Observation of massage with medicinal wine and TDP irradiation in the treatment of frozen shoulder in 56 cases
Abstract: Objective: To observe the therapeutic effect of massage with external medicinal wine and TDP irradiation in the treatment of frozen shoulder. Methods: There were 56 cases in the treatment group and 56 cases in the control group. The treatment group was treated by massage with TDP irradiation of external medicine and wine; the control group was treated by acupuncture. The cure rate of the treatment group was 81%, 45 cases; the effective rate was 97.5%, 55 cases; the cure rate of the control group was 50%, 28 cases; the effective rate was 80%, 44 cases. The efficacy of the two groups was statistically treated (p<0.01), and the difference was significant. Conclusion Massage with TDP irradiation of external medicinal wine is better than acupuncture alone in the treatment of frozen shoulder.
Keywords: frozen shoulder, massage, medicinal wine, TDP irradiation
Our department used massage with medicinal wine and TDP irradiation to treat frozen shoulder with satisfactory results. It is reported as follows.
1.Clinical information
Diagnostic criteria: According to the criteria established by the State Administration of Traditional Chinese Medicine.
(1) Chronic strain, traumatic injury to tendons and bones, lack of qi and blood combined with wind, cold and dampness;
(2) Prevalence is higher in women than in men at the age of 50, more in the right than in the left shoulder, mostly in manual workers, mostly chronic;
(3) Scapular pain and activity pain, aggravated at night radiating to the hand but without sensory abnormalities, often triggered by weather changes and exertion;
(4) Shoulder joint activity is especially limited by supination, abduction, internal and external rotation, and the typical phenomenon of “abduction and shoulder carrying”;
(5) For long duration of disease, scapular girdle muscle atrophy is seen, especially deltoid atrophy is obvious; (6) X-ray examination is mostly negative, which is not helpful for direct diagnosis, but can exclude bone and joint diseases, and osteoporosis is seen for long duration of disease.
Inclusion criteria were: meeting the diagnostic criteria. Exclusion criteria: those with diabetes, severe osteoporosis evidence, bone tuberculosis, tumor patients, those taking anti-inflammatory and analgesic drugs, glucocorticoids and other drugs that can affect the formulation of the results, acute trauma and fractures.
General condition Treatment 112 cases were all outpatients and inpatients of our hospital, and met the diagnostic criteria of frozen shoulder. Your age ranged from 36 to 71, of which 46 cases were male and 66 cases were female; the duration of the disease was as short as 7 days and as long as 3 years. The onset was in the left shoulder in 40 cases, the right shoulder in 68 cases, and both shoulders in 5 cases. There was no significant difference between the two groups in terms of gender, age and duration of disease (P>0.05), which was comparable.
2.Treatment methods
Treatment group: The specific methods of massage treatment are as follows: loosening the tendons. Patients take a sitting position, the shoulder is naturally relaxed, the operator stands on the affected side, using thumb push, palm heel kneading, kneading, L and other techniques, along the muscle group towards the massage technique from light to heavy, repeated manipulation, time about 5 minutes. Diversion of meridians: the patient is in the same position as above, along the shoulder well, shoulder s, shoulderzhen, Zhongfu point, Tianzong, each point is pressed for 1 minute, and then the tips of the index, middle and ring fingers are used in the armpit, along the biceps skirt blocking Χ said cheeks Zha machinery pepper beech zeolotron 17 hip caries Penpen for 5 minutes. Paddle: The operator presses the tip of the thumb vertically against the long head of the biceps tendon and applies the paddle in the direction of the tendon in the intertrochanteric groove in a transverse direction, with the technique as light or heavy as the patient can tolerate, for about 5 minutes. Shaking the joint: the same position as above. The operator holds one hand with the patient and shakes it with force, while shaking it for shoulder joint flexion and extension, rotation around each direction. The other hand is placed on the affected shoulder, and shoulder kneading is performed while shaking the affected shoulder. Then do arm touching shoulder and rotating arm back touching technique, and finally finish the treatment with rubbing and other techniques for about 10 minutes. The Chinese herbal medicine wine is applied externally: The Chinese herbal medicine used is strychnine, sedge, Chuanxiong, Yanhuo, Dushuo, Fangfeng, Gentiana, Caozhu, Angelica, safflower and cinnamon etc. Pounded and soaked in 50% ethanol 500ml for 10d, filtered, if the filter is less than 500ml, then add 50% ethanol to make 500m1, bottled and set aside. First moisten gauze in homemade medicinal wine and put it on the affected area, TDP irradiation: irradiate with preheated TDP lamp for about 20 minutes.
