骨折內固定術后肩關節(jié)功能障礙的 臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年04期
頁碼:
29-32
欄目:
臨床研究
出版日期:
2016-04-20

文章信息/Info

Title:
A clinical study of acupuncture therapy for prevention of shoulder dysfunction after internal fixation of proximal humeral fractures
作者:
孫旗; 姜孟家; 王淑斌; 鄭晨穎; 賈育松
北京中醫(yī)藥大學東直門醫(yī)院,北京 100700
Author(s):
SUN Qi; JIANG Mengjia; WANG Shubin; ZHENG Chenying; JIA Yusong
Dongzhimen hospital of Beijing University of Traditional Chinese Medicine,Beijing 100700,China
關鍵詞:
肱骨骨折;  肩骨折;  針刺療法;  電刺激療法;  臨床試驗
Keywords:
humeral fractures;  shoulder fractures;  acupuncture therapy;  electric stimulation therapy;  clinical trial
摘要:
目的:觀察針刺療法預防肱骨近端骨折內固定術后肩關節(jié)功能障礙的臨床療效。方法:將符合要求的44例肱骨近端骨折患者隨機分為2組,行切開復位內固定術。自術后1 d起,指導患者進行肩關節(jié)功能鍛煉。術后2周切口愈合后,在功能鍛煉基礎上分別采用針刺療法(24例)和中頻電療法(20例)治療,均每周治療3次,連續(xù)治療12周。分別于術后1周、12周、24周行X線檢查,觀察骨折愈合情況。比較2組患者術前及術后1周、4周、12周和24周的改良Constant-Murley肩關節(jié)功能評分,改良評分=健側肩關節(jié)功能評分-患側肩關節(jié)功能評分。結果:X線檢查顯示,術后1周骨折復位及內固定滿意; 術后12周骨折線模糊,有骨痂形成; 術后24周骨折均達到骨性愈合。手術前后不同時間點改良Constant-Murley評分比較,差異有統(tǒng)計學意義,存在時間效應(F=3428.676,P=0.000); 2組患者改良Constant-Murley評分比較,組間差異有統(tǒng)計學意義,存在分組效應(F=-2.195,P=0.029); 術前及術后1周2組患者的改良Constant-Murley評分比較,組間差異均無統(tǒng)計學意義[(87.4±6.8)分,(89.1±7.3)分,t=0.799,P=0.429;(83.7±4.7)分,(81.2±4.1)分,t=1.842,P=0.073]; 術后4周、12周和24周,針刺治療組的改良Constant-Murley評分均低于中頻電療組[(51.7±4.9)分,(65.4±4.5)分,t=-9.611,P=0.000;(17.6±2.0)分,(34.7±2.7)分,t=-24.281,P=0.000;(9.7±1.5)分,(17.9±1.6)分,t=-17.514,P=0.000]; 時間因素和分組因素存在交互效應(F=10.000,P=0.001)。結論:針刺療法可以有效預防肱骨近端骨折內固定術后肩關節(jié)功能障礙,其效果優(yōu)于中頻電療法,可以作為一種輔助方法進行推廣應用。
Abstract:
Objective:To observe the preventative effect of acupuncture therapy on shoulder dysfunction after internal fixation of proximal humeral fractures.Methods:Forty-four patients with proximal humeral fractures enrolled in the study were randomly divided into 2 groups and were treated with open reduction internal fixation.Shoulder functional exercises were performed with guidance from doctors since 1 day after the treatment.Moreover,the patients were treated with acupuncture therapy(24 cases)and medium frequency electrotherapy(20 cases)respectively after the operative incision healing at 2 weeks after the surgery,3 times a week for consecutive 12 weeks.The X-ray examination were performed at 1,12 and 24 weeks after the surgery,and the fracture healing were observed.The improved Constant-Murley shoulder scores were compared between the 2 groups before the surgery and at 1,4,12 and 24 weeks after the surgery.The improved scores were equal to the difference of scores between uninjured shoulder and injured shoulder.Results:The X-ray examination showed(1)the fracture reduction and internal fixation were satisfactory at 1 week after the surgery;(2)the fracture lines were fuzzy and the bony callus were found at 12 weeks after the surgery;(3)the bone union were achieved at 24 weeks after the surgery.There was statistical difference in the improved Constant-Murley scores between different timepoints,in other words,there was time effect(F=3428.676,P=0.000).There was statistical difference in the improved Constant-Murley scores between the 2 groups,in other words,there was group effect(F=-2.195,P=0.029).There was no statistical difference in the improved Constant-Murley scores between the 2 groups before the surgery and at 1 week after the surgery(87.4+/-6.8 vs 89.1+/-7.3 points,t=0.799,P=0.429; 83.7+/-4.7 vs 81.2+/-4.1 points,t=1.842,P=0.073).The improved Constant-Murley scores were lower in acupuncture therapy group compared to medium frequency electrotherapy group at 4,12 and 24 weeks after the surgery(51.7+/-4.9 vs 65.4+/-4.5 points,t=-9.611,P=0.000; 17.6+/-2.0 vs 34.7+/-2.7 points,t=-24.281,P=0.000; 9.7+/-1.5 vs 17.9+/-1.6 points,t=-17.514,P=0.000).There was interaction between time factor and grouping factor(F=10.000,P=0.001).Conclusion:The acupuncture therapy can effectively prevent shoulder dysfunction after internal fixation of proximal humeral fractures,and its curative effect is better than that of medium frequency electrotherapy,so it is worthy of popularizing in clinic as an auxiliary method.

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備注/Memo

備注/Memo:
通訊作者:姜孟家 E-mail:[email protected]
更新日期/Last Update: 2016-08-30