基于“风寒湿邪”理论 三七通痹丸联合关节 运动训练治疗风寒湿痹型 肩关节周围炎的 临床研究

Clinical Study on the Treatment of Wind-Cold-Dampness Bi Syndrome Periarthritis of the Shoulder Joint with Sanqi Tongbi Pill Combined with Joint Exercise Training Based on the “Wind-Cold-Dampness Pathogen” Theory

摘要: 目的：比较三七通痹丸联合关节运动训练与单纯关节运动训练治疗风寒湿痹型肩关节周围炎(肩周炎)的临床疗效及安全性差异。方法：采用单中心随机对照设计，纳入眉山市中医医院骨六科2024年6月~2025年5月收治的60例风寒湿痹型肩周炎患者。通过密封信封法随机分为两组：对照组(关节运动训练)，中药组(三七通痹丸 + 关节运动训练)，疗程10 d。分别于治疗前、治疗后(10 ± 2) d、1个月及3个月随访时，评估两组视觉模拟疼痛评分(VAS)、肩关节功能评分(Constant-Murley评分)、肩关节活动度(ROM)、日常生活能力(ADL量表)及生活质量(SF-36量表)改善情况，并在疗程结束时记录不良反应。结果：与对照组相比，中药组在缓解疼痛、改善关节功能、增加肩关节活动度(前屈、外展、后伸)、提升日常生活能力及生活质量方面均显著更优(均P < 0.01)，总有效率也明显提高，而两组不良反应发生率无显著差异。结论：联合治疗能更有效改善患者临床症状与关节功能，提高生活质量，且疗效持久、安全性好，值得临床推广。

Abstract: Objective: To compare the clinical efficacy and safety differences between Sanqi Tongbi Pill combined with joint exercise training versus pure joint exercise training in the treatment of wind-cold-dampness arthralgia-type periarthritis of the shoulder (periarthritis of the shoulder). Method: A single-center randomized controlled study was conducted, enrolling 60 patients with wind-cold-dampness arthralgia-type periarthritis of the shoulder admitted to the Department of Orthopedics VI at Meishan Hospital of Traditional Chinese Medicine from June 2024 to May 2025. Patients were randomly assigned to two groups using the sealed envelope method: the control group (joint exercise training only) and the herbal medicine group (Sanqi Tongbi Pill + joint exercise training), with a treatment duration of 10 days. Improvements in visual analog pain score (VAS), shoulder joint function score (Constant-Murley score), shoulder range of motion (ROM), activities of daily living (ADL scale), and quality of life (SF-36 scale) were evaluated before treatment, at 10 ± 2 days post-treatment, at 1 month, and at 3 months of follow-up. Adverse reactions were recorded at the end of the treatment course. Results: Compared with the control group, the traditional Chinese medicine group demonstrated significantly superior outcomes in pain relief, joint function improvement, increased shoulder joint range of motion (flexion, abduction, extension), enhanced daily living ability, and improved quality of life (all P < 0.01), with a markedly higher overall response rate. No significant difference in adverse reaction incidence was observed between the two groups. Conclusion: Combined therapy more effectively alleviates clinical symptoms and improves joint function, enhances quality of life, exhibits durable efficacy and favorable safety profiles, making it worthy of clinical promotion.