目的 探讨触发点体外冲击波疗法（ESWT）联合超声引导下肩周类固醇注射（CSI）治疗原发性冻结肩（PFS）的疗效。 方法 选取2024年4—7月于徐州医科大学附属医院疼痛科就诊的PFS患者99例，按随机数字表法分为触发点ESWT组（T组）、CSI组（I组）、联合治疗组（TI组），每组33例；记录治疗前及治疗后1、4、8、12周视觉模拟评分量表（VAS）评分、肩部活动度（SROM）、肩关节评分（CMS）；记录患者治疗前及治疗后1个月的阿森斯失眠量表（AIS）评分；同时记录治疗期间不良反应发生及补救药的使用情况。 结果 与治疗前比较，3组治疗后各时间点VAS评分均降低、SROM及CM评分均改善（均P < 0.05）；3组患者治疗后1个月AIS评分均降低（P < 0.05）；组间比较结果显示，与T组及I组比较，TI组治疗后4、8、12周VAS疼痛评分较低、SROM（前屈、后伸）较大、CM评分较高（Bonferroni校正后P < 0.05），T组与I组比较差异无统计学意义（Bonferroni校正后P > 0.05）；3组患者治疗后1个月的AIS评分及不良反应发生率比较差异无统计学意义（P > 0.05）。 结论 联合治疗相较于单纯触发点体外冲击波治疗、单纯肩周类固醇注射治疗疗效更显著，且患者临床症状、生活质量显著改善。

Objective To investigate the efficacy of extracorporeal shock wave therapy （ESWT） combined with ultrasound-guided corticosteroid injection （CSI） for the treatment of primary frozen shoulder （PFS）. Methods Ninety-nine patients with PFS who visited the pain department of the Affiliated Hospital of Xuzhou Medical University between April 2024 and July 2024 were enrolled and randomly divided into three groups according to the randomized number table method： ESWT group （T group）， CSI group （I group）， and combined treatment group （TI group）， with 33 patients in each group. Visual analogue scale （VAS） scores， shoulder range of motion （SROM）， and Constant-Murley shoulder scores （CMS） were recorded before treatment and at 1， 4， 8， and 12 weeks post-treatment. Additionally， the patients' Ascens Insomnia Scale （AIS） scores were recorded before treatment and 1 month after treatment. The occurrence of adverse effects and the use of remedial medications during the treatment period were also documented. Results Compared with pre-treatment， VAS scores decreased， and SROM and CM scores improved at all time points after treatment in all three groups （P < 0.05）. AIS scores also decreased in all three groups at 1 month post-treatment （all P < 0.05）. Intergroup comparisons revealed that the TI group exhibited significantly lower VAS pain scores， greater SROM （forward flexion and backward extension）， and higher CM scores at 4， 8， and 12 weeks post-treatment compared to the T and I groups （Bonferroni-corrected P < 0.05）. No statistically significant differences were observed between the T and I groups for these measures （Bonferroni-corrected P > 0.05）. Additionally， there were no statistically significant differences in AIS scores or adverse effects occurrence among the three groups at 1 month post-treatment （P > 0.05）. Conclusion The combined treatment demonstrated greater efficacy compared to trigger point extracorporeal shock wave therapy alone and periapical steroid injection alone， resulting in significant improvement in the patient's clinical symptoms and quality of life.