| Objective: To study the clinical characteristics of frozen shoulder patients in the Department of Orthopedics and Traumatology of our hospital,analyze the effectiveness of pulsed radiofrequency surgery combined with blood circulation and muscle relaxation techniques in shoulder joint pulse radiofrequency surgery;and provide a diagnosis and treatment reference for the early prevention and reasonable treatment of frozen shoulder patients.Methods: Selected patients with frozen shoulder who were hospitalized in the Department of Orthopedics and Traumatology of the First Affiliated Hospital of Traditional Chinese Medicine from February 2017 to December 2020.Refer to the "Orthopedic Disease Standards" to find the course records,screen for shoulder MRI examinations,and receive shoulder impulses.Patients with frozen shoulders undergoing radiofrequency treatment were divided into the experimental group combined with activating blood and relaxing muscles and the control group without intraoperative combined with activating blood and flexing muscles according to the intraoperative records of pulsed radio frequency therapy;through the hospital system,the records were collected and entered clinical data of conditional patients: basic information[age,gender,body mass index(BMI),course of disease,distribution of affected shoulders],course records(main complaint,history of present illness,past history,specialist examination,doctor’s order),shoulder MRI,infrared thermal imaging and TCM diagnosis(clinical symptoms,signs,tongue,pulse);Visual Analogue Scale(VAS),Constant-Murley(CM)shoulder scores,and overall curative effects were evaluated before and after treatment to analyze the effectiveness of blood circulation and muscle relaxation techniques during the pulsed radiofrequency surgery.result: 1.Basic informationA total of 91 patients with frozen shoulders were included in this study(control group: 42,test group: 49).The sex,age,BMI,disease course,and shoulder distribution of 91 patients were analyzed.The results showed:(1)female/male ratio was 3.33:1,the prevalence of female were significantly more than that of men.Among them,There were 10 males(23.81%)and 32 females(76.19%)in the control group;11 males(22.45%)and 38 females(77.55%)inthe text group.(2)The average age of patients in the control group was 60.62±9.55 years old,the youngest was 44-year-old,and the oldest was 84-year-old;the average age of patients in the test group was 61.41±9.14 years old,the youngest was 47-year-old,the oldest was 85-year-old.(3)The number of patients on the left shoulder,right shoulder,and both shoulders were 17,20,and 5 respectively in the control group,while the number were 27,21,and 1 respectively in the experimental group.The incidence of the left shoulder accounted for 48.35% of the total incidence,and the right shoulder accounted for 45.05%,The incidence of the left shoulder in the two groups was slightly higher than that of the right shoulder.(4)The average BMI level was 24.60(22.01,27.27)in the control group,and 24.42(22.52,27.12)in the test group.BMI levels had no difference in the two groups(P>0.05),but the average BMI level was common higher(>24kg/m2).(5)The average course of disease for the control group was 6.00(1.00,12.00)months,and 3.00(2.00,6.50)months in the test group.The course of the disease between the two groups were no difference(P>0.05).2.The distribution of admission time in solar terms Most patients with frozen shoulder were admitted to the hospital in summer,with 31 in total,and then 24 in autumn,19 in winter,and 17 in spring.Among them,Lixia is the most solar term,with 10 in total.The wind-cold-dampness-resistance type of patients admitted to the hospital has no obvious distribution of solar terms.In general,winter,spring,and autumn solar terms are the majority,with the proportion of 90%;summer solar terms are the least,with the proportion of 10%.For stasis patients,the main solar terms in hospital admission are Liqiu,Lixia,Guyu,Dashu,Xiaoman,and Lidong.Spring is the most from the perspective of season,accounting for 30.15% of the total,followed by summer(25.40%),autumn(22.22%),and winter(22.22%);The main solar terms of patients with qi-blood deficiency type are Liqiu,Shuangjiang and Chushu.Summer accounts for the most(44.44%),then autumn(38.89%),spring(16.67%),and 0 in winter.3.Number of days in hospital In the control group,the average length of stay in hospital was 11.00(9.75,13.00)days,with the shortest 6 days,and the longest 17 days;In the text group,the average length of stay was 11.00(9.50,14.00)days,with the shortest 8 days,the longest 18 days.Length of hospitalstay has no difference in the two