[1]张士栋,李华东,张萱,等.柔筋抻展推拿法治疗渐冻期冻结肩临床研究[J].陕西中医,2026,(1):115-119.[doi:DOI:10.3969/j.issn.1000-7369.2026.01.021]
　ZHANG Shidong,LI Huadong,ZHANG Xuan,et al.Clinical study on the treatment of frozen shoulder in the freezing stage by the soft tendon stretching Tuina method[J].,2026,(1):115-119.[doi:DOI:10.3969/j.issn.1000-7369.2026.01.021]
点击复制

柔筋抻展推拿法治疗渐冻期冻结肩临床研究

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年1期
页码:
115-119
栏目:
针灸经络
出版日期:
2026-01-05

文章信息/Info

Title:
Clinical study on the treatment of frozen shoulder in the freezing stage by the soft tendon stretching Tuina method
作者:
张士栋1; 2; 李华东3; 张萱4; 李粒萌1; 2; 李华南1; 5; 张玮1; 5; 陈英英1; 5; 乔英杰3; SIRILAKSADAPORN Natthaya1; 2（泰国）; 谭涛1; 5
（1.天津中医药大学第一附属医院 国家中医针灸临床医学研究中心，天津 300193；2.天津中医药大学，天津 301617；3.山东中医药大学附属医院，山东 济南250014；4.辽宁中医药大学，辽宁 沈阳110847；5.国家中医药管理局推拿手法生物效应三级实验室，天津 300193）
Author(s):
ZHANG Shidong1; 2; LI Huadong3; ZHANG Xuan4; LI Limeng1; 2; LI Huanan1; 5; CHEN Yingying1; 5; QIAO Yingjie3; SIRILAKSADAPORN Natthaya1; 2; TAN Tao1; 5
(1.First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300193,China;2.Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;3.Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;4.Liaoning University of Traditional Chinese Medicine,Shenyang 110847, China;5.Level 3 Laboratory of Biological Effects of Massage Manipulation of State Administration of Traditional Chinese Medicine,Tianjin 300193,China)
关键词:
冻结肩; 渐冻期; 纤维化; 炎症; 推拿; 柔筋抻展推拿法; 抻展法
Keywords:
Frozen shoulder; The freezing stage; Fibrosis; Inflammation; Tuina; The soft tendon stretching Tuina method; The stretching method
分类号:
R 244.1
DOI:
DOI:10.3969/j.issn.1000-7369.2026.01.021
文献标志码:
A
摘要:
目的：评价柔筋抻展推拿法治疗渐冻期冻结肩（FS）的临床疗效。方法：70例渐冻期FS患者随机分组，观察组给予柔筋抻展推拿法治疗，对照组给予常规推拿法治疗，干预4周。对比治疗前后Neer肩关节功能评分、外周血清中转化生长因子-β1（TGF-β1）、白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）水平的变化，统计并分析临床疗效。结果：治疗后，观察组Neer肩关节功能评分高于对照组（P＜0.05），观察组TGF-β1、IL-6、IL-1β水平低于对照组（P＜0.05），观察组总有效率（96.88%）高于对照组总有效率（90.91%）（P＜0.05）。结论：柔筋抻展推拿法可以有效改善渐冻期FS患者的肩关节症状，改善关节囊炎症、纤维化程度。在渐冻期FS推拿治疗方案中，选用抻展法优于选用扳法，抻展法的操作相对简单且安全性高，患者依从性高。
Abstract:
Objective:To evaluate the clinical efficacy of the soft tendon stretching Tuina method in treating frozen shoulder (FS) in the freezing stage.Methods:Seventy patients with FS in the freezing stage were randomly grouped and treated with soft tendon stretching Tuina method in the observation group and conventional Tuina method in the control group for 4 weeks of intervention.The Neer shoulder joint function scores and the levels of TGF-β1,IL-6 and IL-1β in peripheral serum were compared before and after treatment,and the clinical efficacy was counted and analyzed.Results:After treatment,compared with the control group the Neer shoulder joint function scores of the observation group were higher (P＜0.05),and the levels of TGF-β1,IL-6,and IL-1β of the observation group were lower (P＜0.05).The total effective rate of 96.88% in the observation group was higher than that of 90.91% in the control group (P＜0.05).Conclusion:The soft tendon stretching Tuina method can effectively improve the shoulder joint symptoms of patients with FS in the freezing stage,and reduce the degree of inflammation and fibrosis of the joint capsule.The stretching method is better than the wrenching method in the Tuina therapy protocol of FS in the freezing stage,and the operation of the stretching method is relatively simple and safe,with high patient compliance.

