中医外治法治疗肩袖损伤临床研究进展

Clinical Research Progress on Traditional Chinese External Therapies for Rotator Cuff Injuries

摘要: 目的：系统梳理近年中医外治法治疗肩袖损伤的临床与机制研究，概括疗效与安全性证据，并提出规范化应用与研究改进方向。方法：基于既往临床试验、回顾性研究与综述，对针刺、电针、小针刀、推拿及中药外用等外治法的应用、疗效与安全性进行分析。结果：多数研究显示，中医外治可显著缓解疼痛、提升肩关节功能，并与康复训练协同促进恢复。常规针刺通过改善微循环与调节炎症通路镇痛；电针联合康复训练在疼痛缓解和功能改善方面可能较单纯康复具有一定优势。超声引导小针刀可松解粘连、减轻疼痛，严重不良事件罕见。推拿与中药外治对功能改善亦有积极作用。结论：中医外治在肩袖损伤的保守治疗与术后康复中具有显著镇痛与功能改善优势，安全性总体可控。未来需大样本、多中心、长期随访的随机对照试验，并统一操作与报告规范。

Abstract: Objective: To systematically review recent clinical and mechanistic studies on traditional Chinese external therapies for rotator cuff injuries (RCI), summarize evidence on efficacy and safety, and propose directions for standardized application and future research improvement. Methods: Based on previous clinical trials, retrospective studies, and reviews, the application, efficacy, and safety of external therapies such as acupuncture, electroacupuncture, small needle-knife, tuina, and topical Chinese herbal medicine were analyzed. Results: Most studies have shown that external therapies of traditional Chinese medicine can significantly relieve pain, improve shoulder joint function, and act synergistically with rehabilitation training to promote recovery. Conventional acupuncture exerts analgesic effects mainly by improving microcirculation and modulating inflammatory pathways; electroacupuncture combined with rehabilitation training may offer certain advantages over rehabilitation alone in pain relief and functional improvement. Ultrasound-guided small needle-knife therapy can release adhesions and alleviate pain, with serious adverse events rarely reported. Tuina and topical Chinese herbal therapies also play a positive role in functional improvement. Conclusions: Traditional Chinese external therapies show notable analgesic and functional benefits in conservative and postoperative management of RCI with an acceptable safety profile. Future research requires large-sample, multicenter randomized controlled trials with long-term follow-up, and standardized intervention procedures and reporting guidelines.