groups(P>0.05).4.Distribution of TCM Syndrome Types In the control group,the stasis type was the most(31,73.81%),and then the Qi-blood deficiency type(9,21.43%),the wind-cold dampness type was the least(2,4.76%);in the test group,the stasis type was also the most(32,65.31%),and then Qi-blood deficiency type(9,18.37%),finally wind-cold-damp resistance type(8,16.33%).5.Infrared thermal imaging inspection This study compared the temperature difference of the anterior,lateral,and posterior shoulders of 91 patients before and after the infrared thermal imaging treatment.After the treatment,both two group’s temperature difference decreased,no matter what part compared with before treatment.There was no difference in the temperature difference in the two groups before treatment on the front side of the shoulder joint(Z=-1.061,P>0.05).After the treatment,It showed a statistical difference in temperature difference(Z=-2.135,P<0.05).The shoulder temperature difference in the experiment group decreased more significantly.Also,there was no significant difference in the temperature difference on the lateral shoulder before treatment(Z=-1.551,P>0.05),and Similarly,we found no significant difference after the treatment(Z=-1.402,P>0.05),indicating that the temperature difference in the two groups did not decrease significantly after treatment.The posterior side of the shoulder joint was no significant difference before treatment(Z=-0.557,P>0.05),and also no difference after treatment(Z=-0.530,P>0.05),indicating that the temperature difference on the posterior side of the shoulder joint did not decrease significantly after treatment.6.Postoperative visual analogue scoring method(VAS score)Before treatment,both the average VAS scores was 7.00(6.00,8.00)in the two groups,After testing,Obviously,VAS scores between the two groups had no difference before treatment(P>0.05).The VAS scores in the control and test group after treatment were 3.00(2.00,3.63)and 2.00(2.00,3.00)respectively.After treatment,the VAS scores showed a difference in these groups(P<0.05).The test group’s VAS scores improved very much compared with the control group’s.7.Constant-Murley(CM)scale score Before treatment,the CM shoulder scores were 45.00(40.75,49.00)in the control groupand 42.00(36.00,46.50)in the test group.No difference was found in CM shoulder scores between the two groups(P>0.05).After treatment,control group’s CM shoulder scores were 57.50(51.25,66.00),and test group ‘s were 67.00(63.50,70.00),P<0.05,The result showed a difference in CM shoulder score,and the test group’s CM scores improved significantly better than the control group’s.8.Comparison of overall efficacy evaluation After the treatment,the clinically cured,markedly effective,effective,and ineffective patients in the control group were 0,5,33,and 4,the total effective rate was 90.48%;In the text group,the clinically cured,markedly effective,effective,and ineffective patients were 0,15,31 and 3.The total effective rate is 93.88%.Two groups’ total effective rate of the two groups is statistically different(P<0.05),obviously,text group’s total effective rate is higher than that in the control groupin conclusion1.There are more female frozen shoulders than male frozen shoulders in the Department of Orthopedics and Traumatology of the First Affiliated Hospital of Traditional Chinese Medicine.Most of them are 60 years old.They are generally obese.The shoulders are mainly affected on the left side.The youngest was 44 years old and the oldest was 85 years old.2.Most patients with frozen shoulder were admitted to the hospital in summer,and Lixia was the most admitted.TCM syndromes were mainly stasis,accounting for 69.23%.3.Both the uncombined activating blood and relaxing muscles techniques during the operation and the intraoperative combined activating blood and relaxing muscles techniques can reduce the temperature difference of anterior,lateral and posterior sides of the shoulder;especially for patients with anterior frozen shoulders,the intraoperative combined activating blood and relaxing muscles techniques can make the temperature difference decline more obviously.4.After comparing VAS score,CM scale score,and overall curative effect evaluation,the improvement degree was better in combined with the technique of activating blood circulation and relaxing muscles during the operation.5.To sum up,the application of blood circulation and muscle relaxation technique in shoulder joint pulsed radiofrequency treatment of frozen shoulder can help relieve the pain of patients,improve shoulder joint function,and is worthy to clinical application. |
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