Article(id=1322922767343026766, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322922680609014711, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.02.011, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793338966450, onlineDateStr=2026-10-30, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793338966450, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793338966450, creator=13701087609, updateTime=1793338966450, updator=13701087609, issue=Issue{id=1322922680609014711, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='2', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1739116800000', pubDateStr='2025-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793338945772, creator='13701087609', updateTime=1793340618065, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929694785536732, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322922680609014711, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929694785536733, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322922680609014711, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=49, endPage=52, ext={EN=ArticleExt(id=1322922767787622991, articleId=1322922767343026766, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Influence of Zhuang Medicine Meridian Tendon Therapy Combined with Guizhi Plus Huangqi Decoction(桂枝加黄芪汤)on Surface Electromyography Signal and Prognosis of Patients with Periarthritis of Shoulder with Wind-Cold-Dampness Bi Syndrome, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the effect of meridian tendon therapy of Zhuang medicine combined with Guizhi plus Huangqi Decoction(桂枝加黄芪汤)on surface electromyography(SEMG)and prognosis of patients with periarthritis of shoulder with wind-cold-dampness Bi syndrome.

Methods

A total of 114 patients with periarthritis of shoulder with wind-cold-dampness Bi syndrome admitted to the hospital from January 2022 to December 2022 were randomly divided into the combined group(57 cases)and the control group(57 cases). Both groups were treated with meridian tendon therapy of Zhuang medicine,and the combined group was treated with Guizhi plus Huangqi Decoction. Both groups lasted for one month. The changes of shoulder joint function score,deltoid muscle SEMGand other indicators were detected before and after treatment in the two groups,and the prognosis of the two groups was evaluated.

Results

After treatment,the scores of pain,muscle strength,shoulder joint activity and functional activity of Constant-Murley shoulder function score(CMS)in both groups were higher than those before treatment. After treatment,the scores of pain,muscle strength,shoulder joint activity and functional activity in the combined group were higher than those in the control group,and the difference was statistically significant(P<0.05). After treatment,integrated electromyography(iEMG)on the surface of deltoid muscle in both groups increased and visual analog scale(VAS)score decreased. After treatment,the value of iEMGof the deltoid muscle surface in the combined group was higher than that in the control group,and its VASscore was lower than that in the control group with statistical significance(P<0.05). After treatment,the total clinical effective rate of the combined group was 97.40%(75/77),which was significantly higher than that of the control group(86.67%,65/75)with statistical significance(P<0.05).

Conclusion

Combined with Guizhi plus Huangqi Decoction on the basis of meridian tendon therapy of Zhuang medicine,it can further improve the SEMG signal of patients with periarthritis of shoulder with wind-cold-dampness Bi syndrome,promote the recovery of shoulder joint function and relieve pain,thus improving the quality of prognosis.

, authors=Jingyang YUAN1, Yong HUANG1, Aizhen TANG1, Xiaojie XU1, Qinglei ZHU1, Mingfu LI2, authorsList=Jingyang YUAN, Yong HUANG, Aizhen TANG, Xiaojie XU, Qinglei ZHU, Mingfu LI, authorCompany=null, correspAuthors=Mingfu LI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322922770375508568, articleId=1322922767343026766, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=壮医经筋疗法联合桂枝加黄芪汤加减对肩周炎风寒湿痹证患者表面肌电信号及预后的影响研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

分析壮医经筋疗法联合桂枝加黄芪汤加减对肩周炎风寒湿痹证患者表面肌电信号及预后的影响。

方法

纳入2022年1月—2022年12月收治的114例肩周炎风寒湿痹证患者,使用简单随机法分别纳入联合组和对照组各57例。两组均接受壮医经筋疗法治疗,联合组加用桂枝加黄芪汤加减治疗,两组治疗均持续1个月。检测两组患者治疗前后肩关节功能评分、三角肌表面肌电信号等指标变化,评估两组预后。

