中文摘要：

目的比较曲安奈德、派瑞昔布钠肩峰下间隙注射治疗肩关节撞击综合征的疗效。方法 59例确诊为肩关节撞击综合征患者随机分为激素组和非甾体消炎药(NSAID)组,激素组注射曲安奈德40mg,NSAID组注射派瑞昔布钠40mg,每位患者注射前后分别进行疼痛(VAS评分)和肩关节功能评价(HSS评分、外展度)。结果 37例最终获得随访,3周后随访,两组患者活动度与疼痛均明显改善。肩关节HSS评分NSAID组和激素组注射后30min均明显优于注射前,3周随访时NSAID组优于注射前,激素组与注射前比较差异无统计学意义。肩关节外展,NSAID组和激素组注射后30min均明显优于注射前,3周随访时NSAID组优于激素组,差异有统计学意义。结论肩峰下注射激素和NSAID药物均有助于减轻肩关节撞击综合征患者的疼痛,NSAID组肩关节活动度和HSS评分优于激素组。

英文摘要：

Background The common symptoms of shoulder impingement syndrome include shoulder pain and shoulder activity limitation,and shoulder pain is the chief complaint of majority of patients.There are many causes for shoulder pain,and the common causes include bursitis and tendon degeneration which are resulted from the impingement between subacromial bursa/rotator cuff and humerus/ acromion in the abduction activity of shoulder.The abnormal activity of humeral head and scapula which is resulted from rotator cuff injury may also cause shoulder impingement and generate symptoms.To alleviate pain and increase joint range of motion,such methods as no-load rest,cold compress,physical therapy,oral administration of nonsteroidalanti-inflammatory drugs (NSAID)and injection of cortical hormone are adopted for non-operational treatment of shoulder impingement.An international multicenter study shows that,injection of cortical hormone is an effective means for the patients for whom the other methods such as rest are ineffective without exception.However,the mechanism of its significant effect has not been made clear,and an widely accepted interpretation to its mechanism is that hormone can relieve sterile inflammatory reaction.However,the adverse effects of application of hormone for many times are obvious, and the common adverse effects include spontaneous rupture of supraspinatus tendon, skin atrophy on local injection site and cartilage degeneration at humeral head etc.The reason why local injection of hormone is effective in treatment of shoulder impingement syndrome is that hormone can relieve local inflammatory reaction.Then, whether local injection of NSAID can also avoid the adverse effects resulted from hormone in the mean time of achieving good curative effects thanks to its anti-inflammatory action? It is the objective of this study to know the effects of local injection of parecoxib sodium in reducing shoulder impingement syndrome as well as the advantages and disadvantages of hormone.Methods Ⅰ.Inclusion and ex