探讨温针治疗对肩关节镜术后患者镇痛消肿临床疗效。

将2019年6月至2020年3月于山东省威海卫人民医院骨科行肩关节镜手术的80例患者，按照随机数字表法随机分为对照组和试验组，每组40例。对照组采用常规肩关节镜治疗，试验组采用常规肩关节镜治疗，术后予以温针治疗。2组术前与术后不同时间的疼痛、肿胀情况比较采用单因素重复测量资料的方差分析，不同时段两组间比较采用LSD-t法检验。

(1)视觉模拟评分(VAS)比较。对照组和试验组治疗后各时段VAS评分均较2组术前降低(F＝2.58、8.42，P均<0.05)；2组治疗后各时段比较：试验组术后后各时段VAS评分与对照组比较，差异有统计学意义(F＝1.715，P<0.05)，进一步两两比较，试验组术后24 h、48 h、72 h的VAS评分较对照组降低，且差异有统计学意义(t＝1.726、1.897、2.526，P均<0.05)。(2)2组患者肘关节外上髁上15 cm处周径变化比较。对照组和试验组术后各时段肘关节外上髁上15 cm周径均较2组术前增大(F＝13.25、198.30，P均<0.05)，随着术后时间增加周径逐渐变小；2组治疗后各时段比较：试验组术后各时段肘关节外上髁上15 cm处周径与对照组比较差异有统计学意义(F＝1.824，P<0.05)，进一步两两比较，试验组术后24 h、48 h、72 h肘关节外上髁上15 cm处周径较对照组减小，且差异有统计学意义(t＝1.598、1.635、1.825，P均<0.05)。(3)2组患者腋窝处周径变化比较。2组术后各时段腋窝处周径均较2组术前明显增大(F＝2.25、212.30，P均<0.05)；2组治疗后各时段比较：试验组术后各时段腋窝处周径与对照组比较差异有统计学意义(F＝1.617，P<0.05)，进一步两两比较，试验组术后24 h、48 h、72 h腋窝处周径较对照组减小，且差异均有统计学意义(t＝1.617、1.826、1.659，P均<0.05)。

温针疗法可以有效减轻肩关节镜术后的肿胀、疼痛，值得临床推广。

To investigate the analgesic and detumescent effect of warm acupuncture on patients after shoulder arthroscopy.

A total of 80 patients undergoing shoulder arthroscopy in the Department of Orthopedics, Weihaiwei People′s Hospital of Shandong Province from June 2019 to March 2020 were randomly divided into a control group and an experimental group according to the random number table method, with 40 patients in each group. The control group was treated with conventional shoulder arthroscopy, while the experimental group was treated with conventional shoulder arthroscopy and postoperative warm acupuncture. The comparison of pain and swelling between the two groups at different times before and after operation was performed by one way ANOVA with single factor repeated measurement data, and the comparison between the two groups at different times was performed by LSD-t method.

(1)Comparison of VAS scores. VAS scores in the control group and the experimental group in each period after treatment were all lower than those in the two groups before treatment (F=2.58, 8.42, all P<0.05). Comparison of each period after treatment between the two groups: the VAS scores of the experimental group and the control group in each period after surgery showed statistically significant differences (F=1.715, P<0.05). Further pin-two comparison showed that the VAS scores of the experimental group at 24 h, 48 h and 72 h after surgery were lower than those of the control group, and the differences were statistically significant (t=1.726, 1.897 and 2.526, all P<0.05). (2)Comparison of circumference at 15 cm of the external epicondyle of elbow joint between 2 groups. The circumference of 15 cm on the external epicondyle of the elbow in the control group and the experimental group in all operation periods increased compared with that before operation in the 2 groups (F=13.25, 198.30, all P<0.05), and the circumference gradually decreased with the increase of postoperative time. And two groups after treatment were compared: the difference between two groups in each period was statistically significant (F=1.824, P<0.05), further comparison showed thatthe circumference of the experimental group after 24 h, 48 h, 72 h group was reduced compared with that of the control group, and the difference was statistically significant (t=1.598, 1.635, 1.825, all P<0.05). (3)Comparison of axillary circumference between 2 groups. The axillary circumference in each period after operation in both groups was significantly larger than that before operation in both groups (F=2.25, 212.30, all P<0.05). And two groups after treatment were compared: the difference in the circumference of the experimental group in each period after treatment was statistically significant compared with the control group(F=1.617, P<0.05), further comparison showed that the circumference of the experimental group after 24 h, 48 h, 72 h was reduced, and the difference was statistically significant (t=1.617, 1.826, 1.659, all P<0.05).

Warm needle therapy can effectively reduce the swelling and pain after shoulder arthroscopy, which is worthy of clinical promotion.