类固醇和透明质酸钠注射联合物理治疗应用于Ⅱ期冻结肩患者的回顾性配对队列研究

关键词：冻结肩  注射治疗  物理治疗  病理分期

Keywords:frozen shoulder  injection therapy  physical treatment  pathological stage

摘要：

      摘要 目的：研究类固醇和透明质酸钠注射联合物理治疗对Ⅱ期冻结肩患者的临床疗效。 方法：本回顾性配对队列研究纳入2018年9月—2020年9月上海第九人民医院门诊治疗的94例Ⅱ期冻结肩患者，从中选择32例患者进行统计学分析。联合治疗组16例接受了类固醇和透明质酸钠注射联合物理治疗，物理治疗组16例仅接受物理治疗。治疗前、治疗1个月，治疗3个月时评估并记录患者肩关节活动度、VAS疼痛评分及Constant肩关节功能评分。 结果：联合治疗组在治疗1个月、3个月时的VAS改善值均优于物理治疗组（P<0.05）。两组患者肩关节活动度改善值无显著性差异（P＞0.05）。联合治疗组在治疗3个月时的Constant评分改善值优于物理治疗组（P<0.05）。 结论：与单独物理治疗相比，类固醇和透明质酸钠注射治疗的加入更有利于Ⅱ期性冻结肩患者短期及中期疼痛改善，以及中期功能评分的提高。

Abstract:

      Abstract Objective： To study the clinical effect of corticosteroid and sodium hyaluronate injection combined with physical therapy on patients with frozen shoulder in phase Ⅱ. Method： This retrospective cohort study included 94 patients with stage Ⅱ frozen shoulder who were treated in the outpatient department of Shanghai Ninth People's Hospital from September 2018 to September 2020， and 32 patients were selected for statistical analysis. 16 cases in the combined treatment group received corticosteroid and sodium hyaluronate injection combined with physical therapy， while 16 cases in the physical treatment group only received physical therapy. The range of motion of shoulder joint， VAS pain score and Constant score were evaluated and recorded before treatment， 1 month after treatment and 3 months after treatment. Result：The improvement of VAS score in the combined treatment group was better than that in the physical treatment group at 1 month and 3 months (P<0.001). There was no significant difference in the improvement of range of motion between the two groups. The improvement of Constant score in the combined treatment group was better than that in the physical treatment group at 3 months after treatment(P<0.05). Conclusion：Compared with physical therapy alone， the addition of steroid and sodium hyaluronate injection therapy is more conducive to the improvement of short-term and medium-term pain and medium-term functional score in patients with stage Ⅱ frozen shoulder.