| 理筋拔戳揉捻法治疗肱骨外上髁炎的多中心临床研究 |
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投稿时间：2024-01-17
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| 作者 | Author | 单位 | Address | E-Mail |
| 侯晓宙 |
HOU Xiao-zhou |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 殷京 |
YIN Jing |
北京电力医院, 北京 100055 |
Beijing Electric Power Hospital, Beijing 100055, China |
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| 王海洋 |
WANG Hai-yang |
北京市丰盛中医骨伤专科医院, 北京 100033 |
Beijing Fengsheng TCM Bone Trauma Hospital, Beijing 100033, China |
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| 谷金玉 |
GU Jin-yu |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 万田豪 |
WAN Tian-hao |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 杨满红 |
YANG Man-hong |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 夏迪 |
XIA Di |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 张清 |
ZHANG Qing |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
zhangqinggys@163.com |
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| 期刊信息：《中国骨伤》2024年，第37卷，第3期，第251-257页 |
| DOI：10.12200/j.issn.1003-0034.20230252 |
| 基金项目: |
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中文摘要:
目的:探讨理筋拔戳揉捻法治疗肱骨外上髁炎(liater epicondylitis,LE)的临床疗效。
方法:自2018年1月至2021年12月采用多中心随机对照研究方法,分别在中国中医科学院望京医院、北京电力医院、北京丰盛骨伤科专科医院收集LE患者192例,采用随机数字表法分为治疗组和对照组。治疗组96例,男36例,女60例;年龄28~60(41.20±5.50)岁;病程1~14(5.24±1.35) d;予理筋拔戳揉捻法配合肘关节练功法治疗,隔日1次,治疗2周。对照组96例,男33例,女63例;年龄26~60(43.35±7.75)岁;病程1~14(5.86±1.48) d,予外用扶他林配合护肘关节固定治疗,治疗2周。分别于治疗前及治疗后第1、3、5、7、11、13天比较疼痛视觉模拟评分(visual analogue scale VAS)、美国特种医院评分系统(Hospital for Surgery Scoring System,HSS)、肘关节旋前及旋后角度、腕关节掌屈及背伸角度、肘关节压痛,并比较治疗前及治疗结束后美国特种医院评分系统2 (Hospital for Surgery Scoring System2,HSS2)肘关节评分。
结果:所有患者获得随访,时间10~14(12.0±1.6) d。治疗组及对照组治疗前VAS分别为(6.83±1.36)、(6.79±1.58)分,末次治疗后降低至(1.49±1.09)、(2.11±1.81)分,其中治疗后第1、3、5、7、9、11、13天,治疗组VAS较对照组明显降低(P<0.05)。两组治疗前HSS评分分别为(61.73±11.00)、(36.47±12.45)分,末次治疗后提高至(94.42±5.90)、(91.44±9.11)分,其中治疗后第1、3、5、7、9、11、13天,治疗组HSS显著高于对照组(P<0.05)。治疗后第5天,治疗组肘关节外旋角度、内旋角度分别为(66.41±12.69)°、(66.35±13.54)°,对照组为(62.08±16.03)°、(61.77±16.35)°;治疗后第7天,治疗组肘关节外旋角度、内旋角度分别为(69.79±12.64)°、(70.02±13.55)°,对照组为(65.28±15.86)°、(65.09±16.67)°,以上时间点治疗组肘关节活动度大于对照组(P<0.05)。治疗后第5天,治疗组腕关节背伸、掌屈角度为(39.43±15.94)°、(46.68±11.10)°,对照组为(38.51±18.49)°、(44.27±13.58)°;治疗后第7天,治疗组腕关节背伸、掌屈角度分别为(42.52±16.50)°、(49.23±10.96)°,对照组为(41.18±20.09)°、(46.64±14.63)°;治疗组腕关节活动度大于对照组(P<0.05)。治疗后第13天,治疗组HSS2为(93.61±6.32)分,高于对照组(92.06±7.94)分(P<0.05)。两组各时间点肘关节压痛值比较,差异无统计学意义(P>0.05)。
结论:扶他林外用联合肘部固定和理筋拔戳揉捻手法均能有效改善LE的症状,理筋拔戳揉捻手法较扶他林外用治疗具有止痛时间长和恢复肘关节功能更好的优势。 |
| 【关键词】手法 肱骨外上髁炎 病例对照研究 |
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| A multicenter clinical study on the treatment of lateral epicondylitis of humerus by manipulation |
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ABSTRACT
Objective To investigate clinical effect of tendons pulling,poking and kneading for the treatment of external humeral epicondylitis.
