| Background:Frozen shoulder is a common and frequently-occurring disease in middle-aged and elderly people.The main symptoms of frozen shoulder are pain and limitation of motor function,which seriously affect the daily life of patients.The pathological basis of frozen shoulder is soft tissue degeneration,adhesion and contracture around shoulder.Traditional needle-knife and manipulation release,as a distinctive traditional Chinese medicine treatment method,is widely used in clinic because of its non-invasive,simple and relatively simple operation.But because they can’t operate directly at the lesion site,they can’t deal with the lesion more accurately.Modern medical operations are mainly operated under arthroscope.Although they can thoroughly release adhesion and remove pathological changes,they are not accepted by patients with more basic diseases and less pathological changes because they require general anesthesia and more wounds.In recent years,needle-knife endoscopy,which combines endoscopy technology and needle-knife therapy,has emerged as the times require.It has achieved remarkable results in the treatment of knee joint diseases and has unique advantages,which provides a new method for the treatment of frozen shoulder.Objective:To objectively evaluate the short-term clinical efficacy of minimally invasive needle-knife endoscopy combined with traditional Chinese medicine release in the treatment of frozen shoulder through clinical observation,analyze the specific indications of minimally invasive needle-knife endoscopy treatment,provide preliminary evaluation evidence for clinical efficacy,lay a foundation for the observation of long-term clinical efficacy,and better guide clinical treatment.Methods:60 frozen shoulder patients from December 2017 to December 2018 in Department of Orthopaedics,First Clinical Medical College of Beijing University of Traditional Chinese Medicine were selected as the subjects of this study.All patients were randomly divided into observation group and control group with 30 cases in each group.There were 8 males and 22 females in the experimental group;the age range was 47-62 years old,the age range was(54.20+4.18)years old,13 patients with left side lesion and 17 patients with right side lesion.In the control group,there were 9 males and 21 females;the age range was 48-69 years old,the average age was(56.10+6.96)years old,14 patients with left side lesion and 16patients with right side lesion were treated with traditional Chinese medicine release.All patients in the experimental group received routine functional exercise after operation.All patients in the two groups were followed up.The pain degree of shoulder joint and shoulder joint function were scored and evaluated by VAS score and shoulder joint function evaluation scale before operation,2 weeks after operation,1 month after operation and 3 months after operation.The pain relief and functional recovery of shoulder joint after operation were compared between the two groups according to the score results,and the results were evaluated.Results:The preoperative VAS scores of the control group and the experimental group were 5.03±1.27 and 5.00±1.23,respectively.There was no statistical difference between the two groups.After treatment,the VAS scores of the two groups decreased gradually with the prolongation of treatment time.Compared with the preoperative VAS scores of the same group,the VAS scores of the control group and the experimental group decreased significantly in 2 weeks,1 month and 3 months after operation,with statistical significance(P<0.05).The VAS scores of the experimental group at 2 weeks,1 month and 3 months after operation were 1.90±0.76,0.90±0.71 and 0.50±0.40,respectively.The VAS scores of the control group at 2 weeks,1 month and 3 months after operation were 3.07±0.98,2.20±0.89 and 1.83±0.75,respectively.Compared with the control group,the VAS scores of the experimental group at each time point were lower than those of the control group,and the difference between the two groups was statistically significant(P<0.05).The preoperative joint function scores of the experimental group and the control group were 55.23±8.80 and 56.20±9.08,respectively.There was no significant difference between the two groups.After treatment,the shoulder function score of the two groups increased gradually with the prolongation of treatment time.Compared with the preoperative score of the same group,the shoulder function score of the control group and the experimental group increased significantly in 2 weeks,1 month and 3 months after operation,with statistical significance(P<0.05).The functional scores of the experimental group at 2 weeks,1 month and 3 months after operation were 80.93±5.34,88.77±3.87and 92.47±3.71 respectively,while those of the control group at 2 weeks,1 month and 3 months after operation were 72.53 ±8.10,81.50±7.92 and 84.87±5.32,respectively.Compared with the control group,the scores of the experimental group at each time point were higher than those of the control group,and the differences between the two groups were statistically significant(P<0.05).Conclusion:The treatment of frozen shoulder with minimally invasive needle-knife endoscopy combined with traditioal Chinese medicine release can relieve pain and improve shoulder function,and combined use is better than simple treatment.It is worthy of further promotion and application. |
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