针灸推拿治疗肱二头肌长头腱肌腱炎的研究进展

Research Progress in the Treatment of Tendinitis of Long Head of Biceps Brachii with Acupuncture and Moxibustion and Massage

摘要: 肱二头肌长头腱肌腱炎是一种常见的肩部运动损伤，主要因肱二头肌长头腱在肩关节反复活动中遭受摩擦、劳损或外伤，导致腱鞘充血、水肿及粘连，临床表现为肩部前侧疼痛、活动受限及Yergason征阳性。高发人群包括中老年人、长期从事肩部重复性运动的运动员及有肩部外伤史者。当前临床治疗以阶梯式方案为主：急性期采用休息、冰敷、非甾体抗炎药及局部封闭；慢性期结合物理治疗功能锻炼预防冻结肩；保守治疗无效者考虑手术松解。针灸推拿作为中医特色疗法，近年来在该病治疗中展现独特优势。针灸通过刺激阿是穴、肩髃、肩井等穴位，结合电针、温针、刺络拔罐等技术，可调节局部炎症因子表达，改善微循环，促进软组织修复。研究表明，针灸不仅能显著缓解疼痛，还可提升肩关节活动度，其作用机制涉及中枢镇痛物质释放、局部炎症抑制及粘连松解。推拿手法配合关节松动术，可舒筋通络、松解肌腱粘连，改善肩部力学平衡。相较于传统疗法，针灸推拿具有微创、低副作用及整体调节的特点，尤其适用于慢性期及术后康复。本文聚焦于针灸推拿治疗肱二头肌长头腱肌腱炎的研究进展，以推动该疗法的临床规范化应用。

Abstract: Tendinitis of the long head of the biceps brachii muscle is a common shoulder movement injury, mainly caused by friction, strain or trauma of the long head tendon of the biceps brachii muscle during repeated activities of the shoulder joint, resulting in congestion, edema and adhesion of the tendon sheath. Clinical manifestations include anterior shoulder pain, limited movement and positive Yergason sign. The high-risk population includes middle-aged and elderly people, athletes who have engaged in repetitive shoulder exercises for a long time, and those with a history of shoulder injuries. The current clinical treatment mainly adopts a step-by-step approach: rest, ice compress, nonsteroidal anti-inflammatory drugs, and local blockade are used in the acute phase; Chronic phase combined with physical therapy and functional exercise to prevent frozen shoulder; Patients who fail conservative treatment may consider surgical release. Acupuncture and moxibustion and massage, as the characteristic treatment of traditional Chinese medicine, have shown unique advantages in the treatment of this disease in recent years. Acupuncture and moxibustion can regulate the expression of local inflammatory factors, improve microcirculation and promote the repair of soft tissue by stimulating Ashi, Jiandang, Jianjing and other points, combined with electroacupuncture, warm acupuncture, blood letting puncture and cupping and other techniques. Research shows that acupuncture and moxibustion can not only significantly relieve pain, but also improve shoulder joint mobility. Its mechanism involves the release of central analgesic substances, local inflammation inhibition and adhesion release. Massage techniques combined with joint mobilization can relax tendons, unblock collaterals, release tendon adhesions, and improve shoulder mechanical balance. Compared with traditional therapy, acupuncture and moxibustion and massage have the characteristics of minimally invasive, low side effects and overall regulation, especially suitable for chronic stage and postoperative rehabilitation. This article focuses on the research progress of acupuncture and moxibustion and massage in the treatment of tendinitis of the long head of biceps brachii to promote the clinical standardized application of this therapy.