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对粘性囊炎的非手术治疗策略进行比较:叙述性综述
Shu-Mei Yang1, Shu-Chiang Hsu1, Pei-Xuan Shih1
1Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan.
Journal of the Formosan Medical Association = Taiwan yi zhi
|August 19, 2025
概括
有针对性的治疗和多模式策略可以改善粘合性囊炎 (冷肩) 的结果. 探索除了皮质类固醇之外的选择,如氨酸或富血小板血,提供个性化的疼痛缓解和增强的移动性.
科学领域:
- 整形外科 整形外科 整形外科
- 运动医学 运动医学
- 物理疗法物理治疗
背景情况:
- 粘合性囊炎,或结的肩膀,导致显著的疼痛和有限的运动.
- 目前的治疗方法,如皮质类固醇注射,具有可变的有效性.
- 对向注射,替代疗法和非手术方法的兴趣越来越大.
研究的目的:
- 审查关于粘合性囊炎的非手术治疗方法的证据.
- 评估各种注射剂和治疗方式的疗效.
- 根据疾病阶段和解剖学来确定最佳的治疗策略.
主要方法:
- 49个随机对照试验的叙述性综述.
- 治疗方法的分析包括皮质类固醇,酸 (HA),富血小板血 (PRP),脉冲射频 (PRF),体外冲击波疗法 (ESWT),水解 (HD) 和上神经阻塞 (SSNB).
- 评估有针对性的注射策略和多模式方法.
主要成果:
- 针对特定的部位 (例如旋转器间隔) 和多式模式策略可以改善早期的症状缓解.
- 氨酸提供一种类固醇节约的选择,具有类似的长期效果.
- 富含血小板的血可能有助于慢性病例;水分扩张增强了早期的运动能力.
- ESWT和PRF提供疼痛调节和组织恢复机制.
结论:
- 根据疾病阶段和解剖学的参与来个性化治疗至关重要.
- 头骨上神经阻塞可以作为缓解疼痛的辅助.
- 长期有效性评估需要标准化方案和进一步的高质量试验.
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