医学运动康复联合关节松动技术治疗肩峰下撞击综合征的疗效观察(1)
摘 要 目的：探讨医学运动康复联合关节松动技术治疗肩峰下撞击综合征的临床疗效。方法：选取南方医科大学深圳医院收治的肩峰下撞击综合征患者44例，按随机数表法分为观察组和对照组，每组22例。对照组给予关节松动技术治疗，观察组在此基础上给予医学运动康复技术治疗。观察两组基线期及治疗后Constant、UCLA积分变化。结果：治疗后，观察组Constant、UCLA积分显著高于对照组，P<0.05；两组的Constant、UCLA积分与各自基线期比较，P<0.05。结论：与单纯关节松动技术相比，联合医学运动康复技术能更好地治疗肩峰下撞击综合征。
关键词 医学运动康复技术 关节松动技术 肩峰下撞击综合征
中图分类号：R684.1； R493 文献标志码：B 文章编号：1006-1533(2018)15-0037-03
Effect of medical training therapy combined with joint mobilization in the treatment of patients with subacromial impingement syndrome
LIU Chuanyao， CHEN Xuan， LIU Lu， FAN Sijia， QIN Ping， HUANG Lanfen(Department of Rehabilitation Medicine， Shenzhen Hospital of Southern Medical University， Guangdong Shenzhen 518100， China)
ABSTRACT Objective： To discuss the clinical efficacy of medical training therapy combined with joint mobilization on patients with subacromial impingement syndrome. Methods： Forty-four patients with subacromial impingement syndrome were selected and divided into an observation group and a control group with 22 cases each based on a random number table method. The control group was treated with joint mobilization therapy while medical training therapy was additionally given in the observation group. Baseline period and the changes of constant and UCLA integral after treatment were compared between the two groups. Results： Constant and UCLA integral after treatment was significantly higher in the observation group than the control group (P<0.05). Comparison of constant and UCLA integral with their respective baseline periods showed statistical significance (P<0.05). Conclusion： Combination of joint mobilization therapy with medical training therapy can better improve subacromial impingement syndrome as compared with simple joint loosening technique.
KEY WORDS medical training therapy； joint mobilization； subacromial impingement syndrome
肩部功能障礙和疼痛是肩峰下撞击综合征的主要体征及症状，肩峰下间隙中结构上的不匹配是肩峰下机械撞击的解剖基础，也是造成肩袖损伤的主要原因[1-2]，因此，控制疼痛和解除肩胛带结构上的不匹配是治疗肩峰下撞击综合征的思路。
1 资料与方法
1.1 一般资料
选取2016年10月—2017年12月南方医科大学深圳医院收治的肩峰下撞击综合征患者44例，按不同治疗方式分为观察组和对照组，每组22例。观察组：年龄20～44岁，平均(32.53±4.12)岁；男11例，女11例；症状持续3～14月，平均(8.38±3.17)月；Neer分期为Ⅰ期8例，Ⅱ期14例；以往治疗情况为肩峰下封闭4例，非甾体类抗炎药14例。对照组：年龄20～44岁，平均(32.60±4.31)岁；男11例，女11例；症状持续3～14月，平均(8.67±3.97)月；Neer分期为Ⅰ期7例，Ⅱ期15例；以往治疗情况为肩峰下封闭4例，非甾体类抗炎药14例。两组患者一般资料分布均衡(P>0.05)，具有可比性。
1.2 诊断标准
符合下列5项中的1项，即可诊断为肩峰下撞击综合征：①肩峰前外缘压痛；②肩外展时痛并存在疼痛弧；③与被动活动相比，肩关节主动活动时疼痛明显；④撞击征阳性(Neer撞击试验)；⑤肩峰骨赘，肩袖部分撕裂或全层撕裂。
1.3 病例入选标准, 百拇医药(刘传耀 陈绚 刘璐 范思佳 秦萍 黄兰芬)
关键词 医学运动康复技术 关节松动技术 肩峰下撞击综合征
中图分类号：R684.1； R493 文献标志码：B 文章编号：1006-1533(2018)15-0037-03
Effect of medical training therapy combined with joint mobilization in the treatment of patients with subacromial impingement syndrome
LIU Chuanyao， CHEN Xuan， LIU Lu， FAN Sijia， QIN Ping， HUANG Lanfen(Department of Rehabilitation Medicine， Shenzhen Hospital of Southern Medical University， Guangdong Shenzhen 518100， China)
ABSTRACT Objective： To discuss the clinical efficacy of medical training therapy combined with joint mobilization on patients with subacromial impingement syndrome. Methods： Forty-four patients with subacromial impingement syndrome were selected and divided into an observation group and a control group with 22 cases each based on a random number table method. The control group was treated with joint mobilization therapy while medical training therapy was additionally given in the observation group. Baseline period and the changes of constant and UCLA integral after treatment were compared between the two groups. Results： Constant and UCLA integral after treatment was significantly higher in the observation group than the control group (P<0.05). Comparison of constant and UCLA integral with their respective baseline periods showed statistical significance (P<0.05). Conclusion： Combination of joint mobilization therapy with medical training therapy can better improve subacromial impingement syndrome as compared with simple joint loosening technique.
KEY WORDS medical training therapy； joint mobilization； subacromial impingement syndrome
肩部功能障礙和疼痛是肩峰下撞击综合征的主要体征及症状，肩峰下间隙中结构上的不匹配是肩峰下机械撞击的解剖基础，也是造成肩袖损伤的主要原因[1-2]，因此，控制疼痛和解除肩胛带结构上的不匹配是治疗肩峰下撞击综合征的思路。
1 资料与方法
1.1 一般资料
选取2016年10月—2017年12月南方医科大学深圳医院收治的肩峰下撞击综合征患者44例，按不同治疗方式分为观察组和对照组，每组22例。观察组：年龄20～44岁，平均(32.53±4.12)岁；男11例，女11例；症状持续3～14月，平均(8.38±3.17)月；Neer分期为Ⅰ期8例，Ⅱ期14例；以往治疗情况为肩峰下封闭4例，非甾体类抗炎药14例。对照组：年龄20～44岁，平均(32.60±4.31)岁；男11例，女11例；症状持续3～14月，平均(8.67±3.97)月；Neer分期为Ⅰ期7例，Ⅱ期15例；以往治疗情况为肩峰下封闭4例，非甾体类抗炎药14例。两组患者一般资料分布均衡(P>0.05)，具有可比性。
1.2 诊断标准
符合下列5项中的1项，即可诊断为肩峰下撞击综合征：①肩峰前外缘压痛；②肩外展时痛并存在疼痛弧；③与被动活动相比，肩关节主动活动时疼痛明显；④撞击征阳性(Neer撞击试验)；⑤肩峰骨赘，肩袖部分撕裂或全层撕裂。
1.3 病例入选标准, 百拇医药(刘传耀 陈绚 刘璐 范思佳 秦萍 黄兰芬)