Clinical Observation On The Treatment Of Rotator Cuff Injury Combined With Frozen Shoulder By The Manipulations In Tendon-smoothing Combined With Fumigation Therapy

Objective:Through clinical research observation,the effect of applying manipulations in tendon-smoothing combined with fumigation therapy on shoulder joint pain,mobility,laboratory index and UCLA shoulder function score in the postoperative rehabilitation of rotator cuff injury with frozen shoulder under shoulder arthroscopy,It provides a clinical basis for the postoperative rehabilitation of Chinese medicine in rotator cuff injury combined with frozen shoulder.Methods:From March 2018to January 2019,we selected 68 patients with a diagnosis of rotator cuff injury with a frozen shoulder and underwent shoulder arthroscopy.According to the random number table method,the patients were assigned to the observation group and the control group,with 34 cases in each group.In the observation group,the conventional rehabilitation treatment was performed with the combination of the manipulations in tendon-smoothing and the shujin external washing granule fumigation.The control group was treated with routine rehabilitation.The follow-up observation records were followed up for 3 months.VAS pain score,shoulder mobility(fore flexion,abduction,external rotation,internal rotation),laboratory examination(ESR,CRP,TNF-a),nocturnal rest pain,and UCLA shoulder function score were evaluated its clinical efficacy.Results:All 68 patients underwent a complete 3 month follow-up.Statistical analysis showed no statistical comparison between VAS pain score,shoulder mobility,laboratory examination,nocturnal rest pain,and UCLA shoulder function scores in the first two groups(P>0.05).After 3 months of treatment,the results showed:The VAS pain scores were compared.The VAS score of the observation group was 1.41x0.49 points in the third month after operation,which was better than the control group of 2.26±0.51 points.The difference was statistically significant(P=0.000<0.05).Comparative analysis of fore flexion of shoulder joints:The fore flexion activity of the observation group was 123.38±5.82° in the second month after operation,which was better than the control group of 119.65±7.59°,the difference was statistically significant(P=0.026<0.05).The fore flexion activity of the observation group was 145.50±7.59° in the third month after operation,which was better than that of the control group was 134.5±5.43°,the difference was statistically significant(P=0.000<0.05).Comparative analysis of abduction activity of shoulder joint:The abduction activity of the observation group in the third month after operation was 141.62±6.30°,which was better than that of the control group was 136.97±5.24°,the difference was statistically significant(P=0.002<0.05).Comparative analysis of external rotation activity of shoulder joints:Before treatment and 3 months after operation,there was no significant difference between the two groups,the difference was not statistically significant(P>0.05);the external rotation activity of observation group was 54.24±5.48 °in the third month after operation,better than the pre-treatment of 29.24±4.64°,the difference was statistically significant(P=0.000<0.05).The external rotation activity of the control group in the third month after operation was 53.85±5.90°,which was better than before-treatment of 28.15±7.44°,the difference was statistically significant(P=0.000<0.05).Comparative analysis of internal mobility of shoulder joints:In the second month after operation,the score of the internal rotation of the observation group was 5.21±1.04,which was better than that of the control group of 4.53±0.62,the difference was statistically significant(P=0.007<0.05).In the third month after operation,the intra-spinning back activity score was 7.65±0.85,which was better than the control group of 5.91±0.75,the difference was statistically significant(P=0.007<0.05).Comparative analysis of laboratory examination:The CRP of the observation group was 3.55±3.99 mg/L in the first month after operation,which was higher than that of the control group of 1.82±1.24 mg/L,the difference was statistically significant(P=0.006<0.05).The ESR of the observation group in January was 37.42±18.03,which was higher than that of the control group of 28.85±11.36,the difference was statistically significant(P=0.038<0.05).Comparative analysis of rest pain at night:Compared with before treatment,the observation group had a difference in nighttime rest pain rate,which was statistically significant(P=0.000<0.05).Compared with before treatment,the control group was compared with 3 months after treatment,the resting pain rate at night was different and statistically significant(P=0.000<0.05).Comparative analysis of UCLA shoulder function score:The UCLA shoulder function score of the observation group was 22.29±3.68 points in the second month after operation,which was superior to the control group of 19.62±3.83 points,the difference was statistically significant(P=0.004<0.05).After the third month,the UCLA shoulder function score was 28.47±2.22,which was better than the control group of 26.50±2.74,the difference was statistically significant(P=0.004<0.05).Conclusion:Under the guidance of traditional Chinese medicine theory,the combination of Manipulations in tendon-smoothing and fumigation therapy was introduced into the arthroscopic rehabilitation of rotator cuff injury and frozen shoulder.After early postoperative follow-up,it was found that the conventional rehabilitation treatment was performed with the combination of the manipulations in tendon-smoothing and the shujin external washing granule fumigation can better relieve shoulder pain,improve fore flexion of the shoulder joint,abduction and internal rotation function,and the shoulder function score is better,although the inflammatory reaction of the control group was no significant decrease in the level,but no adverse complications such as signs of infection were found after the operation,therefore,the treatment plan is safe and effective,and it is worthy of clinical application.