因气候与生活习惯影响,广东地区老年性肩周炎临床特点及康复需求具有独特性,亟待制定规范、具有当地特色的康复方案。为制订适合地区差异化的康复方案,广东省中西医结合学会康复专业委员会联合广东省康复医学发展研究会疼痛康复发展研究分会牵头发起,省内多家机构专家学者共同制订《老年性肩周炎中医全周期康复广东专家共识(2026年版)》。该共识以ICF框架为基础,立足肩周炎康复循证医学证据,结合多学科专家产教研实践经验,对肩周炎 ICF评定、中医适宜技术及康复治疗技术运用、阶梯式干预性措施制定和中西医全周期康复协同等方面形成共识性意见。本共识的发布,将为老年性肩周炎中医全周期康复提供规范化、本土化的“广东方案”。
Due to climatic and lifestyle influences,the clinical characteristics and rehabilitation needs of senile periarthritis of the shoulder in Guangdong region exhibit unique features,necessitating the development of standardized and locally tailored rehabilitation protocols.To formulate regionally differentiated rehabilitation plans,the Rehabilitation Professional Committee of Guangdong Association of Integrative Medicine and the Pain Rehabilitation Development Research Branch of Guangdong Rehabilitation Medicine Development Research Association jointly initiated the development of the “Guangdong Expert Consensus on TCM Full-Cycle Rehabilitation for Senile Periarthritis of the Shoulder(2026 Edition)” through collaboration with multiple provincial institutions and experts.Based on the International Classification of Functioning,Disability and Health(ICF)framework and evidence-based rehabilitation medicine for periarthritis of the shoulder,this consensus integrates multidisciplinary expertise from industry,academia,and research to establish unified guidelines on ICF assessment,application of appropriate TCM techniques and rehabilitation therapies,implementation of stepwise intervention measures,and integrated TCM-Western medicine full-cycle rehabilitation approaches.The publication of this consensus will provide a standardized and localized “Guangdong Solution” for TCM-based full-cycle rehabilitation of senile periarthritis of the shoulder.
目的 观察康柏西普玻璃体腔注射治疗湿性老年性黄斑变性病变对于视网膜神经纤维厚度的影响。方法 对2016年10月—2017年10月在汕头大学附属韶关市粤北人民医院采用康柏西普玻璃体腔注射治疗湿性老年性黄斑变性35例38眼中符合标准的患者18例(18眼)的临床资料进行回顾性分析,患者行最佳矫正视力、眼压(NCT)检查、OCT、荧光眼底血管造影(FFA)检查后,均接受0.05 mL康柏西普玻璃体腔注射,分别注射后1和2月观察患者最佳矫正视力 (BCVA)、视网膜神经纤维厚度(RNFL)变化。结果 18眼共接受康柏西普玻璃体腔注射54次,所有患眼均注射3次。注射3个月后,OCT检查结果显示有18眼视力有提高,CRT厚度有下降。第1次注射时和注射后1个月、2个月的BCVA分别为0.1(0.04,0.12),0.20(0.10,0.30)和0.25(0.12,0.30),总体比较差异有统计学意义(χ2=13.880,P<0.001);第1次注射时和注射后1个月、2个月的CRT(μm) 319.50(269.50,390.50), 271.00(219.00,296.25) 和234.50(182.75,273.25)总体比较差异有统计学意义(χ2=11.978,P<0.05),第1次注射时和注射后1个月、2个月后的 ARNFL(μm)86.00(76.25,98.00) 83.00(76.00,95.50)和 83.00(76.25,94.75) 总体比较差异无统计学意义(χ2=11.978,P>0.05),第1次注射时和注射后1个月、2个月眼压(kPa)2.27(1.97,2.44),16.0(13.7,17.0),和 2.00(1.84,2.31) 总体比较差异无统计学意义(χ2=1.604,P>0.05)。结论 玻璃体腔注射康柏西普治疗湿性老年性黄斑变性对视网膜神经纤维厚度无明显的损害,安全且有效,但仍需要大样本量及长期随访观察。
Objective To observe the effect on the thickness of retinal nerve fibers in the patients with wet age-related macular degeneration by adopted intravitreal injection with Conbercept. Methods We analyzed 18 cases (18 eyes) that conform to the standard from 35 cases(38 eyes) retrospectively,who were treated with wet age-related macular degeneration by adopted intravitreal injection with Conbercept in Shaoguan Yuebei People's Hospital Affiliated to Shantou University from October in 2016 to October in 2017.After undergoing best corrected visual acuity (BCVA),intraocular pressure (IOP) and fluorescein angiography (FFA),all of them were adopted intravitreal injection with 0.05mL Conbercept. We observed the changes of best corrected visual acuity (BCVA) and retinal nerve fiber thickness (RNFL) after 1 and 2 months of adopted intravitreal injection with 0.05 mL Conbercept. Results 18 eyes were adopted intravitreal injection Conbercept 54 times totally. All the eyes were injected three times. After 3 months of injection,OCT showed that the visual acuity of 18 eyes improved and the thickness of CRT decreased. The BCVA values at the first injection,after the first injection and after the second injection were 0.1(0.04,0.12),0.20(0.10,0.30)和0.25(0.12,0.30)respectively. The overall difference was statistically significant (χ2=13.880,P< 0.001). CRT(μm)values at the first injection,after the first injection and after the second injection were 319.50(269.50,390.50),271.00(219.00,296.25) and 234.50(182.75,273.25)respectively. The overall difference was statistically significant (χ2=11.978,P< 0.05). ARNFL(μm)values at the first injection,after the first injection and after the second injection were 86.00(76.25,98.00),83.00(76.00,95.50) and 83.00(76.25,94.75)respectively. There was no significant difference (χ2=11.978,P> 0.05). The IOP(mmHg)values at the first injection,after the first injection and after the second injection were 17.0(14.8,18.3),16.0(13.7,17.0),和 15.0(13.8,17.3)respectively. There was no significant difference(χ2=1.604,P>0.05). Conclusion There was no obvious damage to the retinal nerve fiber by adopted intravitreal injection with Conbercept to treat the patients with wet age-related macular degeneration. That’s safe and effective,but need a large sample to follow-up for a longtime.