肩胛上神经阻滞联合关节腔激素注射与单纯 关节腔激素注射治疗冻结肩疗效对比

Comparison of Efficacy between Suprascapular Nerve Block Combined with Intra-Articular Corticosteroid Injection and Intra-Articular Corticosteroid Injection Alone in the Treatment of Frozen Shoulder

摘要: 目的：探讨肩胛上神经阻滞(SSNB)联合关节腔糖皮质激素(GC)注射与单纯关节腔GC注射治疗冻结肩(FS)的临床疗效差异。方法：选取2024年6月至2025年5月青岛大学附属医院康复医学科门诊40例FS患者，采用随机数字表法分为实验组(SSNB联合关节腔GC注射，n = 20)和对照组(单纯关节腔GC注射，n = 20)。两组患者注射后均接受关节松动训练及两周康复训练指导。比较两组治疗后即刻、1周、4周、12周的肩关节疼痛视觉模拟评分(VAS)、肩痛和残疾指数(SPADI)及肩关节活动度(ROM)。采用SPSS26.0软件进行统计学分析。结果：两组患者治疗后各时间点VAS评分、SPADI评分及肩关节各方向活动度均较治疗前显著改善(P < 0.05)。治疗后即刻及1周，实验组VAS评分、SPADI评分显著低于对照组(P < 0.001)；实验组肩关节前屈、外展、外旋活动度显著优于对照组(P < 0.05)，内旋活动度在治疗后即刻及1周均显著优于对照组(P < 0.05)。治疗后4周及12周，两组上述指标比较差异无统计学意义(P > 0.05)。结论：SSNB联合关节腔GC注射治疗FS可快速缓解早期疼痛、改善肩关节功能及关键方向活动度，短期疗效优于单纯关节腔GC注射，长期疗效与单纯关节腔GC注射相当，可为FS临床治疗提供参考。

Abstract: Objective: To explore the difference in clinical efficacy between suprascapular nerve block (SSNB) combined with intra-articular corticosteroid (GC) injection and intra-articular GC injection alone in the treatment of frozen shoulder (FS). Methods: A total of 40 FS patients who were treated in the outpatient department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University from June 2024 to May 2025 were selected. They were divided into an experimental group (SSNB combined with intra-articular GC injection, n = 20) and a control group (intra-articular GC injection alone, n = 20) using a random number table method. All patients in both groups received joint mobilization training immediately after injection and two-week rehabilitation training guidance. The shoulder pain visual analog scale (VAS) scores, shoulder pain and disability index (SPADI) scores and shoulder joint range of motion (ROM) of the two groups were compared immediately after treatment, 1 week, 4 weeks and 12 weeks after treatment. SPSS 26.0 software was used for statistical analysis. Results: At each time point after treatment, the VAS scores, SPADI scores and shoulder joint ROM in all directions of both groups were significantly improved compared with those before treatment (P < 0.05). Immediately after treatment and 1 week after treatment, the VAS scores and SPADI scores of the experimental group were significantly lower than those of the control group (P < 0.001). The shoulder joint forward flexion, abduction and external rotation ROM of the experimental group were significantly better than those of the control group (P < 0.05), and the internal rotation ROM was significantly better than that of the control group both immediately after treatment and 1 week after treatment (P < 0.05). There were no statistically significant differences in the above indicators between the two groups 4 weeks and 12 weeks after treatment (P > 0.05). Conclusion: SSNB combined with intra-articular GC injection in the treatment of FS can quickly relieve early pain, improve shoulder joint function and ROM in key directions. Its short-term efficacy is better than that of intra-articular GC injection alone, and the long-term efficacy is equivalent to that of intra-articular GC injection alone, which can provide a reference for the clinical treatment of FS.