结果

两组治疗后CMS量表疼痛、肌力、肩关节活动、功能活动评分均较治疗前升高;联合组治疗后Constant-Murley肩关节功能评分(Constant-Murley shoulder function score,CMS)量表疼痛、肌力、肩关节活动、功能活动评分均高于对照组,差异有统计学意义(P<0.05)。两组治疗后患侧三角肌表面积分肌电值(Integrated electromyography,iEMG)均较治疗前升高,疼痛视觉模拟评分(Visual analog score,VAS)评分均较治疗前下降;联合组治疗后患侧三角肌表面iEMG均高于对照组,其VAS评分低于对照组,差异有统计学意义(P<0.05)。联合组治疗后临床总有效率为97.40%(75/77),较对照组的86.67%(65/75)显著较高,差异有统计学意义(P<0.05)。

结论

在壮医经筋疗法的基础上联合桂枝加黄芪汤加减治疗,能够进一步改善肩周炎风寒湿痹证患者表面肌电信号、促进肩关节功能恢复及疼痛减轻,从而提高预后质量。

, authors=袁经阳1, 黄永1, 唐爱珍1, 许潇杰1, 朱庆磊1, 李名福2, authorsList=袁经阳, 黄永, 唐爱珍, 许潇杰, 朱庆磊, 李名福, authorCompany=null, correspAuthors=李名福, authorNote=

袁经阳(1979-),男,广西玉林人,副主任医师,硕士,研究方向:中医骨伤科学。

, correspAuthorsNote=
李名福(1985-),男,广西南宁人,副主任医师,硕士,研究方向:临床教育+互联网教育。E-mail:。
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袁经阳(1979-),男,广西玉林人,副主任医师,硕士,研究方向:中医骨伤科学。

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袁经阳(1979-),男,广西玉林人,副主任医师,硕士,研究方向:中医骨伤科学。

