| ObjectiveA randomized controlled research methods and evidence-based medical research principle, Jin three-needle group, joint mobilization group as a control group, Jin three needles combined with joint mobilization techniques in the treatment of periarthritis of clinical observation, to explore Jin three-needle and joint mobilization both the clinical efficacy of the therapy, therapeutic mechanism, the feasibility and the problems in order to make this system, objective and scientific evaluation of the efficacy, combination therapy for the disease to find an effective and reliable.MethodsThe patients were selected from Taiwan Yongtai clinic during November2011to February2013. A total of95patients meet the study criteria, the ratio of1:1:1randomly assigned to Jin three needles and joint mobilization group, Jin three-needle group, joint mobilization group, which Jin acupuncture combined with joint mobilization group32cases, Jin three-needle group of32cases, joint mobilization group31cases. Frozen shoulder periarthritis Western developed with reference to the Second National the frozen shoulder Symposium (1991· Hubei) diagnostic criteria; reference to the Chinese acupuncture clinical diagnostic and treatment practices in the shoulder paralysis diagnostic criteria in the diagnostic criteria. Jin three needles, joint mobilization surgery the next day treatment time,10times as a course of two courses. Efficacy endpoint was to simplify the McGill Pain Questionnaire, shoulder function Constant-Murley evaluation method, activities of daily living (ASES shoulder function evaluation form), shoulder flexion, outreach, ear spacing refers to the vertebral spacing. The TCM syndromes standard reference to the State Administration of Traditional Chinese disease diagnosis and efficacy standards "frozen shoulder TCM syndromes standard. Frozen shoulder the overall efficacy of the standard of Chinese medicine clinical research guiding principles (Ministry of Health issued in1997, the third series)"frozen shoulder" effect of the standard. SPSS17.0software for statistical analysis. Measurement data with the mean±standard deviation (x±s), count data used in forming the ratio (%).Results1The general information before treatment:This study included95cases, including42males,53females. Divided into Jin acupuncture combined with joint mobilization group, Jin three-needle group, joint mobilization group. Three groups of patients with periarthritis analysis and comparison of baseline factors of age, disease duration, gender, TCM typing, the difference was not statistically significant (P>0.05), indicating that the set of baseline conditions consistent, comparable.2The comparison of curative efficacy2.1The comparison of shoulder pain assessment (McGill Pain Questionnaire)By statistical analysis, Jin three-pin binding joint surgery in patients with frozen shoulder loose McGill Pain treatment significantly reduced compared to the total score and treatment, the difference was statistically significant (P<0.01); Jin-pin patientsMcGill pain Questionnaire total score difference of before and after treatment also significantly reduced; joint mobilization surgery patients McGill Pain decreased compared to the total score before treatment, the difference was statistically significant (P<0.05). Between the two groups, after two courses of treatment, McGill pain total score assessment, Jin three-needle combination of joint mobilization surgery pain out of Jin-pin, joint mobilization group score be reduced compared to the three groups by analysis of variance, the difference was statistically significant (P<0.05). Tip:improving the patients with frozen shoulder pain rating index, the prevalence of emotional (weak, tired, fear, etc.), visual analog grading existing pain intensity, three therapies varying degrees of efficacy, can reduce shoulder Zhou Yan patients with shoulder pain assessment score (McGill pain Questionnaire). But in comparison、Jin three-pin and joint mobilization therapy is preferred, especially to improve the PRI of patients with frozen shoulder feel points, visual analog grading assessment (VAS), PPI improve the most obvious.2.2The comparison of shoulder function motor function assessment (shoulder function Constant-Murley assessment method)The statistical analysis, Jin three-pin binding joint loose surgery in patients with frozen shoulder treatment shoulder function motor function assessment (shoulder function Constant-Murley evaluation method) Total before treatment significantly improved, the difference was statistically significant (P<0.01); Jin needle group of patients before and after treatment of shoulder function Constant-Murley assessment score difference also increased; joint mobilization surgery shoulder function in patients with Constant-Murley rating score before treatment compared improve differencestatistically significant (P<0.05). Between the two groups, after two courses of treatment, the function of the shoulder motor function assessment (shoulder function Constant-Murley evaluation method) and branch assessment, Jin pin in conjunction with joint mobilization surgery group shoulder motor function score Jin pin, joint mobilization group compared to score to reduce the three groups by analysis of variance test, the difference was statistically significant (P<0.05). Tip:improve frozen shoulder shoulder function in patients with activities Jin three-pin combined with joint mobilization can be used to relieve local pain and improve shoulder mobility, enhanced shoulder flexion, extension, abduction, adduction, on the move, external rotation range of activities to improve the patient’s upper limbs, is conducive to the recovery of activities of daily living in patients with frozen shoulder. Of two synergistic effect of the combination therapy was significantly more than monotherapy. Joint mobilization to improve the patients with frozen shoulder range of motion has a good advantage, but the overall function of the shoulder as Jin effect of acupuncture combined with joint mobilization