参考文献/References:

[1]周昊,孙岩军,李石良.肩关节周围炎针刀临床诊疗指南[J].中华中医药杂志,2024,39(11):5989-5994.
[2]MILLAR N L,MEAKINS A,STRUYF F,et al.Frozen shoulder[J].Nat Rev Dis Primers,2022,8(1):59.
[3]吕小锋,刘姗姗,邓鑫敏,等.甲状腺功能障碍与肩周炎的因果关系：一项双向、两样本孟德尔随机化研究[J].现代预防医学,2023,50(18):3438-3446.
[4]TANG L,CHEN K,MA Y,et al.Scapular stabilization exercise based on the type of scapular dyskinesis versus traditional rehabilitation training in the treatment of periarthritis of the shoulder:Study protocol for a randomized controlled trial[J].Trials,2021,22(1):713.
[5]黄晨晨,寇久社,江振华,等.雌激素在疼痛调控中的作用机制[J].神经解剖学杂志,2023,39(6):723-727.
[6]张莉,王亚利,何利,等.肩周炎患者维生素D营养水平与骨代谢指标相关性研究[J].营养学报,2022,44(6):573-576.
[7]杨铎.“以松治痛”理论指导治疗冻结肩（冻结期）的临床研究[D].乌鲁木齐:新疆医科大学,2024.
[8]秦晓宽,孙凯,刘军,等.《肩关节周围炎中医诊疗指南》解读[J].中国循证医学杂志,2024,24(5):536-542.
[9]KARBOWIAK M,HOLME T,MIRZA M,et al.Frozen shoulder[J].BMJ,2022,377:68547.
[10]张丽艳,唐梦雨,任普阳,等.体外冲击波治疗肩关节周围炎90例临床观察[J].陕西医学杂志,2010,39(11):1558.
[11]刘莎莎,叶济灵,徐丽丽,等.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[J].中国康复医学杂志,2023,38(4):472-477.
[12]邹欢,曾飞,叶立祥,等.粘连性肩关节囊炎治疗研究进展[J].中国疼痛医学杂志,2023,29(2):127-132.
[13]薛庆云,赵立连,徐旭阳,等.奇正消痛贴膏治疗渐冻期冻结肩的多中心随机对照临床试验[J].中华肩肘外科电子杂志,2021,9(4):352-359.
[14]郑利君,王建民,乔英杰,等.推拿对肩关节周围炎模型兔滑膜炎症及关节囊纤维化因子的影响[J].山东中医药大学学报,2023,47(6):757-765.
[15]卢园,陈海南,杨舟,等.小鱼际滚法对兔骨骼肌急性钝搓伤组织机化期GDF-8/Smad2通路的影响[J].湖南中医药大学学报,2021,41(9):1345-1349.
[16]李薇薇,满斌.针刺联合横络解结法治疗气滞血瘀证神经根型颈椎病30例[J].中国针灸,2023,43(12):1433-1434.
[17]王振国.灵枢经[M].2版.北京:中国中医药出版社,2022:292.
[18]吴锡,董宝强,林星星,等.论经筋针刺的辨证施治思维[J].中华中医药学刊,2024,42(5):61-64.
[19]孙晓薇,阚伯红,边明彤,等.针刺“肩三针”治疗肩周炎研究进展[J].陕西中医,2024,45(8):1151-1153.
[20]蒋全睿,冯祥,刘丹,等.不同力量推拿按法对大鼠肌筋膜疼痛触发点的影响[J].中国组织工程研究,2024,28(27):4360-4366.
[21]方仪德,胡浩,许金海,等.手法治疗肩周炎有效性和安全性的Meta分析[J].中国全科医学,2024,27(5):628-636.
[22]蒋海军,卜献忠,钟远鸣,等.棍点理筋正骨手法治疗肩周炎患者30例的随机对照试验[J].中医杂志,2024,65(3):292-298.
[23]郑宽广,陈志标,许美珍,等.运动式推拿疗法联合关节松动术对冻结肩患者疼痛、肩关节活动及血清炎症指标的影响[J].陕西中医,2021,42(3):372-375.
[24]孙宇辰.推拿联合拉伸疗法治疗冻结肩粘连期的疗效观察[D].济南:山东中医药大学,2020.
[25]王建民.三步推拿法干预冻结肩关节囊纤维化的临床及实验研究[D].济南:山东中医药大学,2022.
[26]郭磊,齐岩松,牛啸博.转化生长因子β亚家族调控骨关节炎中的作用[J].中国组织工程研究,2024,28(35):5695-5701.
[27]宋宇,包秀丽.JNK与TGF-β、非经典Wnt信号通路在眼部纤维化中的研究进展[J].陕西医学杂志,2023,52(2):233-237.
[28]李超然,闫蕾,王惠,等.炎性细胞因子对肺血管内皮细胞与肺成纤维细胞三维立体培养基质金属蛋白酶2的影响[J].陕西医学杂志,2023,52(7):920-924.
[29]申成凯,刘坤,刘伟良,等.白细胞介素1B基因连锁不平衡与原发性冻结肩的易感性[J].中国组织工程研究,2024,28(27):4367-4372.
[30]张照庆,王小飞,尹晶,等.针刀疗法对肩周炎模型兔肩关节囊局部组织中基因蛋白表达的影响[J].陕西中医,2021,42(8):991-994.

备注/Memo

备注/Memo:
国家中医药管理局高水平中医药重点学科-推拿学建设项目（2024ZDK002）；国家中医药管理局区域中医（推拿专科）诊疗中心建设项目（963042）；国家中医药管理局中医药传承与创新“百千万”人才工程（岐黄工程）项目（885022）；第七批全国老中医药专家学术经验继承工作项目（202276）；天津市名中医传承工作室建设项目（TJMZY2405）；齐鲁医派中医学术流派传承项目（鲁卫函〔2022〕93号）；济南市临床医学科技创新计划项目（202019059）
更新日期/Last Update: 2026-01-08