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JSESInt,2022,6(6):970-977., articleTitle=Shoulder muscle activity after latissimus dorsi transfer in an active elevation, refAbstract=null), Reference(id=1322922778566984355, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, doi=null, pmid=null, pmcid=null, year=2022, volume=39, issue=6, pageStart=75, pageEnd=78, url=null, language=null, rfNumber=[22], rfOrder=21, authorNames=张萌, 高祥祥, journalName=甘肃中医药大学学报, refType=null, unstructuredReference=张萌,高祥祥. 肩三针傍刺联合桂枝加黄芪汤加减治疗肩周炎风寒湿痹证42例临床观察[J]. 甘肃中医药大学学报,2022,39(6):75-78., articleTitle=肩三针傍刺联合桂枝加黄芪汤加减治疗肩周炎风寒湿痹证42例临床观察, refAbstract=null), Reference(id=1322922778655064740, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, doi=null, pmid=null, pmcid=null, year=2020, volume=37, issue=6, pageStart=59, pageEnd=62, url=null, language=null, rfNumber=[23], rfOrder=22, authorNames=韩伟, journalName=甘肃中医药大学学报, refType=null, unstructuredReference=韩伟. 中药联合推拿治疗肩周炎风寒湿痹证45例临床观察[J]. 甘肃中医药大学学报,2020,37(6):59-62., articleTitle=中药联合推拿治疗肩周炎风寒湿痹证45例临床观察, refAbstract=null), Reference(id=1322922778717979301, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, doi=null, pmid=null, pmcid=null, year=2020, volume=41, issue=10, pageStart=1492, pageEnd=1495, url=null, language=null, rfNumber=[24], rfOrder=23, authorNames=张晓燕, 张凌娟, 张礼璐, journalName=陕西中医, refType=null, unstructuredReference=张晓燕,张凌娟,张礼璐,等. 中药热熨、针灸联合点揉法治疗老年肩周炎效果及对患者肩关节功能、炎症状态、疼痛递质的影响[J]. 陕西中医,2020,41(10):1492-1495., articleTitle=中药热熨、针灸联合点揉法治疗老年肩周炎效果及对患者肩关节功能、炎症状态、疼痛递质的影响, refAbstract=null), Reference(id=1322922778780893862, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, doi=null, pmid=null, pmcid=null, year=2022, volume=35, issue=8, pageStart=124, pageEnd=128, url=null, language=null, rfNumber=[25], rfOrder=24, authorNames=欧喜智, 洪苹, 邓钦文, journalName=西部中医药, refType=null, unstructuredReference=欧喜智,洪苹,邓钦文,等. 循经灸联合祛瘀通络开窍汤治疗缺血性脑卒中疗效观察[J]. 西部中医药,2022,35(8):124-128., articleTitle=循经灸联合祛瘀通络开窍汤治疗缺血性脑卒中疗效观察, refAbstract=null), Reference(id=1322922778860585639, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, doi=null, pmid=null, pmcid=null, year=2021, volume=18, issue=20, pageStart=144, pageEnd=147, url=null, language=null, rfNumber=[26], rfOrder=25, authorNames=方锦舒, 朱宝龙, 翟萍萍, journalName=中国医药导报, refType=null, unstructuredReference=方锦舒,朱宝龙,翟萍萍. 益气祛瘀通络方辅助治疗气虚血瘀型奥沙利铂化疗所致神经毒性患者的效果及对外周神经损伤的影响[J]. 中国医药导报,2021,18(20):144-147., articleTitle=益气祛瘀通络方辅助治疗气虚血瘀型奥沙利铂化疗所致神经毒性患者的效果及对外周神经损伤的影响, refAbstract=null)], funds=[Fund(id=1322922775207346829, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, awardId=GZMZ1296, language=CN, fundingSource=国家中医药管理局科技项目(GZMZ1296), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322922770622972505, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, xref=1., ext=[AuthorCompanyExt(id=1322922770639749722, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, companyId=1322922770622972505, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.Guangxi International Zhuang Medical Hospital,Nanning 530001,Guangxi,China), AuthorCompanyExt(id=1322922770648138331, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, companyId=1322922770622972505, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.广西国际壮医医院,广西 南宁 530001)]), AuthorCompany(id=1322922770740413020, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, xref=2., ext=[AuthorCompanyExt(id=1322922770748801629, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, companyId=1322922770740413020, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.Sains New School of Medicine,Guangxi University of Traditional Chinese Medicine,Nanning 530222,Guangxi,China), AuthorCompanyExt(id=1322922770757190238, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, companyId=1322922770740413020, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.广西中医药大学赛恩斯新医药学院,广西 南宁 530222)])], figs=[ArticleFig(id=1322922774582395525, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数年龄/(岁)病程/(年)性别/[例(%)]病变侧别/[例(%)]
男女单侧双侧
联合组5756.69±7.181.62±0.3424(42.11)33(57.89)37(64.91)20(35.09)
对照组5756.81±7.031.55±0.2822(38.60)35(61.40)39(68.42)18(31.58)
t/χ2值-0.0901.2000.1460.158
P值-0.9280.2330.7030.691
), ArticleFig(id=1322922774687253126, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, language=CN, label=表1, caption=

两组肩周炎患者基线资料对比(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数年龄/(岁)病程/(年)性别/[例(%)]病变侧别/[例(%)]
男女单侧双侧
联合组5756.69±7.181.62±0.3424(42.11)33(57.89)37(64.91)20(35.09)
对照组5756.81±7.031.55±0.2822(38.60)35(61.40)39(68.42)18(31.58)
t/χ2值-0.0901.2000.1460.158
P值-0.9280.2330.7030.691
), ArticleFig(id=1322922774750167687, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别患肩数疼痛肌力肩关节活动功能活动
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
联合组776.83±1.1512.69±2.07*12.34±2.1916.52±2.88*27.41±5.8033.46±6.75*10.14±1.7814.55±2.39*
对照组756.75±0.9610.34±1.58*12.46±2.2714.11±2.62*27.53±5.7530.58±6.42*10.22±1.9512.37±2.05*
t/χ2值-0.4657.8530.3325.3920.1282.6940.2646.029
P值-0.643<0.0010.741<0.0010.8980.0080.792<0.001
), ArticleFig(id=1322922774821470856, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, language=CN, label=表2, caption=

