肩關節是人類所有關節中活動度最大的關節，一但肩關節活動失能，則患者的許多生活功能長久受限，一般估計冷凍肩（frozen shoulder）約佔所有肩膀疼痛患者之2 % - 3 %。 早期研究指出對於冷凍肩的治療包括口服藥物、局部注射、物理治療以及外科手術去除沾黏性組織，但在執行上均有一定難度及副作用。而中醫針灸治療冷凍肩方面，在傳統中醫典籍上早已有明確記載且臨床上也已被證實。然而治療前後療效的評估仍是依賴目視或是精準度低的量尺進行量測。因此關於這部分的定量與科學驗證方面至今未曾被發表。本研究為首次將中醫針刺治療冷凍肩後，利用三維動態立體攝影技術(stereophotogrammetry)進行定量評估。 本研究中設立了三種狀態，分別為對照、偽穴與真實治療。對照狀態為受試者尚未接受任何治療，偽穴狀態是希望排除測試時的各種心理作用產生的影響，實穴治療為針刺條口(Tiao-kou , ST-38)透承山 (Chen-shan , UB-57)。利用三維動態立體攝影技術進行定量評估冷凍肩患者在這些狀態下的肩部活動情況。研究結果顯示針刺條口透承山穴後，確實能改善患者手臂外展情況且帶來了瞬間的療效。這樣的結果印證了中醫典籍上針刺治療對冷凍肩的說法。另外一方面證實整個肱骨外展(abduction)角度的改善是來自肩胛胸廓關節(scapulothoracic joint, ST joint)上的改變，而非病灶點盂肱關節(glenohumeral joint, GH joint)上。 冀希借此建立一套客觀的量測技術且有助於冷凍肩療效的診斷與機制的研究。; The shoulder joint is one of the most mobile joints in the body, playing an important role in the normal function of the upper extremity. Any injury or disease will cause degradation or even loss of function of the upper limb with huge impact on the daily living and a number of frozen shoulder patients comprise 2-3% of that of shoulder’s pain. It has been pointed out that treatment with drugs, including taking orally or local injection, with physical therapy, and with surgery that dealt with adhesive tissues may come with other complications, however, there exists a certain degree of side effects and difficulty in practice. As to the therapy of frozen shoulder in Chinese acupuncture, the effect of the therapy is not only precisely documented in the classical Chinese medical literature but also proven in the clinical medicine. However, the efficacy of treatment was generally judged by subjective observations by the naked eye or by less accurate goniometers. Therefore no quantitative and scientific evidence has been reported. The study is the first in the world that used high precision three-dimensional video-based stereophotogrammetry to evaluate quantitatively the treatment effects of acupuncture therapy of frozen shoulders. Three test conditions were included in the study: blank, fake and true treatment. The blank condition was tested first before the subject received any treatment. Fake test condition was used to test possible psychological effects of the acupuncture treatment. True treatment was that it treated with acupuncture at Tiao-kou (ST-38) and Chen-shan (UB -57). They were to evaluate quantitatively the motion of frozen shoulders by using video-based stereophotogrammetry and electromyography. The results reported in the present study are immediate treatment effects that the patients can abducing more after the therapeutic acupoints”ST-38 and UB-57”. This finding confirms the teachings described in the classical Chinese medical literature. Another result was showed the improvement of humeral abduction angle was form the scapulothoracic joint, was not the pathogeny of glenohumeral joint. It is hoped that the efficacy of this treatment can be scientifically proven the developed measurement and evaluation technique will be helpful for the diagnosis of patients with frozen shoulders and will be helpful for the planning and implementation of long-term studies on the treatment mechanism and efficacy of acupuncture in frozen shoulder.