Control group: acupuncture shoulder k shoulder chastity shoulder well A is point, hegu arm shoulder outer Yu, shoulder middle Yu Tianzong. The acupuncture was performed as usual, and the needles were left in place for 30 minutes, with additional electro-acupuncture at the A-Ye point and shoulder Sanzhen.
Both groups were treated once a day for 10 days, with one day of rest between treatments. 2 courses of treatment were observed.
Treatment evaluation
3.Efficacy criteria
(1) Cure: The shoulder pain disappears and the shoulder joint function is completely or basically restored.
(2)Improved: The shoulder pain is reduced and the function of the activity is improved.
(3) Not cured: no improvement of symptoms.
4. Treatment results: In the treatment group, the cure rate was 81%, 45 cases, and the efficiency rate was 97.5%, 55 cases; in the control group, the cure rate was 50%, 28 cases, and the efficiency rate was 80, 44 cases. By statistical processing: the two groups healing rate comparison has a highly significant (X2 = 10.1p<0.01), the two groups efficiency comparison has a highly significant (X2 = 9.3p<0.01)
Therefore, it can be concluded that the treatment of frozen shoulder by massage with medicinal wine and TDP irradiation is better than the treatment by acupuncture
Discussion
Frozen shoulder is a common disease characterized by shoulder joint pain and shoulder joint dysfunction. It is a chronic aseptic inflammation of the soft tissues around the shoulder joint caused by chronic strain, trauma, wind, cold and dampness, resulting in degenerative lesions such as adhesions of the soft tissues around the shoulder joint, contracture of the joint capsule, adhesions and atrophy of the synovial bursa, reduced secretion, reduced lubrication and degenerative contracture of the ligaments. It is mostly caused by the gradual decline of vital energy, deficiency of liver and kidneys, deficiency of qi and blood, and loss of tendon moistening in the middle-aged and elderly people, as well as localized wind, cold and dampness, traumatic injury and strain, and strain and flash, resulting in poor qi and blood flow in the affected shoulder or damage to the tendons and veins. The Suwen Paralysis Book says: “Wind, cold and dampness are mixed to the three qi, and combined to make paralysis”. If the shoulder disease is prolonged, the local Qi and blood will be stagnant, and dampness and heat will be generated, resulting in mild swelling of the affected area, or even stiffness of the joint and inability to move the elbow and arm. If the disease persists for a long time, muscle atrophy may occur in the affected limb due to stagnation of wind and cold, stagnation of qi and blood, and paralysis of tendons and veins. In this formula, Douhu, Fangfeng, Gentiana macrophylla, and Wuzhu snake can dispel wind and dispel cold, relieve tendons and activate collaterals to treat wind-damp pain and wind-cold damp paralysis; Chuanxiong and Yanhuo move qi and relieve pain, so that qi can move blood; Cao Wu and Ma Qianzi dispel dampness and cold, which can activate blood and resolve blood stasis, and have the effect of dispelling wind and collaterals to stop paralysis; Gui Zhi is pungent and warm, moving up the shoulder and arm to relieve tendon and vein contractures and joint congestion; Radix et Rhizoma Pseudostellariae warms the meridians and disperses cold; Angelicae Sinensis and Hong Hua can invigorate blood, nourish blood and open collaterals. TDP has a strong thermal effect, which increases skin temperature, expands skin capillaries, promotes blood circulation and metabolism, and the drug penetrates the skin through the expanded pores, relaxes muscles and ligaments, loosens adhesions, and dissolves freezing and coagulation. Tui Na is a traditional Chinese medicine treatment method, its function of opening the meridians, activating the channels, resolving stasis and relieving pain is very significant. The rolling, kneading, flicking and plucking techniques in Tui Na are conducive to loosening local soft tissue adhesions; the pulling and shaking techniques applied to the shoulder can promote the flow of joint fluid to increase the nutritional supply of joint cartilage, loosening the adhesions of tendons, preventing joint degeneration, preventing re-adhesions and improving the range of motion of joints. The combined use of various therapies will make the shoulder blood and Qi flourish, the meridians and channels pass, the function is restored and various symptoms disappear naturally or are relieved.