两组肩周炎患者治疗前后CMS评分变化比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别患肩数疼痛肌力肩关节活动功能活动
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
联合组776.83±1.1512.69±2.07*12.34±2.1916.52±2.88*27.41±5.8033.46±6.75*10.14±1.7814.55±2.39*
对照组756.75±0.9610.34±1.58*12.46±2.2714.11±2.62*27.53±5.7530.58±6.42*10.22±1.9512.37±2.05*
t/χ2值-0.4657.8530.3325.3920.1282.6940.2646.029
P值-0.643<0.0010.741<0.0010.8980.0080.792<0.001
), ArticleFig(id=1322922774896968329, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别患肩数iEMG/(mV)VAS评分/(分)
治疗前治疗后治疗前治疗后
联合组772.47±0.323.61±0.68*6.55±1.061.73±0.38*
对照组752.51±0.293.08±0.54*6.47±0.972.63±0.41*
t/χ2值-0.8075.3130.48514.041
P值-0.421<0.0010.628<0.001
), ArticleFig(id=1322922774976660106, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, language=CN, label=表3, caption=

两组肩周炎患者治疗前后iEMG及VAS评分变化比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别患肩数iEMG/(mV)VAS评分/(分)
治疗前治疗后治疗前治疗后
联合组772.47±0.323.61±0.68*6.55±1.061.73±0.38*
对照组752.51±0.293.08±0.54*6.47±0.972.63±0.41*
t/χ2值-0.8075.3130.48514.041
P值-0.421<0.0010.628<0.001
), ArticleFig(id=1322922775047963275, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别患肩数痊愈显效有效无效总有效
联合组7719(24.68)36(46.75)20(25.97)2(2.60)75(97.40)
对照组759(12.00)28(37.33)28(37.33)10(13.33)65(86.67)
χ2值-----6.022
P值-----0.014
), ArticleFig(id=1322922775119266444, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922767343026766, language=CN, label=表4, caption=

两组肩周炎患者治疗后临床疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别患肩数痊愈显效有效无效总有效
联合组7719(24.68)36(46.75)20(25.97)2(2.60)75(97.40)
对照组759(12.00)28(37.33)28(37.33)10(13.33)65(86.67)
χ2值-----6.022
P值-----0.014
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壮医经筋疗法联合桂枝加黄芪汤加减对肩周炎风寒湿痹证患者表面肌电信号及预后的影响研究
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袁经阳 1 , 黄永 1 , 唐爱珍 1 , 许潇杰 1 , 朱庆磊 1 , 李名福 2
中华中医药学刊 | 国家项目点击 2025,43(2): 49-52
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中华中医药学刊 |国家项目点击 2025 , 43 (2) : 49 -52
壮医经筋疗法联合桂枝加黄芪汤加减对肩周炎风寒湿痹证患者表面肌电信号及预后的影响研究
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袁经阳1, 黄永1, 唐爱珍1, 许潇杰1, 朱庆磊1, 李名福2
作者信息
  • 1.广西国际壮医医院,广西 南宁 530001
  • 2.广西中医药大学赛恩斯新医药学院,广西 南宁 530222
通讯作者:
李名福(1985-),男,广西南宁人,副主任医师,硕士,研究方向:临床教育+互联网教育。E-mail:。
作者简介:

