探讨以50%高渗葡萄糖注射液肩关节注射联合针刀治疗颈脊髓损伤后肩痛的临床疗效。

选取2023年7月至2025年4月在宁波市康复医院脊髓损伤康复科住院治疗的颈脊髓损伤后肩痛患者82例，根据数字表法随机均分为2组。对照组行颈脊髓损伤常规康复训练，包括肢体关节活动训练、肢体功能训练（15~20 min/次，1次/d，5次/周）；观察组在对照组的基础上给予50%葡萄糖注射液注射治疗联合针刀治疗松解肩痛点（1次/周，共4周）。通过比较治疗前后Constant-Murley肩关节评分包括疼痛评分、日常生活能力评分、关节被动活动度和肌力评分来评定疗效。于第4周治疗后，以肩关节评分好转率和有效率进行疗效评价。痊愈：无肩痛，显效为肩关节评分好转率≥50%，有效为肩关节评分好转率为20%~50%，无效：肩关节评分<20%。

2组患者治疗后的Constant-Murley肩关节评分较治疗前改善，差异均有统计学意义（Z_对照组=6.667、Z_观察组=6.035，P均<0.01）。高渗葡萄糖注射联合针刀治疗后，患者的Constant-Murley肩关节评分总评分改善较对照组更明显（t=6.962，P<0.05），疼痛方面（Z=-3.306，P<0.05）等改善明显。50%高渗葡萄糖注射治疗可以有效缓解颈脊髓损伤患者的肩痛情况，其中痊愈20例，显效19例，有效2例，总有效率95.12%，与对照组（70.73%）相比，差异具有统计学意义（χ²=8.613，P<0.01）。

高渗葡萄糖注射治疗联合针刀治疗可缓解颈脊髓损伤患者的肩痛，提高上肢运动及感觉功能，疗效显著。

To investigate the clinical effect of 50% hypertonic glucose injection into the shoulder joint combined with acupotomology in the treatment of shoulder pain after cervical spinal cord injury.

A total of 82 patients with shoulder pain after cervical spinal cord injury who were hospitalized in Department of Spinal Cord Injury Rehabilitation，Ningbo Rehabilitation Hospital from July 2023 to April 2025 were selected and randomly divided into 2 groups according to the random number table method. The control group received limb joint range of motion training and limb function training （15–20 min per session， once daily， 5 times weekly）， while the observation group， on the basis of the control group's training， additionally received ultrasound-guided 50% hypertonic glucose injection combined with acupotomy for releasing shoulder pain points （once weekly， for a total of 4 weeks）； efficacy was assessed by comparing the pre- and post-treatment Constant-Murley shoulder joint scores， including pain score， activities of daily living score， passive range of motion score， and muscle strength score， and after 4 weeks of treatment， efficacy was further evaluated using shoulder score improvement rate and effective rate. Cured: no shoulder poin, markedly effective: reduced shoulder pain with shoulder score improvement rate of ≥50%, effective: shoulder joint score improvement rate between 20% and 50%, ineffective : shoulder joint score improvement rate <20%.

Within each group， the Constant-Murley shoulder joint scores of patients in both groups were significantly improved after treatment compared with those before treatment， and the differences were statistically significant （Z_{control group}=6.667，Z_{observation group}=6.035, both P<0.01）. In the intergroup comparison， the total Constant-Murley shoulder joint score of patients in the observation group （treated with high glucose injection combined with needle knife therapy） was improved more significant than the control group (t=6.962, P<0.05)， with remarkable improvements in pain （Z=-3.306, P<0.05） etc.. The 50% hypertonic glucose injection combined with needle knife therapy （administered to the observation group） could effectively relieve shoulder pain in patients with cervical spinal cord injury. Among the observation group patients， 20 cases were cured， 19 cases were marked effective， 2 cases showed effect， and the total effective rate was 95.12%, which was statistically significant compared with the control group (70.73%) (χ²=8.613, P<0.01).

Hypertonic glucose injection therapy combined with needle knife therapy can relieve shoulder pain in patients with cervical spinal cord injury， improve the motor and sensory functions of the upper limbs， and the therapeutic effect is remarkable.