Metods From January 2018 to December 2021,a multicenter randomized controlled study was performed to collect 192 patients with external humeral epicondylitis in Wangjing Hospital,Beijing Dianli Hospital,and Beijing Fengsheng Osteotraumatology Hospital,respectively,and they were divided into treatment group and control group by random number table method. There were 96 patients in treatment group,including 36 males and 60 females,aged from 28 to 60 years old with an average of (41.20±5.50) years old;the course of disease ranged from 1 to 14 days with an average of (5.24±1.35) days;they were treated once every other day for 2 weeks. There were 96 patients in control group,including 33 males and 63 females,aged from 26 to 60 years old with an average of (43.35±7.75) years old;the course of disease ranged from 1 to 14 days with an average of (5.86±1.48) days;they were treated with topical voltaalin combined with elbow joint fixation for 2 weeks. Visual analogue scale (VAS) and Hospital for Surgery Scoring System (HSS) elbow pronation and supination angles,wrist metacarpal flexion and dorsal extension angles,elbow tenderness between two groups were compared before treatment and at 1,3,5,7,11 and 13 days after treatment;Hospital for Surgery Scoring System 2 (HSS2) was compared before treatment and the final treatment.
Results All patients were followed up for 10 to 14 days with an average of (12±1.6) days. VAS between treatment group and control group before treatment were 6.83±1.36 and 6.79±1.58,respectively,and decreased to 1.49±1.09 and 2.11±1.81 after the final treatment. VAS of treatment group were significantly lower than those of control group at 1,3,5,7,9,11 and 13 days after treatment (P<0.05). HSS between two groups were 61.73±11.00 and 36.47±12.45 before treatment,respectively,and increased to 94.42±5.9 and 91.44±9.11 at the final treatment. HSS of treatment group were significantly higher than those of control group at 1,3,5,7,9,11 and 13 days after treatment (P<0.05). On the 5th day after treatment,the external and internal rotation angles of elbow in treatment group were (66.41±12.69)° and (66.35±13.54)°,while those in control group were (62.08±16.03)° and (61.77±16.35)°. On the 7th day after treatment,the external and internal rotation angles of elbow were (69.79±12.64)° and (70.02±13.55)° in treatment group,and (65.28±15.86)° and (65.09±16.67)° in control group. Elbow joint motion in treatment group was higher than that in control group (P<0.05). On the 5th day after treatment,angles of wrist dorsiflexion and palm flexion were (39.43±15.94)° and (46.68±11.10)° in treatment group,and (38.51±18.49)° and (44.27±13.58)° in control group. On the 7th day after treatment,angles of wrist dorsiflexion and palm flexion were (42.52±16.50)° and (49.23±10.96)° in treatment group,and (41.18±20.09)° and (46.64±14.63)° in control group. The motion of wrist joint in treatment group was higher than that in control group (P<0.05). On the 13th day after treatment,HSS2 in treatment group 93.61±6.32 were higher than those in control group 92.06±7.94(P<0.05). There was no significant difference in elbow tenderness between two groups at each time point (P>0.05).
Conclusion Voltaren external treatment combined with elbow fixation and tendons pulling,poking and kneading could effectively improve symptoms of external humeral epicondylitis. Compared with voltaren external treatment,tendons pulling,poking and kneading has advantages of longer analgesic time and better elbow function recovery. |
| KEY WORDS Manipulation Lateral epicondylitis Case-control study |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 侯晓宙,殷京,王海洋,谷金玉,万田豪,杨满红,夏迪,张清.理筋拔戳揉捻法治疗肱骨外上髁炎的多中心临床研究[J].中国骨伤,2024,37(3):251~257 |
| 英文格式: | HOU Xiao-zhou,YIN Jing,WANG Hai-yang,GU Jin-yu,WAN Tian-hao,YANG Man-hong,XIA Di,ZHANG Qing.A multicenter clinical study on the treatment of lateral epicondylitis of humerus by manipulation[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(3):251~257 |
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