袁经阳(1979-),男,广西玉林人,副主任医师,硕士,研究方向:中医骨伤科学。

Influence of Zhuang Medicine Meridian Tendon Therapy Combined with Guizhi Plus Huangqi Decoction(桂枝加黄芪汤)on Surface Electromyography Signal and Prognosis of Patients with Periarthritis of Shoulder with Wind-Cold-Dampness Bi Syndrome
Jingyang YUAN1, Yong HUANG1, Aizhen TANG1, Xiaojie XU1, Qinglei ZHU1, Mingfu LI2
Affiliations
  • 1.Guangxi International Zhuang Medical Hospital,Nanning 530001,Guangxi,China
  • 2.Sains New School of Medicine,Guangxi University of Traditional Chinese Medicine,Nanning 530222,Guangxi,China
出版时间: 2025-02-10 doi: 10.13193/j.issn.1673-7717.2025.02.011
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目的

分析壮医经筋疗法联合桂枝加黄芪汤加减对肩周炎风寒湿痹证患者表面肌电信号及预后的影响。

方法

纳入2022年1月—2022年12月收治的114例肩周炎风寒湿痹证患者,使用简单随机法分别纳入联合组和对照组各57例。两组均接受壮医经筋疗法治疗,联合组加用桂枝加黄芪汤加减治疗,两组治疗均持续1个月。检测两组患者治疗前后肩关节功能评分、三角肌表面肌电信号等指标变化,评估两组预后。

结果

两组治疗后CMS量表疼痛、肌力、肩关节活动、功能活动评分均较治疗前升高;联合组治疗后Constant-Murley肩关节功能评分(Constant-Murley shoulder function score,CMS)量表疼痛、肌力、肩关节活动、功能活动评分均高于对照组,差异有统计学意义(P<0.05)。两组治疗后患侧三角肌表面积分肌电值(Integrated electromyography,iEMG)均较治疗前升高,疼痛视觉模拟评分(Visual analog score,VAS)评分均较治疗前下降;联合组治疗后患侧三角肌表面iEMG均高于对照组,其VAS评分低于对照组,差异有统计学意义(P<0.05)。联合组治疗后临床总有效率为97.40%(75/77),较对照组的86.67%(65/75)显著较高,差异有统计学意义(P<0.05)。

结论

在壮医经筋疗法的基础上联合桂枝加黄芪汤加减治疗,能够进一步改善肩周炎风寒湿痹证患者表面肌电信号、促进肩关节功能恢复及疼痛减轻,从而提高预后质量。

壮医经筋疗法  /  黄芪汤  /  肩周炎  /  肌电信号
Objective

To analyze the effect of meridian tendon therapy of Zhuang medicine combined with Guizhi plus Huangqi Decoction(桂枝加黄芪汤)on surface electromyography(SEMG)and prognosis of patients with periarthritis of shoulder with wind-cold-dampness Bi syndrome.

Methods

A total of 114 patients with periarthritis of shoulder with wind-cold-dampness Bi syndrome admitted to the hospital from January 2022 to December 2022 were randomly divided into the combined group(57 cases)and the control group(57 cases). Both groups were treated with meridian tendon therapy of Zhuang medicine,and the combined group was treated with Guizhi plus Huangqi Decoction. Both groups lasted for one month. The changes of shoulder joint function score,deltoid muscle SEMGand other indicators were detected before and after treatment in the two groups,and the prognosis of the two groups was evaluated.

Results

After treatment,the scores of pain,muscle strength,shoulder joint activity and functional activity of Constant-Murley shoulder function score(CMS)in both groups were higher than those before treatment. After treatment,the scores of pain,muscle strength,shoulder joint activity and functional activity in the combined group were higher than those in the control group,and the difference was statistically significant(P<0.05). After treatment,integrated electromyography(iEMG)on the surface of deltoid muscle in both groups increased and visual analog scale(VAS)score decreased. After treatment,the value of iEMGof the deltoid muscle surface in the combined group was higher than that in the control group,and its VASscore was lower than that in the control group with statistical significance(P<0.05). After treatment,the total clinical effective rate of the combined group was 97.40%(75/77),which was significantly higher than that of the control group(86.67%,65/75)with statistical significance(P<0.05).

