目的

探讨温经止痛针法对肱骨外科颈骨折术后肩关节功能障碍患者肩关节功能康复的影响。

方法

选取2023 年1 月至2024 年6 月于郑州西区中医院疼痛科门诊收治的64 例肱骨外科颈骨折术后肩关节功能障碍患者，采用随机数字表法分为对照组和观察组，每组各32 例。 对照组给予康复训练治疗，观察组在对照组治疗的基础上给予温经止痛针法治疗，隔日治疗1 次，每周3 次，连续治疗5 周。 观察比较2 组患者干预后肩关节功能、肩关节活动度、疼痛程度、疼痛介质的变化，并评估2 组临床疗效。

结果

治疗5 周后，观察组肌力、疼痛、日常生活能力、肩关节活动度评分及总评分均高于对照组（t＝3.620、5.772、4.688、5.500、7.790，P＜0.05）；前屈、外展、内旋、外旋活动度高于对照组（t＝5.935、3.646、5.375、4.845，P＜0.05）；视觉模拟量表评分低于对照组（t＝10.654，P＜0.05）；5-羟色胺、内皮素-1、前列腺素E2、P 物质水平低于对照组（t ＝7.920、14.202、3.629、4.410，P＜0.05）；总有效率（96.88%）高于对照组（62.50%）（χ² ＝9.653，P＜0.05）。 2 组均无明显不良反应发生。

结论

温经止痛针法能够有效改善肱骨外科颈骨折术后患者肩关节活动功能，增加肩关节活动度，缓解疼痛程度，疗效明显，安全性好。

Objective

To investigate the effects of “Wenjing Zhitong” acupuncture method on the rehabilitation of shoulder joint function after surgical neck fracture of humerus.

Methods

A total of 64 patients with shoulder joint dysfunction after surgical neck fracture of humerus，who were treated in the outpatient department of the Pain Department of Zhengzhou West District Traditional Chinese Medicine Hospital from January 2023 to June 2024，were selected.The patients were divided into the control group and the observation group by random number table method，with 32 cases in each group.The control group was given rehabilitation training，and the observation group was given “Wenjing Zhitong” acupuncture treatment on the basis of the treatment of the control group.The treatment was carried out every other day，three times a week，for five consecutive weeks.The changes in shoulder joint function，range of motion of the shoulder joint，pain degree，and pain mediators of the two groups after intervention were observed and compared，and the clinical efficacy of the two groups was evaluated.

Results

After five weeks of treatment，the scores of muscle strength，pain，daily living ability，range of motion of the shoulder joint，and the total score in observation group were higher than those in the control group（t＝3.620，5.772，4.688，5.500，7.790， P＜0.05）.The ranges of motion of the forward flexion，abduction，internal rotation，and external rotation were higher than those in the control group（t＝5.935，3.646，5.375，4.845， P＜0.05）.The Visual Analogue Scale was lower than that in the control group（t ＝10.654， P＜0.05）.The levels of 5-hydroxutryptamine，endothelin-1，prostaglandin E2，and substance P were lower than those in the control group（t＝7.920，14.202，3.629，4.410， P＜0.05）.The total effective rate was higher than those in the control group（χ2 ＝9.653， P＜0.05）.There was no obvious adverse reactions in both groups.

Conclusion

＂Wenjing Zhitong” acupuncture method can effectively improve the shoulder joint movement function of patients after surgical neck fracture of humerus，increase the range of motion of the shoulder joint，relieve the pain degree，has obvious curative effect and good safety.