| Frozen shoulder, medical ly referred to as adhesive capsulitis, is a disorder in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, greatly restricting motion and causing chronic pain.Adhesive capsulitis, for which an exact cause is unknown, is a painful and disabling condition that frequently appears in the middle-aged and elderly. Movement of the shoulder is severely restricted. Certain movements or bumps can cause sudden onset of tremendous pain and cramping that can last several minutes.ObjectiveFrozen shoulder has three pathological stages:the painful stage, the adhesive stage and the recovery. Clinical studies suggest that the treatment effect of acupotomy is better in the adhesion stage. However, we believe that the therapy also can interrupt the pathological process of periarthritis, so the early use of acupotomy could shorten the course of frozen shoulder and reduce the patient suffering. In this study, the intervention effects of acupotomy were observed. Through the organization of morphological and biochemical methods, the thesis attemps to seek the pathogenesis of frozen shoulder and the onset mechanism of acupotomy.Methods48 male New Zealand rabbits,6±0.5 months old and weigh 2.5±0.5kg each, are selected. The rabbits are randomly divided into 6 groups:normal group, model group, electroacupuncture group, acupotomy group A (intervention in the painful stage), acupotomy group B (intervention in the adhesive stage), acupotomy group C (intervention both in the painful stage and adhesive stage). Each group has 8 rabbits. Application of ice application plus strain is used to prepare the frozen shoulder rabbit models.Acupotomy groups undergoes acupuncture therapy; electroacupuncture group receives electroacupuncture treatment; the normal group and model group has no treatment. And all the groups were raised under the same conditions for 33 days. The plasma, biceps, supraspinatus, and inf raspinatus muscle are taken to observe the malondialdehyde levels, superoxide dismutase and total antioxidant capacity. The beginning of the biceps tendon to the far side of the tendon and the synovium are taken to observe the pathological changes by the light microscope after HE staining.ResultsThe pathological examination showedNormal Group:Tendon:the outer membrane of connective tissue was surrounded by the most outer epithelial cell layer of 1 to 2 cubic cells arranged in neat rows, tendon fibers were arranged regularly.Model Group:Tendon:irregular arrangement of epithelial cells of the outer membrane, epithelial cells were increased up to 4 to 5 layers, epithelial deep down fiber increased, dense structure. Synovium and tendon were no significant infiltration of inflammatory cells.EA group:Tendon of the outer membrane (tendon sheath visceral) epithelial cells, but less than the model group, mostly 2 to 3 layers. Subepithelial connective tissue was more dense.Acupotomy group A and Acupotomy group B and Acupotomy group C:the same pathological changes with the basic electro-acupuncture group.2. The content of hydroxyproline in the biceps, supraspinatus and infraspinatus showed that the model group has much more hydroxyproline than the other groups, and the other three groups has no clear differences from each other.3. According to the results of the content of protein in the biceps, supraspinatus and infraspinatus showed that the normal group has much less protein than other groups. The difference between the normal group and and acupotomy group A and B group is significant.ConclusionCompared to other treatments, the needle-knife therapy of acupotomology highlights the advantages of cutting decomposition adhesion. The needle knife relaxing therapy can relieve the neurovascular compression or traction syndrome by relaxing the local contracted, adhesive soft tissue, so as to relieve tension pain and finally recover the painful condition of frozen shoulder. |
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