Conclusion

Combined with Guizhi plus Huangqi Decoction on the basis of meridian tendon therapy of Zhuang medicine,it can further improve the SEMG signal of patients with periarthritis of shoulder with wind-cold-dampness Bi syndrome,promote the recovery of shoulder joint function and relieve pain,thus improving the quality of prognosis.

meridian tendon therapy of Zhuang medicine  /  Huangqi Decoction(黄芪汤)  /  periarthritis of shoulder  /  EMGsignal
袁经阳, 黄永, 唐爱珍, 许潇杰, 朱庆磊, 李名福. 壮医经筋疗法联合桂枝加黄芪汤加减对肩周炎风寒湿痹证患者表面肌电信号及预后的影响研究. 中华中医药学刊, 2025 , 43 (2) : 49 -52 . DOI: 10.13193/j.issn.1673-7717.2025.02.011
Jingyang YUAN, Yong HUANG, Aizhen TANG, Xiaojie XU, Qinglei ZHU, Mingfu LI. Influence of Zhuang Medicine Meridian Tendon Therapy Combined with Guizhi Plus Huangqi Decoction(桂枝加黄芪汤)on Surface Electromyography Signal and Prognosis of Patients with Periarthritis of Shoulder with Wind-Cold-Dampness Bi Syndrome[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (2) : 49 -52 . DOI: 10.13193/j.issn.1673-7717.2025.02.011
肩周炎是以肩关节主被动活动障碍为主要表现的常见病,人群患病率超过20%,关节疼痛及活动受限对患者正常生活、工作均带来了严重负面影响[1]。目前临床治疗肩周炎的手段包括非甾体类抗炎药、松解手术、功能锻炼等,但效果均不甚理想[2]。壮医经筋疗法是在十二经筋理论指导下演变而来的新型疗法,以经筋“摸结”诊断和“解结”治疗为主要特点,符合关节病变的治疗原则[3]。中医学认为,肩周炎属“痹证”范畴,风寒湿痹是本病主要病机,故治疗当以祛风活血、温热寒湿、通络止痛为主。桂枝加黄芪汤是痹证治疗的中医经典方剂,有益卫固表、舒筋活络之功,在肩周炎风寒湿痹证的治疗中备受关注[4]。此次研究尝试探索壮医经筋疗法联合桂枝加黄芪汤治疗肩周炎风寒湿痹证的疗效,从而为肩周炎的治疗提供新的思路,现报道如下。
纳入广西国际壮医医院2022年1月—2022年12月收治的114例肩周炎风寒湿痹症患者,纳入标准:(1)符合肩周炎临床诊断标准,即存在肩关节夜间痛、静息痛、活动障碍等症状,但影像学检查未见阳性表现[5];(2)符合中医风寒湿痹证判定标准,主证包括肩部串痛、畏风恶寒,遇风寒痛增、得温痛减,肩部沉重感,次证包括关节活动不利,肌肤麻木不仁,舌淡胖、苔白腻,脉弦沉细,符合≥1项主证及≥1项次证即可明确辨证分型[6];(3)病程≤3年;(4)拟于我院接受治疗且能够配合研究。排除标准:(1)合并肩关节结核、骨折等其他病变;(2)合并胆囊炎、类风湿性关节炎等其他病因所致肩关节疼痛、活动受限;(3)合并认知、精神障碍;(4)随访时间≤1个月。征得患者及家属知情同意后,使用简单随机法将114例患者分别纳入联合组、对照组各57例。两组性别、病变侧别等基线资料对比,具有可比性(P>0.05),见表1。本研究已征得广西国际壮医医院医学伦理委员会批准。