activities.2.3The comparison of activities of daily living (ASES shoulder function evaluation form)Jin acupuncture combined with statistical analysis, joint mobilization after surgery in patients with frozen shoulder treatment activities of daily living (ASES shoulder function evaluation form) score significantly improved compared with before treatment, after treatment difference was significant (P<0.01); activities of daily living score Jin pin patients after treatment than before treatment also improved by paired samples t-test was statistically significant (P<0.05); joint mobilization surgery group of patients with activities of daily living before treatment compared toimprove the difference was statistically significant (P<0.05). Between the two groups, after two courses of treatment, activities of daily living (ASES shoulder function evaluation form) score, Jin three-pin combination of joint mobilization surgery group activities of daily living (ASES shoulder function evaluation form) total score than joint mobilization group score significantly improved compared to the difference between the two groups was statistically significant (P<0.05). Jin three-needle group was not significantly different (P>0.05). Tip:For improving frozen shoulder patients with activities of daily living (ASES shoulder function evaluation form) score, Jin three-pin binding joint mobilization techniques can significantly improve frozen shoulder patients with activities of daily living such as dressing, hair on the toilet, lifting, etc., thereby effectively improving the quality of life of patients. In contrast, Jin three-needle group also have some effect, but the improvement was not significant joint mobilization group, combined with previous studies, joint mobilization for frozen shoulder range of motion has a good effect, but the analgesic as effective as combined efficacy of acupuncture may to a certain extent affected the living ability of patients with frozen shoulder.2.4The comparison of shoulder joint functionAfter two courses of treatment, Jin three-pin combination loose joint surgery of shoulder flexion, abduction, refers to the ear spacing vertebral spacing than before treatment showed significant improvement, the difference was statistically significant (P<0.01). Jin three-pin combination treatment loose joint surgery group patients with frozen shoulder shoulder flexion, abduction, ear spacing to improve the situation Jin three-pin group improved significantly, and the difference was statistically significant (P<0.05). Jin acupuncture combined with loose joint mobilization group and joint surgery of shoulder joint functional situation between the two groups was not significantly different (P>0.05).2.5The comparison of TCM syndromeJin acupuncture combined with joint mobilization group, Jin three-needle group and joint mobilization group after treatment, the rank-sum test, H=4.28, P=0.065the three groups TCM syndromes difference was statistically significant (P<0.05), Jin acupuncture combined with joint mobilization group for clinical recovery of18.8%, markedly by43.7%,25.0%effective, ineffective12.5%, total effective rate was87.5%; Jin three-pin clinical cure was12.9%, effective32.3%effective for16.1%,38.7%invalid, the total effective rate was61.3%; joint mobilization surgery clinical cure was9.7%, markedly to38.7%,19.3%effective, ineffective for32.5%, total effective rate was67.7%. Tip:Jin acupuncture combined with joint mobilization treatment of patients with frozen shoulder surgery group Jin three-needle group and joint mobilization group compared improve the performance of patients with frozen shoulder methods in patients with clinical symptoms, signs, etc. more significant clinical effect than good.2.6The comparison of clinical efficacy of frozen shoulderJin acupuncture combined with joint mobilization group, Jin three-needle group and joint mobilization treatment after rank-sum test, H=11.34, P=0.021, the three groups frozen shoulder the overall efficacy difference was statistically significant (P<0.05), where Jin acupuncture combined with joint mobilization group were cured,18.8%, effective in46.9%,25.0%effective, ineffective to9.4%, the total effective rate was90.6%; Jin three-needle group clinical recovery was16.1%, markedly29.1%effective for16.1%,38.7%invalid, the total effective rate was61.3%; the joint mobilization clinical recovery was12.9%, markedly to35.5%,22.6%effective for invalid for29.0%, total effective rate was70.9%. Tip:to improve the clinical efficacy of the overall comparison of patients with frozen shoulder, Jin three-pin combination of joint mobilization group and Jin three-needle group, can relieve symptoms of shoulder pain, joint mobilization group compared to promote the recovery of shoulder mobility range normal, to improve the quality of life of patients with frozen shoulder.ConclusionFrozen shoulder is a common disease, frequently-occurring disease, a serious impact on the work and life of the patient. Pain and movement disorder is the main reason for treatment and quality of life in patients with frozen shoulder most influential factor in. How to better improve the efficacy in patients with frozen shoulder, to alleviate their pain, is a challenge to our traditional medicine.The results of this research are initially prompted Jin acupuncture combined with joint mobilization treatment of frozen shoulder with good clinical results. This therapy can be the acupuncture analgesic anti-inflammatory, stimulation of acupoints and meridians conduction, and joint mobilization to promote recovery of shoulder function, the organic integration of the lysis of adhesions, improve blood circulation, promote the transport and degradation of inflammatory substances, relieve inflammatory edema and improve tissue nutrition disorders play a role. Jin acupuncture combined with joint mobilization surgery method is simple, safe, and with Chinese characteristics, is a safe and effective non-toxic side effects of therapy. |
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