超声可视化引导下针刀配合液压扩张术治疗粘连性肩关节囊炎的研究进展

Research Progress on Ultrasound-Guided Acupotomy Combined with Hydrodilatation for Adhesive Capsulitis of Shoulder

摘要: 粘连性肩关节囊炎(ACS)是一种以肩部不适及活动受限为主要特征的病症。近年来，一种结合了超声可视化引导下的液压扩张与针刀技术的新疗法逐渐兴起，并显示出良好的治疗效果和安全性。本综述总结了过去十年间该领域内的研究进展，概述了超声可视化指导、针刀干预以及液压扩张法的基本概念。针刀通过解除局部粘连、调整生物力学特性及调节神经功能来恢复关节的功能平衡；而液压扩张法则利用液体压力作用于粘连部位，从而增加关节活动范围并减轻疼痛感。然而，单独使用任一方法都有其局限之处：针刀可能无法有效处理关节囊内部的炎症问题，而单纯依靠液压扩张则难以彻底分离那些已经纤维化的组织。当两者联合应用时，针刀可以预先松解周围区域的粘连状态，为后续的液压扩张创造有利条件，进而形成一套综合性的治疗策略。不过，现阶段仍存在基础科学研究不足的问题，缺乏长期跟踪观察的数据支持。未来的研究方向应该着眼于扩大样本规模的临床试验和动物模型实验，优化标准化操作流程，进一步验证这一疗法的有效性。

Abstract: Adhesive capsulitis of the shoulder (ACS) is a condition characterized mainly by shoulder discomfort and limited range of motion. In recent years, a new treatment combining ultrasound-guided hydrodilatation and acupotomy has emerged, showing good therapeutic effects and safety. This review summarizes the research progress in this field over the past decade and outlines the basic concepts of ultrasound visualization guidance, acupotomy intervention, and hydrodilatation. Acupotomy restores the functional balance of the joint by releasing local adhesions, adjusting biomechanical properties, and regulating nerve function. Hydrodilatation uses fluid pressure on the adhesions to increase the joint’s range of motion and relieve pain. However, each method has its limitations when used alone. Acupotomy may not effectively address the inflammation inside the joint capsule, while hydrodilatation alone may struggle to completely separate fibrotic tissues. When the two methods are combined, acupotomy can pre-release the adhesions in the surrounding area, creating favorable conditions for subsequent hydrodilatation, thus forming a comprehensive treatment strategy. Nevertheless, there is currently a lack of basic scientific research and long-term follow-up data. Future research should focus on clinical trials with larger sample sizes and animal model experiments, optimize standardized operating procedures, and further verify the effectiveness of this therapy.