两组均接受壮医经筋疗法治疗。(1)经筋推拿手法解结:沿患肢手三阳经筋线,使用肘关节鹰嘴、巩固内踝、前臂及拇指指腹,自手至头方向,使用按压、揉捏、点按、推拿、弹拨等方式松筋理络,促使手三阳经筋全线松解。以扳动手法行肩关节广泛粘连、僵硬地松解,包括帮助患者行肩关节上举、反手摸背、梳头动作等,适当施加辅助力以增加肩关节活动范围,逐步撕裂粘连。(2)火针拔罐解结:于手三阳经筋查找经筋结点,全面消毒后将烧红的毫针针尖迅速刺入结点,得气后立即出针。出针后局部拔火罐10 min,以拔出黄色澄清液体为宜。壮医经筋疗法隔日1次,持续1个月。居家康复期间嘱患者每日坚持行肩关节功能训练,包括内旋、外展、环转等,以缓慢、可耐受为宜,避免剧烈运动或负重运动。
在壮医经筋疗法的基础上,联合组加用桂枝加黄芪汤加减治疗。组方:黄芪30 g,桂枝20 g,白芍20 g,威灵仙20 g,羌活10 g,独活10 g,片姜黄10 g,生姜10 g,大枣10 g,细辛6 g。阴虚者加麦冬10 g,五味子10 g;痰咳者加陈皮10 g,半夏10 g;气滞者加川芎10 g,香附10 g;脾虚纳少者加淮山药15 g,莲蓉10 g。取水300 mL煎服,1剂/d,分早晚2次服用,各150 mL。桂枝加黄芪汤加减治疗持续1个月。
分别于治疗前、治疗后,使用Constant-Murley肩关节功能评分(Constant-Murley shoulder function score,CMS)评估两组肩关节功能变化,CMS量表包括疼痛(15分)、肌力(20分)、肩关节活动(40分)、功能活动(20分)共4个项目,各项目评分越高则肩关节功能越佳[7]。另外,记录两组治疗前后患侧三角肌表面积分肌电值(Integrated electromyography,iEMG)变化,使用美国MoitonLabs表面肌电仪,将电极贴附于患者三角肌肌腹沿肌纤维方向最高点,嘱患者坐立并自然放松、挺胸抬头,记录iEMG,记录3次,取平均值[8]。此外,分别于治疗前、治疗后,使用疼痛视觉模拟评分(Visual analog score,VAS)记录两组患者肩关节疼痛情况,VAS总分0~10分,评分越高则疼痛越严重[9]。基于治疗前后VAS评分变化评估临床预后,疼痛评分降低≥90%、60%~<90%、30%~<60%、<30%分别判定为痊愈、显效、有效、无效,总有效率=(痊愈+显效+有效)/总例数×100%[10]。病变侧别为双侧者,分别评估双侧肩关节CMS、iEMG、VAS变化及疗效。
使用SPSS 22.0统计学软件分析本研究相关数据,计数资料以[例数/(百分比]即[例/(%)]表示,并采用卡方检验(χ2检验),计量资料均符合正态分布,以平均数±标准差()表示,采用双侧t检验,当P<0.05时,认为差异存在统计学意义。
两组治疗后CMS量表疼痛、肌力、肩关节活动、功能活动评分均较治疗前升高;联合组治疗后CMS量表疼痛、肌力、肩关节活动、功能活动评分均高于对照组,差异有统计学意义(P<0.05)。见表2。
两组治疗后患侧三角肌表面iEMG均较治疗前升高,VAS评分均较治疗前下降;联合组治疗后患侧三角肌表面iEMG均高于对照组,其VAS评分低于对照组,差异有统计学意义(P<0.05)。见表3。
联合组治疗后临床总有效率为97.40%,较对照组的86.67%显著升高,差异有统计学意义(P<0.05)。见表4。
肩周炎是一种无菌性炎症,好发于中老年人群,与外伤劳损、体感风凉、骨退行性变、内分泌变化等多种因素有关。本病早期症状以肩关节疼痛、活动受限为主,随着病程进展,病变组织粘连逐渐加剧,与关节功能障碍持续恶化有关,严重者可能出现肩关节外展、外旋、后伸完全受限,生活质量受到严重影响[11-12]。因此,肩周炎的治疗原则以缓解关节疼痛、减轻关节功能障碍为主。
