[1]丁立鹏,余佳程,蒋文钰,等.麻醉下石氏伤科松解术治疗冻结肩对肩部重要肌腱和韧带弹性的影响[J].中国中医骨伤科杂志,2024,32(10):13-18+25.[doi:10.20085/j.cnki.issn1005-0205.241003]
　DING Lipeng,YU Jiacheng,JIANG Wenyu,et al.Effect of Shi's Traumatology Treatment of Frozen Shoulder for Loosening Procedure under Anesthesia on the Key Shoulder Tendons and Ligaments[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(10):13-18+25.[doi:10.20085/j.cnki.issn1005-0205.241003]
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麻醉下石氏伤科松解术治疗冻结肩对肩部重要肌腱和韧带弹性的影响()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年10期
页码:
13-18+25
栏目:
临床研究
出版日期:
2024-10-15

文章信息/Info

Title:
Effect of Shi's Traumatology Treatment of Frozen Shoulder for Loosening Procedure under Anesthesia on the Key Shoulder Tendons and Ligaments
文章编号:
1005-0205(2024)10-0013-06
作者:
丁立鹏1; 余佳程1; 蒋文钰1; 刘永铭1; 熊轶喆1; 王翔1; 詹红生1△
1上海中医药大学附属曙光医院(上海,201203)
Author(s):
DING Lipeng1; YU Jiacheng1; JIANG Wenyu1; LIU Yongming1; XIONG Yizhe1; WANG Xiang1; ZHAN Hongsheng1△
1Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China.
关键词:
冻结肩;  弹性;  麻醉下石氏伤科松解术
Keywords:
frozen shoulder;  elasticity;  Shi's traumatology treatment of frozen shoulder for loosening procedure under anesthesia
分类号:
R686.1
DOI:
10.20085/j.cnki.issn1005-0205.241003
文献标志码:
A
摘要:
目的:探讨麻醉下石氏伤科松解术治疗冻结肩对肩部重要肌腱和韧带弹性的影响。方法:共纳入75例冻结肩单侧发病患者,患侧肩为观察组,健侧肩为对照组,在治疗前、治疗后第2周和第4周对患肩进行Constant-Murley肩关节功能评分和视觉模拟量表(VAS)评分,并使用Supersonic AixPlorer超声诊断仪采集患者双肩冈上肌腱、喙肱韧带、冈下肌腱的弹性模量值。采用中位数和四分位数距来描述数据的统计特征; 采用配对样本秩和检验来进行假设检验,比较治疗前健侧肩和患侧肩之间弹性模量值的差异; 采用Spearman相关性分析法分析弹性模量值与Constant-Murley肩关节功能评分的相关性。结果:治疗前患侧肩和健侧肩弹性模量值差异有统计学意义(P<0.001); 患者的Constant-Murley肩关节功能评分在治疗后有所提升,VAS评分明显下降,差异有统计学意义(P<0.05); 患侧肩弹性模量值与肩关节功能评分负相关(P<0.001)。结论:冻结肩患者患肩的冈上肌腱、喙肱韧带、冈下肌腱相对于健肩弹性模量值有所升高; 麻醉下石氏伤科松解术可以提高冻结肩患者的肩关节功能,改善患者疼痛情况,改善肩关节组织弹性。
Abstract:
Objective:To investigate the effect of Shi's traumatology treatment of frozen shoulder for loosening procedure under anesthesia on the elasticity of key tendons and ligaments of the shoulder.Methods:75 patients with unilateral onset of frozen shoulder were included in this study,with the affected shoulder as the observation group and the healthy shoulder as the control group.Constant-Murley shoulder function scores and visual analogue scale(VAS)scores were performed on the affected shoulders before treatment,2 weeks and 4 weeks after treatment,and the Young's modulus values of the supraspinatus tendon,rostro-humeral ligament,and infraspinatus tendon of the patients' bilateral shoulders were collected using Supersonic AixPlorer ultrasonic diagnostic instrument.Median and interquartile distance were used to characterize the statistics of the data.The paired-samples rank-sum test was used for hypothesis testing to compare the differences in Young's modulus values between the healthy and affected shoulders before treatment.Spearman correlation analysis was used to correlate Young's modulus values with Constant-Murley shoulder function scores.Results:The difference in Young's modulus values between the affected shoulder and the healthy shoulder before treatment was statistically significant(P<0.001).After treatment,the patients' Constant-Murley shoulder function scores improved,and the VAS scores decreased significantly,with a statistically significant difference(P<0.05).The Young's modulus values of the affected shoulder were negatively correlated with the shoulder function scores(P< 0.001).Conclusion:The Young's modulus of supraspinatus tendon,rostro-humeral ligament,and infraspinatus tendon of the affected shoulder in patients with frozen shoulder had elevated values relative to that of the healthy shoulder.Shi's traumatology treatment of frozen shoulder for loosening procedure under anesthesia can improve the shoulder function of patients with frozen shoulder,improve the patient's pain,and improve the elasticity of the shoulder joint tissues.

