| Objective:To observe the effect of glenohumeral cavity,subacromial bursa and sulcus intertubercularis triple-injection combined with Acupotomy by ultrasound guided in the treatment of adhesive capsulitis of shoulder,discuss its effectiveness and safety.Methods:80 cases of adhesive capsulitis were randomly divided into two groups,40 cases one groups,ultrasound group using high-freq-uency ultrasound guided glenohumeral cavity,subacromial bursa and sulcus intertubercularis triple injection combined with ultrasound guided Acupotomy treatment,the control group using traditional anatomical location method for glenohumeral joint cavity,subacromial bursa and sulcus intertubercularis injection combined with Acupotomy.1 weeks after treatment,4 weeks,12 weeks using the international visual analogue scale(VAS),Constant-Murley score after treatment to evaluate the curative effect,and the image data recorded on the glenohumeral joint contrast cavity puncture successful cases,calculation puncture Success rate was used to evaluate the accuracy of puncture.Results:There were no significant difference in VAS and Constant-Murley scores between the two groups before treatment(P>0.05);1.VAS score:two groups all have significantly better VAS score improvements after treatment compare with before treatment(P<0.05).The ultrasound group all have significantly better VAS score improvements at 1 weeks,4 weeks and 12 weeks after treatment(2.96±0.58?2.56±0.52?2.26±0.53)compared with the control group(3.78±0.63?3.3±0.60?2.98±0.55).The VAS scores of the two groups were significantly decreased compare 12 weeks after treatment with 1 weeks after treatment,with the ultrasound group(2.26±0.53?2.96±0.58)and the control group(2.98±0.55?3.78±0.63).2.The Constant-Murley score:Two groups all have significantly better pain,daily life ability and range of motion improvements at1 weeks,4 weeks and 12 weeks after treatment compared with before treatment(P<0.01).The range of motion score of the ultrasound group at 1 weeks,4 weeks and 12 weeks after treatment were 27.82+2.96,33.84±3.06,36.17±2.61.While the control group score were23.70±2.63?28.59±3.78?32.43±2.86.The ultrasound group have significantly better range of motion improvements compared with the control group(P<0.01);The ultrasound group have significantly better pain score improvements at 1 weeks and 4 weeks after treatment compared with the control group(P<0.01),with the pain scores of the ultrasound group were 10.62±3.66 and 13.16±3.08.While the control group were 8.15±3.98 and 10.42±3.51.3.Glenohumeral joint puncture:ultrasound group was successful in 38 cases,2 cases failed,the success rate was 95%,the control group was successful in 29 cases,11 cases failed,the success rate was 72.5%,the ultrasound group has a higher success rate of puncture than the control group(?~2=7.3467,P=0.0067).4.After 6 months follow-up,ultrasound group 39 cases were followed up(1 cases lost due to long-time business trip).the control group 38 cases were followed up(1 cases were due to poor compliance off,1 cases lost due to change of contact).The ultrasound group 19 cases were cured,markedly effective 12 cases,effective 6 cases,no effect 2 cases,the cure rate was 48.7%,the markedly effective rate was 79.5%,the total efficiency was 94.9%;While the control group 12 cases were cured,markedly effective 9cases,effective 14 cases,no effect 3 cases,the cure rate was 31.6%,the effective rate was 55.3%,the total efficiency was 92.1%,ultrasound group was significantly higher than the control group(?~2=5.0841,P=0.0241),the total effective rate and cure rate were not significantly different between the two groups(P=0.6246,P=0.1277).Conclusion:Triple-injection combined with acupotomy is an effective method in the treatment of adhesive capsulitis of shoulder.ultrasound guided group is better than the control group in the pain relief,shoulder joint activity and the ability of daily life improvement.ultrasound guided group has a higher success rate and safety of joint puncture. |
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