超声下痛点注射联合银质针治疗慢性肩袖损伤的临床研究

Ultrasound-guided trigger point injections combined with silver needle therapy for chronic rotator cuff disorders: a clinical study

摘要:

目的：探讨超声引导下痛点注射联合银质针疗法对慢性肩袖损伤患者疼痛缓解及肩关节功能恢复的临床研究。 方法：本研究选取上海市浦东新区公利医院疼痛科2023年5月～2024年9月收治的100例慢性肩袖损伤患者，通过随机数字表法分为痛点注射组（T组n=50）和联合治疗组（C组n=50）。T组接受超声引导下肩关节周围痛点注射治疗，C组则在痛点注射治疗后进一步接受银质针骨骼肌松解疗法。治疗前收集两组患者的一般资料，分别在治疗前、治疗后1天、1个月及3个月时，采用疼痛数字评价量表（Numerical rating scale,NRS）评估患者的疼痛程度、记录肩关节活动度（包括主动前屈、外展和后伸）、采用加州大学肩关节评分系统 (University of California Los Angeles Shoulder Scale，UCLA)评估肩关节功能以及口服镇痛药物的使用量。记录两组患者在治疗过程中出现的不良反应或并发症。 结果：治疗后1个月、3个月C组NRS评分低于T组（P<0.01）。治疗后1天，C组前屈、后伸活动比T组有改善（P<0.05），其中后伸的改善较显著（P<0.01）；治疗后1月，C组肩关节前屈、外展的活动范围比T组明显改善（P<0.01），两组后伸的活动度差异无统计学意义；治疗后3月，C组肩关节前屈、外展、后伸的活动改善均明显优于T组（P<0.01）。治疗后1天、治疗后1月、治疗后3月C组患者UCLA评分比T组均有提高（P<0.01）。治疗后1个月、治疗后3个月C组口服镇痛药量低于T组（P<0.01）。治疗病程中两组患者均未发生不良反应或并发症。 结论：超声引导下痛点注射联合银质针疗法在治疗慢性肩袖损伤中表现出快速缓解疼痛、疗效持久且肩关节功能显著改善的优势，具有安全、远期疗效稳定的临床应用价值。

Abstract:

Objective: To investigate the clinical efficacy of ultrasound-guided trigger point injection combined with silver needle release therapy in alleviating pain and restoring shoulder joint function in patients with chronic rotator cuff injuries. Methods: A total of 100 patients with chronic rotator cuff injuries treated at the Pain Management Department of Gongli Hospital in Pudong New Area, Shanghai, from May 2023 to September 2024 were enrolled, and randomly assigned to two groups via a random number table: the trigger point injection group (Group T n=50) and the combined treatment group (Group C n=50). Group T received ultrasound-guided periarticular trigger point injections, while Group C underwent additional silver needle release therapy following trigger point injections. General patient data were collected prior to treatment. Pain intensity was assessed using the Numerical Rating Scale (NRS), shoulder joint range of motion (active flexion, abduction, and extension) was measured, and shoulder function was evaluated via the University of California Los Angeles Shoulder Scale (UCLA). Oral analgesic consumption and treatment-related adverse events or complications were recorded. Assessments were performed at baseline and at 1-day, 1-month, and 3-month follow-up. Results: At 1-month and 3-month follow-ups, Group C exhibited significantly lower NRS scores compared to Group T (P<0.01). At 1-day follow-up, Group C demonstrated improved flexion and extension compared to Group T (P<0.05), with particularly significant improvement in extension (P<0.01). At 1 month, Group C showed greater improvements in flexion and abduction (P<0.01), while no significant difference was observed in extension. At 3-month follow-up, Group C exhibited superior improvements in flexion, abduction, and extension compared to Group T (P<0.01). UCLA scores in Group C were significantly higher than those in Group T at all post-treatment time points (P<0.01). Oral analgesic consumption was significantly lower in Group C at 1 and 3 months post-treatment (P<0.01). No adverse events or complications were reported in either group. Conclusion: Ultrasound-guided trigger point injection combined with silver needle release therapy demonstrates rapid pain relief, sustained efficacy, and significant functional improvement in chronic rotator cuff injuries. This combined approach is safe and offers stable long-term clinical outcomes.