参考文献/References:

[1] 冻结肩诊疗的多学科合作中国专家共识编写专家组.冻结肩诊疗的多学科合作中国专家共识(2023版)[J].中华疼痛学杂志,2023,19(5):727-737.
[2] 王艳华,陈建海.凝肩:ISAKOS上肢委员会专家共识(下)[J].中华肩肘外科电子杂志,2017,5(1):61-65.
[3] 李会会,王翔,熊轶喆,等.臂丛麻醉下石氏手法松解术治疗继发性凝肩临床疗效观察[J].辽宁中医药大学学报,2022,24(8):172-177.
[4] 王芮花,张景锋,张天,等.超声剪切波弹性成像技术在冻结肩诊断中的应用价值[J].生物医学工程与临床,2022,26(3):314-320.
[5] 田子睿,姚敏,王拥军,等.中文版Constant-Murley肩关节评分量表的研制与应用[J].中医正骨,2019,31(5):20-21.
[6] CODMAN E A.The shoulder:rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa[M].Boston:Thomas Todd Co,1934:22-25.
[7] NEVIASER T J.Adhesive capsulitis[J].Orthop Clin North Am,1987,18(3):439-444.
[8] 王玥,党晓谦,王坤正,等.原发性冻结肩发病的分子机制及研究现状[J].中华关节外科杂志(电子版),2014,8(1):113-115.
[9] 陆军,王宸.冻结肩的诊疗进展[J].中华关节外科杂志(电子版),2015,9(4):527-531.
[10] OMARI A,BUNKER T D.Open surgical release for frozen shoulder surgical findings and results of the release[J].J Shoulder Elbow Surg,2001,10(4):353-357.
[11] 陈疾忤,陈世益,翟伟韬,等.关节镜下粘连松解术治疗原发性冻结肩[J].中国运动医学杂志,2009,28(1):7-9.
[12] 詹红生,石印玉,张明才,等.基于“骨错缝、筋出槽”病机认识的椎间盘病症诊治新观点[J].上海中医药杂志,2007,41(9):4-6.
[13] 《脊柱筋出槽骨错缝临床诊疗指南》标准化项目专家组.基于德尔菲法构建《脊柱筋出槽疾病诊断标准》专家共识[J].中医正骨,2023,35(3):1-5.
[14] 赵明宇,杨超凡,赵启,等.“筋滞骨错”理论指导下手法治疗粘连期肩凝症[J].中医正骨,2016,28(4):57-58.
[15] YUN S J,JIN W,CHO N S,et al.Shear-wave and strain ultrasound elastography of the supraspinatus and infraspinatus tendons in patients with idiopathic adhesive capsulitis of the shoulder:a prospective case-control study[J].Korean J Radiol,2019,20(7):1176-1185.
[16] ICHINOSE R,SANO H,KISHIMOTO K N,et al.Alteration of the material properties of the normal supraspinatus tendon by nicotine treatment in a rat model[J].Acta Orthop,2010,81(1):634-638.
[17] HERBERT R D,CROSBIE J.Rest length and compliance of nonimmobilised and immobilised rabbit soleus muscle and tendon[J].Eur J Appl Physiol Occup Physiol,1997,76(5):472-479.

备注/Memo

备注/Memo:
基金项目:上海市2022年度“科技创新行动计划”医学创新研究专项项目(22Y21920200)
上海市慢性筋骨病临床医学研究中心项目(20MC1920600)
詹红生全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)
△通信作者 E-mail:13918449223@139.com
更新日期/Last Update: 2024-10-05