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[1]徐平,陳選寧,張漢慶,等.椅背屈肘復(fù)位法與手牽足蹬復(fù)位法治療肩關(guān)節(jié)前脫位的療效比較[J].中醫(yī)正骨,2018,30(12):9-12.
　XU Ping,CHEN Xuanning,ZHANG Hanqing,et al.A clinical comparison of chair-back-bent-elbow reduction versus Hippocrates reduction for treatment of anterior dislocation of shoulder joints[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(12):9-12.
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椅背屈肘復(fù)位法與手牽足蹬復(fù)位法治療肩關(guān)節(jié)前脫位的療效比較()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年12期
頁碼:
9-12
欄目:
臨床研究
出版日期:
2018-12-20

文章信息/Info

Title:
A clinical comparison of chair-back-bent-elbow reduction versus Hippocrates reduction for treatment of anterior dislocation of shoulder joints
作者:
徐平; 陳選寧; 張漢慶; 董曉俊; 奚海翔; 李彥錦; 魯周同
(湖北省武漢市中醫(yī)醫(yī)院,湖北 武漢 430014)
Author(s):
XU Ping; CHEN Xuanning; ZHANG Hanqing; DONG Xiaojun; XI Haixiang; LI Yanjin; LU Zhoutong
Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430014,Hubei,China
關(guān)鍵詞:
肩脫位;  肩關(guān)節(jié);  正骨手法;  椅背屈肘復(fù)位法;  手牽足蹬復(fù)位法;  臨床試驗(yàn)
Keywords:
shoulder dislocation;  shoulder joint;  bone setting manipulation;  chair-back-bent-elbow reduction;  Hippocrates reduction;  clinical trial
摘要:
目的:比較椅背屈肘復(fù)位法與手牽足蹬復(fù)位法治療肩關(guān)節(jié)前脫位的臨床療效。方法:將60例肩關(guān)節(jié)前脫位患者隨機(jī)分為2組,每組30例。分別采用椅背屈肘復(fù)位法和手牽足蹬復(fù)位法治療,復(fù)位結(jié)束后肩關(guān)節(jié)均外敷中藥截血膏,每日1次,連續(xù)外敷1周。比較2組患者的一次復(fù)位成功率、復(fù)位時(shí)間、復(fù)位過程中肩部疼痛視覺模擬量表(visual analogue scale,VAS)評分及Constant-Murley肩關(guān)節(jié)功能評分。結(jié)果:椅背屈肘組30例患者均一次復(fù)位成功,手牽足蹬組30例患者中9例未一次復(fù)位成功,二次復(fù)位時(shí)采用了丙泊酚靜脈麻醉。椅背屈肘組的一次復(fù)位成功率高于手牽足蹬組(χ2=10.588,P=0.001),復(fù)位時(shí)間短于手牽足蹬組[(1.80±1.20)min,(4.50±2.10)min,t=-6.120,P=0.021],復(fù)位過程中肩部疼痛VAS評分低于手牽足蹬組[(3.13±0.57)分,(6.24±1.11)分,t=-13.650,P=0.015]。所有患者均獲隨訪,隨訪時(shí)間2～8個(gè)月,中位數(shù)5個(gè)月。末次隨訪時(shí),2組患者的Constant-Murley肩關(guān)節(jié)功能評分比較,椅背屈肘組的疼痛評分高于手牽足蹬組[(13.51±2.10)分,(12.12±1.81)分,t=2.746,P=0.012],2組患者的日常活動(dòng)能力評分、肩關(guān)節(jié)活動(dòng)度評分、肌力評分、總分的組間差異均無統(tǒng)計(jì)學(xué)意義[(17.11±2.20)分,(16.48±1.23)分,t=-1.369,P=0.280;(35.21±3.25)分,(35.65±3.12)分,t=0.726,P=0.276;(23.36±1.13)分,(22.12±1.77)分,t=-3.234,P=0.721;(90.34±5.28)分,(87.82±3.60)分,t=-2.160,P=0.122]。結(jié)論:采用椅背屈肘復(fù)位法治療肩關(guān)節(jié)前脫位,比采用手牽足蹬復(fù)位法復(fù)位時(shí)間短、一次復(fù)位成功率高、患者肩部疼痛程度輕,但兩種方法治療后患者的肩關(guān)節(jié)功能恢復(fù)無差異。
Abstract:
Objective:To compare the clinical curative effects of chair-back-bent-elbow reduction versus Hippocrates reduction for treatment of anterior dislocation of shoulder joints.Methods:Sixty patients with anterior dislocation of shoulder joints were randomly divided into 2 groups,30 cases in each group,and were treated with chair-back-bent-elbow reduction(group A)and Hippocrates reduction(group B)respectively.After the reduction,the traditional Chinese medicine Jiexuegao(截血膏)was externally applied to the shoulder joints of patients in the 2 groups,once a day for consecutive 1 week.The success rate of one-time reduction,reduction time,shoulder pain visual analogue scale(VAS)scores during the reduction process and constant-murley shoulder function scores were compared between the 2 groups.Results:The one-time reduction was finished successfully in all patients of group A and unfinished successfully in 9 patients of group B,and the second reduction was performed under the intravenous anesthesia with propofol.The success rate of one-time reduction was higher,the reduction time was shorter and the shoulder pain VAS scores during the reduction process were lower in group A compared to group B(χ2=10.588,P=0.001; 1.80+/-1.20 vs 4.50+/-2.10 minutes,t=-6.120,P=0.021; 3.13+/-0.57 vs 6.24+/-1.11 points,t=-13.650,P=0.015).All patients in the 2 groups were followed up for 2-8 months with a median of 5 months.At the last follow-up,the evaluation results of constant-murley shoulder function scores showed that the pain scores were higher in group A compard to group B(13.51+/-2.10 vs 12.12+/-1.81 points,t=2.746,P=0.012)and there was no statistical difference in activity of daily living(ADL)scores,shoulder range of motion(ROM)scores,muscle strength scores and total scores between the 2 groups(17.11+/-2.20 vs 16.48+/-1.23 points,t=-1.369,P=0.280; 35.21+/-3.25 vs 35.65+/-3.12 points,t=0.726,P=0.276; 23.36+/-1.13 vs 22.12+/-1.77 points,t=-3.234,P=0.721; 90.34+/-5.28 vs 87.82+/-3.60 points,t=-2.160,P=0.122).Conclusion:The chair-back-bent-elbow reduction has such advantages as shorter reduction time,higher success rate of one-time reduction and lower degree of shoulder pain compared to Hippocrates reduction in treatment of anterior dislocation of shoulder joints.However,there is no difference between the two therapies in posttreatment shoulder function recovery.

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通訊作者:徐平 E-mail:[email protected](收稿日期:2018-08-29 本文編輯:郭毅曼)
更新日期/Last Update: 2019-05-30