肩周炎的壮医病名为“旁巴尹”,认为肩部火路、龙路阻滞,是导致肩关节活动受限、功能障碍及疼痛的主要原因[13-14]。因此,壮医经筋疗法以经筋消灶、经筋查灶为主要原则,旨在通过疏通气血达到祛邪通痹之目的。本研究两组患者治疗后CMS量表疼痛、肌力、肩关节活动、功能活动评分均较治疗前升高,表明壮医经筋疗法对于改善肩周炎风寒湿痹证患者肩关节功能有重要作用。其优势在于:经筋手法、火针、拔罐的联合应用能够有效作用于筋结点,达到“结解则松、筋松则顺”的功效,也符合中医理论的“通则不痛”观点[15-17]。另外,火针温通经脉、火罐祛瘀通络之机制,不仅有助于通畅瘀阻的经络与血脉,也能够激发组织修复功能,从而有效松解局部粘连、促进关节软组织修复。得益于这一优势,本研究两组患者治疗后患侧三角肌iEMG升高、VAS评分下降,表明关节功能显著改善、疼痛大幅减轻,对于改善患者预后大有裨益[18-22]。
针对肩周炎的治疗,西医治疗方案以口服镇痛、消炎药物为主,但疗效有限且不良反应明显,因此,近年来越来越多的患者尝试寻求肩周炎中医干预方案。《素问·痹论篇》指出,“痹者,各以其时重感于风寒湿之气也”,指出风寒湿痹是痹证,即肩周炎的主要病因,故治疗当以温通经络、滑利关节为本[23]。桂枝加黄芪汤出自《金匮要略》,原方主治黄汗之病,近年来在风寒湿痹证的治疗中受到了越来越多的关注[24]。方中黄芪为君,有益气固表、利水化湿之功;桂枝、白芍、威灵仙为臣,可温通经脉、缓急止痛、祛风化湿;羌活、独活、细辛为佐,有通经止痛、解表散寒之效;片姜黄、生姜、大枣为使,有外调营卫、内调气血之功。数药共奏,可达通痹止痛、活血畅气之效,符合肩周炎风寒湿痹证的治疗原则。同时,基于患者兼征加麦冬、陈皮、川芎、淮山等药材,可达益气温经之功,共同实现和营除痹之效[25]。现代药理学研究显示,黄芪提取物能够显著提高机体抗炎、镇痛功能,并促进免疫调节功能改善[26],进一步印证了本方在肩周炎治疗中的重要地位。得益于桂枝加黄芪汤加减标本兼治之优势,本研究联合组治疗后CMS评分、iEMG、VAS评分均较对照组改善更为明显,且临床总有效率为97.40%,较对照组的86.67%显著升高,显现出该方在肩周炎风寒湿痹证治疗中的优秀效果与重要价值。
综上所述,在壮医经筋疗法的基础上联合桂枝加黄芪汤加减治疗,能够进一步改善肩周炎风寒湿痹证患者表面肌电信号、促进肩关节功能恢复及疼痛减轻,从而提高预后质量,值得推广应用。
  • 国家中医药管理局科技项目(GZMZ1296)
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2025年第43卷第2期
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doi: 10.13193/j.issn.1673-7717.2025.02.011
  • 首发时间:2026-10-30
  • 出版时间:2025-02-10
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国家中医药管理局科技项目(GZMZ1296)
作者信息
    1.广西国际壮医医院,广西 南宁 530001
    2.广西中医药大学赛恩斯新医药学院,广西 南宁 530222

通讯作者:

李名福(1985-),男,广西南宁人,副主任医师,硕士,研究方向:临床教育+互联网教育。E-mail:。
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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2025.02.011
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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