转化医学杂志

目的 观察远部取穴针刺联合消肿止痛软膏治疗急性肩袖损伤的临床效果。方法 选择2023年3月至2024年12月淄博宝华中医医院和中国中医科学院望京医院收治的64例急性肩袖损伤患者作为研究对象，由中央随机系统分配随机号，分为试验1组（22例）、试验2组（22例）和对照组（20例）。试验1组采用远部取穴针刺治疗，试验2组在试验1组的基础上联合消肿止痛软膏治疗，对照组采用《针灸学》中推荐的针刺方法治疗，均治疗10 d。比较3组临床疗效、视觉模拟评分法（VAS）评分、美国肩肘外科医师协会（ASES）评分、肩关节活动度（ROM）及不良事件。结果 在治疗过程中，试验2组脱落1例，对照组脱落1例。试验2组总有效率（100.00%）显著高于对照组（73.68%）和试验1组（72.73%）(P<0.05)。治疗后，3组VAS评分均降低（P<0.05）,ASES评分均升高（P<0.05），且试验2组VAS评分显著低于试验1组和对照组（P<0.05）,ASES评分及VAS评分差值、ASES评分差值均显著高于试验1组和对照组（P<0.05）。治疗后，3组前屈、外展、外旋角度均较治疗前增加（P<0.05），且试验2组均高于试验1组和对照组（P<0.05）。3组不良事件发生率比较，差异无统计学意义（P>0.05）。结论 远部取穴配合消肿止痛软膏外涂治疗急性肩袖损伤临床效果良好，可有效减轻患者疼痛，促进肩关节功能恢复。

Objective To observe the clinical efficacy of distal acupoint acupuncture combined with Xiaozhong Zhitong Ointment in treating acute rotator cuff injuries. Methods A total of 64 patients with acute rotator cuff injuries admitted to the Zibo Baohua Hospital of Traditional Chinese Medicine and Wangjing Hospital, China Academy of Chinese Medical Sciences from March 2023 to December 2024 were selected as study subjects. They were assigned random numbers by a central randomization system and divided into experimental group 1(n=22), experimental group 2(n=22), and control group(n=20). Experimental group 1 received distal acupoint acupuncture. Experimental group 2 received the same treatment as experimental group 1 with the addition of topical application of Xiaozhong Zhitong Ointment. The control group received acupuncture at points recommended in the textbook "Acupuncture and Moxibustion". All groups were treated for 10 days. Clinical efficacy, Visual Analog Scale(VAS) score, American Shoulder and Elbow Surgeons(ASES) score, shoulder range of motion(ROM), and adverse events were compared among the three groups. Results During treatment, one patient dropped out from experimental group 2 and one from the control group. The total effective rate in experimental group 2(100.00%) was significantly higher than that in the control group(73.68%) and experimental group 1(72.73%)(P<0.05). After treatment, VAS scores decreased in all three groups(P<0.05), and ASES scores increased(P<0.05). The VAS score in experimental group 2 was significantly lower than that in experimental group 1 and the control group(P<0.05), while the ASES score and the differences in VAS and ASES scores were significantly higher in experimental group 2 than in the other two groups(P<0.05). After treatment, flexion, abduction, and external rotation angles increased in all three groups compared with those before treatment(P<0.05), and these angles in experimental group 2 were greater than those in experimental group 1 and the control group(P<0.05). There was no statistically significant difference in the incidence of adverse events among the three groups(P>0.05). Conclusion Distal acupoint acupuncture combined with topical application of Xiaozhong Zhitong Ointment is clinically effective in treating acute rotator cuff injuries, significantly alleviating pain and promoting the recovery of shoulder joint function.