目的 探讨壮筋养血中药外敷对军训慢性冈上肌腱损伤的治疗效果。方法 选择2019年1-6月因军事训练导致慢性冈上肌腱损伤,在联勤保障部队940医院中医康复科住院的军队伤病员60例,随机分对照组和观察组,各30例,对照组给予布洛芬缓释胶囊(0.4 g,口服2次/d),观察组予以壮筋养血中药研沫调和蜂蜜外敷于冈上肌腱等肩关节疼痛部位,联合TDP灯加热促进药物渗透吸收,每次30 min,治疗15 d,结束后观察治疗效果。结果 观察组患者治疗后与治疗前相比,肩关节疼痛症状好转,差异有统计学意义(P<0.05),但与对照组相比,治疗后肩关节疼痛症状无统计学差异;两组患者治疗后相比,观察组患者肩关节活动度明显改善,与对照组相比差异有统计学意义(P=0.000);观察组患者上肢肌力提高,日常生活自理能力改善,肩关节Constant-Murley评估总分明显提高,与对照组相比差异均有统计学意义(P=0.013)。观察组治疗中的不良反应发生率(3.3%)低于对照组(13.3%),但差异无统计学意义。结论 壮筋养血中药外敷在军事训练所致慢性冈上肌腱损伤的治疗中,其止痛效果类似于布洛芬缓释胶囊,在改善肩关节功能、提高生活自理能力方面具有更显著疗效,值得推广应用于军事训练伤的康复治疗中。

Objective To observe the efficacy of Zhuang-jin-yang-xue herbal plaster against chronic supraspinatus injury caused by military training. Methods Sixty military patients with chronic supraspinatus tendon injury caused by military training who were treated in our department between January 2019 and June 2019 were selected and randomly divided into the control group and observation group, with thirty cases in each. The control group was given oral ibuprofen sustained release capsules 1/12 hour (0.4 g), while the observation group had Zhuang-jin-yang-xue herbal medicine powder combined with honey placed on the sites of supraspinatus tendon injury. The TDP lamp heating was used to promote drug infiltration and absorption, 30 minutes each time and for 15 days. The curative effect was observed after one course of treatment. Results 1. The symptoms of shoulder joint pain in the observation group were improved after treatment, with statistically significant difference (P<0.05), but there was no statistically significant difference in the alleviation of symptoms of shoulder joint pain compared with the control group. 2. After treatment, the shoulder joint activity of the observation group was significantly improved, and the difference was statistically significant compared with the control group (P=0.000). The total score of Constant-Murley assessment of joints was significantly improved, and the difference was statistically significant compared with the control group (P=0.013). The incidence of adverse reactions in the observation group (3.3%) was lower than that in the control group (13.3%), but the difference was not statistically significant. Conclusions External application of Chinese herbal medicine Zhuang-jin yang-xue in the treatment of chronic supraspinatus tendon injury caused by military training can deliver similar analgesic effect to ibuprofen sustainable-release capsules or other oral analgesic drugs, and it is more effective for improving shoulder joint function and the self-care ability in daily life. This approach is applicable to the rehabilitation of military training injuries.