Abstract:

Objective　This study aimed to evaluate the effectiveness of Yuxue Bi tablets combined with warm needle acupuncture in improving shoulder function recovery and pain relief in patients with periarthritis of shoulder. Methods　This randomized controlled trial included 83 patients with periarthritis of shoulder treated at the Department of physiotherapy, Yulin Hospital of the First Affiliated Hospital of Xi'an Jiaotong University, from April 2020 to April 2023. The patients were randomly divided into a control group (41 cases) receiving warm needle acupuncture and an observation group (42 cases) receiving Yuxue Bi tablets combined with warm needle acupuncture, using envelope drawing method. The control group included 27 males and 14 females, the age was (55.84±5.21) years old, the course of disease was (7.91±0.91) months, and the position of shoulder periarthritis was on the left side in 17 cases and right side in 24 cases. The observation group included 31 males and 11 females, the age was (55.88±5.15) years old, the course of disease was (7.94±0.93) months, and the position of shoulder periarthritis was on the left side in 15 cases and right side in 27 cases. The clinical efficacy, shoulder joint function [Range of Motion (ROM) score], levels of pain mediators [serum 5-hydroxytryptamine (5-HT), prostaglandin E2 (PGE2), and substance P (SP)], and Traditional Chinese Medicine (TCM) syndrome scores (joint swelling, joint pain, joint aversion to cold, and joint heaviness) were compared between the two groups after 3 courses of treatment. Independent sample t test and χ² test were used. Results　After 3 courses of treatment, the total effective rate of the observation group [92.86% (39/42)] was higher than that of the control group [75.61% (31/41)], with a statistically significant difference (P<0.05). The anterior flexion [(127.97±13.54)°], abduction [(101.60±10.43)°], posterior extension [(36.26±3.67)°], internal rotation [(52.78±4.99)°], and external rotation range [(54.78±5.06)°] in the observation group were higher than those in the control group [(118.14±12.52)°, (90.18±9.58)°, (28.84±3.59)°, (43.82±4.76)°, and (45.82±4.58)°], with statistically significant differences (all P<0.05). The levels of 5-HT [(5.96±0.63) ng/L], PGE2 [(148.06±15.43) ng/L], and SP [(232.91±23.66) mg/L] in the observation group were lower than those in the control group [(9.52±0.94) ng/L, (184.18±18.50) ng/L, and (280.95±28.50) mg/L], with statistically significant differences (all P<0.05). The scores of joint swelling [(0.51±0.05) points], joint pain [(0.65±0.07) points], joint aversion to cold [(0.49±0.05) points], and joint heaviness [(0.89±0.08) points] in the observation group were all lower than those in the control group [(1.33±0.16) points, (1.72±0.14) points, (1.08±0.10) points, and (1.79±0.18) points], with statistically significant differences (all P<0.05). Conclusions　Yuxue Bi tablets combined with warm needle acupuncture can effectively improve the shoulder joint function and TCM symptom scores in patients with periarthritis of shoulder, and lower their pain mediator levels, thereby enhancing the clinical efficacy. This approach shows promising application prospects.

Key words:

Periarthritis of shoulder, Yuxue Bi tablets, Warm needle acupuncture, Shoulder joint function, Pain mediators

摘要：

目的　评估瘀血痹片联合温针灸治疗对肩周炎患者肩部功能恢复和疼痛缓解的有效性。方法　本研究为随机对照试验，选取2020年4月至2023年4月期间西安交通大学第一附属医院榆林医院理疗科收治的83例肩周炎患者，按信封抽签法将患者随机分为对照组（41例）和观察组（42例）。对照组男27例，女14例；年龄（55.84±5.21）岁；病程（7.91±0.91）个月；肩周炎位置：左侧17例，右侧24例；采用温针灸治疗。观察组男31例，女11例；年龄（55.88±5.15）岁；病程（7.94±0.93）个月；肩周炎位置：左侧15例，右侧27例；采用瘀血痹片（口服）联合温针灸治疗。比较两组患者治疗3个疗程后的临床疗效，治疗前及治疗3个疗程后的肩关节功能［肩关节活动度量表（ROM）］、疼痛介质水平［血清5-羟色胺（5-HT）、前列腺素E（PGE2）、P物质（SP）］及中医症候积分（关节肿胀、关节疼痛、关节畏寒、关节沉重）。采用独立样本t检验和χ²检验。结果　治疗3个疗程后，观察组治疗总有效率［92.86%（39/42）］高于对照组［75.61%（31/41）］，差异有统计学意义（P<0.05）；观察组ROM中前屈［（127.97±13.54）°］、外展［（101.60±10.43）°］、后伸［（36.26±3.67）°］、内旋［（52.78±4.99）°］、外旋［（54.78±5.06）°］活动度均高于对照组［（118.14±12.52）°、（90.18±9.58）°、（28.84±3.59）°、（43.82±4.76）°、（45.82±4.58）°］，差异均有统计学意义（均P<0.05）；观察组5-HT［（5.96±0.63）ng/L］、PGE2［（148.06±15.43）ng/L］、SP［（232.91±23.66）mg/L］水平均低于对照组［（9.52±0.94）ng/L、（184.18±18.50）ng/L、（280.95±28.50）mg/L］，差异均有统计学意义（均P<0.05）；观察组中医症候积分中关节肿胀［（0.51±0.05）分］、关节疼痛［（0.65±0.07）分］、关节畏寒［（0.49±0.05）分］、关节沉重［（0.89±0.08）分］评分均低于对照组［（1.33±0.16）分、（1.72±0.14）分、（1.08±0.10）分、（1.79±0.18）分］，差异均有统计学意义（均P<0.05）。结论　瘀血痹片联合温针灸治疗能有效改善肩周炎患者肩关节功能及中医症候积分，降低其疼痛介质水平，提高临床疗效，有较好的应用前景。

关键词:

肩周炎, 瘀血痹片, 温针灸, 肩关节功能, 疼痛介质