| Objective:The aim of this study was to observe the clinical efficacy of myofascial trigger points he-gu acupuncture therapy combined with mulligan mobilization with movement therapy in the treatment of stage I and II subacromial impingement syndrome through a clinical randomized controlled trial,so as to provide a safe and effective method for the treatment of stage I and II subacromial impingement syndrome.Methods:Seventy patients who met the inclusion criteria in the outpatient clinic of the fifth department of acupuncture and moxibustion the first department of orthopedics and traumatology of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine were randomly divided into a treatment group and a control group of 35 patients each.The treatment group was treated with myofascial trigger points he-gu acupuncture therapy combined with mulligan mobilization with movement therapy,while the control group was treated with conventional acupuncture therapy combined with mulligan mobilization with movement therapy.All the patients in the two groups received acupuncture once a day,and received treatment on the five days of the week with a rest of two days,for continuous six weeks.At the end of the acupuncture treatment,mulligan mobilization with movement was performed twice a week at least 2 days apart,for continuous six weeks.The visual analogue scale(VAS)and Constant-Murley(CMS)shoulder function scale scores of patients before treatment,after the third week of treatment and after the end of treatment as well as the effusion depth changes of SDB before treatment and after treatment were recorded in the two groups.The efficacy was evaluated based on the reducing rate of CMS total score.The data analysis part was performed with SPSS 26.0 software,and the results were compared and the differences in efficacy between the two groups were observed.Results:1.Sixty-six cases were treated(four cases was fallen off during the treatment),thirty-three cases in the treatment group(myofascial trigger points he-gu acupuncture therapy combined with mulligan mobilization with movement therapy)and thirty-three cases in the control group(conventional acupuncture therapy combined with mulligan mobilization with movement therapy).There was no significant difference in the general conditions(age,gender,course of disease,and location of disease),VAS score,CMS details and total score,the effusion depth of SDB of the two groups before treatment(P>0.05),with comparability.2.Clinical efficacy: The total effective rate of the treatment group was87.88%,while that of the control group was 72.73%,and the difference between the two groups was statistically significant(P<0.01).3.VAS score: After the third week of treatment and after the end of treatment,the VAS score of the two groups was significantly different between the two groups(P<0.01),and the treatment group was superior to the control group in reducing the VAS score;the VAS score of the two groups before treatment,after the third week of treatment and after the end of treatment was significantly different(P<0.01),and the VAS score of the two groups before treatment and after the third week of treatment,after the third week of treatment and after the end of treatment was significantly different between the two groups,in which the VAS score of the control group before treatment and after the third week of treatment was significantly different(P<0.05),and the VAS score of the other control group and the treatment group was significantly different between the two groups(P<0.01).4.CMS-pain score: After the third week of treatment and after the end of treatment,there was significant difference in CMS-pain score between the two groups(P<0.01),and the treatment group was superior to the control group in increasing the pain score;there was significant difference in CMS-pain score before treatment,after the third week of treatment and after the end of treatment between the two groups(P<0.01),and there was significant difference between the two groups before treatment and after the third week of treatment,after the third week of treatment and after the end of treatment,before treatment and after the end of treatment,in which there was significant difference between the control group after the third week of treatment and after the end of treatment(P<0.05),and there was significant difference between the other control groups and the treatment group(P<0.01).5.CMS-ADL score: After the third week of treatment and after the end of treatment,the CMS-ADL score of the two groups was significantly different between groups(P<0.01),and the treatment group was superior to the control group in increasing the ADL score;the CMS-ADL score of the two groups before treatment,after the third week of treatment and after the end of treatment was significantly different(P<0.01),and the CMS-ADL score of the two groups before treatment and after the third week of treatment,after the third week of treatment and after the end of treatment,before treatment and after the end of treatment were significantly different between the two groups(P<0.01).6.CMS-ROM score: After the third week of treatment and after the end of treatment,the CMS-ROM score of the two groups was significantly different between groups(P<0.01),and the treatment group was superior to the control group in increasing the ROM score;the CMS-ROM score of the two groups was significantly different before treatment,after the third week of treatment,and after the end of treatment(P<0.01),and the CMS-ROM score of the two groups was significantly different between the two groups before treatment and after the third week of treatment,after the third week of treatment and after the end of treatment,and before treatment and after the end of treatment(P<0.01).7.CMS-muscle strength score: After the third week of treatment,the CMS-muscle strength score was significantly different between the two groups(P<0.05).At the end of the treatment,the CMS-muscle strength score was significantly different between groups(P<0.01),and the treatment group was superior to the control group in increasing the muscle strength score;the CMS-muscle strength score was significantly different between the two groups before treatment,after the third week of treatment,and after the end of treatment(P<0.01),and the pairwise comparison between the two groups before treatment and after the third week of treatment,after the third week of treatment and after the end of treatment,before treatment and after the end of treatment,in which the difference between the control group after the third week of treatment and after the end of treatment was statistically significant(P<0.05),and the pairwise comparison between the other control groups and the treatment group was statistically significant(P<0.01).8.Total CMS score: After the third week of treatment and after the end of treatment,the CMS total score of the two groups was significantly different between groups(P<0.01),and the treatment group was superior to the control group in increasing the CMS total score;the CMS total score of the two groups before treatment,after the third week of treatment,and after the end of treatment was significantly different(P<0.01),and the CMS total score of the two groups before treatment and after the third week of treatment,after the third week of treatment and after the end of treatment,before treatment and after the end of treatment were significantly different between the two groups(P<0.01).9.The effusion depth of SDB: After the end of treatment,the depth of SDB effusion was significantly different between the two groups(P<0.01),and the treatment group was superior to the control group in reducing the depth of SDB effusion;the depth of SDB effusion was significantly different between the two groups before treatment and after the end of treatment(P<0.01).10.Follow-up: The follow-up was performed one month after the end of treatment.The results showed that the recurrence rate was 6.06% in the treatment group and 27.27% in the control group.The recurrence rate in the treatment group was significantly lower than that in the control group,and the difference had statistical significance(P<0.05).Conclusion:1.Based on mulligan mobilization with movement therapy,acupuncture at myofascial trigger points he-gu acupuncture therapy and conventional acupuncture therapy can effectively treat stage I and II subacromial impingement syndrome,the degree of pain is relieved,the degree of shoulder joint movement limitation is alleviated,the muscle strength around the shoulder muscle group is significantly enhanced,effectively improve the daily life ability of patients,and the effect of acupuncture at myofascial trigger points he-gu acupuncture therapy is superior to conventional acupuncture.2.Based on mulligan mobilization with movement therapy,acupuncture at myofascial trigger points he-gu acupuncture therapy and conventional acupuncture therapy can effectively reduce the effusion depth of SDB,and and the effect of acupuncture at myofascial trigger points he-gu acupuncture therapy is superior to conventional acupuncture.3.Acupuncture myofascial trigger points he-gu acupuncture therapy combined with mulligan mobilization with movement therapy in the treatment of stage I and II subacromial impingement syndrome is superior to conventional acupuncture therapy combined with mulligan mobilization with movement therapy,which has more advantages in the long-term efficacy. |
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