[1]宁凡友△ 王冲 王楠 孔丽 许海燕.中医药综合疗法与关节镜手术治疗顽固性肱骨外上髁炎的疗效比较[J].中国中医骨伤科杂志,2020,28(11):18-21.
 NING Fanyou WANG Chong WANG Nan KONG Li XU Haiyan.Clinical Study of Refractory Lateral Epicondylitis with ArthroscopicSurgery and Comprehensive Treatment of Traditional Chinese Medicine[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(11):18-21.
点击复制

中医药综合疗法与关节镜手术治疗顽固性肱骨外上髁炎的疗效比较()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年11期
页码:
18-21
栏目:
临床研究
出版日期:
2020-11-10

文章信息/Info

Title:
Clinical Study of Refractory Lateral Epicondylitis with ArthroscopicSurgery and Comprehensive Treatment of Traditional Chinese Medicine
文章编号:
1005-0205(2020)11-0018-04
作者:
宁凡友1△ 王冲1 王楠1 孔丽1 许海燕1
1河南省洛阳正骨医院(河南省骨科医院)上肢损伤中心(河南 洛阳,471002)
Author(s):
NING Fanyou1△ WANG Chong1 WANG Nan1 KONG Li1 XU Haiyan1
1Department of Superior Extremities, Luoyang Orthopedic-Traumatological Hospital, Luoyang 471002,Henan China.
关键词:
顽固性肱骨外上髁炎 关节镜手术 微创 中医药综合疗法
Keywords:
refractory lateral epicondylitis arthroscopy minimal invasive comprehensive treatment of TCM
分类号:
R681.7
文献标志码:
A
摘要:
目的:比较中医药综合疗法与关节镜手术治疗顽固性肱骨外上髁炎的疗效。方法:选取自2016年12月至2018年3月诊治的120例顽固性肱骨外上髁炎患者,其中60例采用中医药综合疗法治疗(中医药组),另外60例采用关节镜手术治疗(关节镜组)。比较两组术后4周、6个月、12个月疼痛VAS评分、肘关节功能Mayo评分及末次随访时Verhaar评分。结果:120例均获得12个月随访。中医药组与关节镜组治疗后疼痛VAS评分、肘关节功能Mayo评分较治疗前均明显改善,而且关节镜组治疗后4周、6个月、12个月疼痛VAS评分低于中医药组,关节镜组治疗后6个月、12个月肘关节功能Mayo评分高于中医药组,关节镜组末次随访时Verhaar评分优于中医药组,差异有统计学意义(P<0.05)。结论:中医药综合疗法与关节镜微创手术均是顽固性肱骨外上髁炎的有效治疗方法,中医药综合疗法可避免手术创伤,更容易被患者接受,但治疗效果稍差; 关节镜微创手术对桡侧腕短伸肌腱止点的清理、松解更为彻底,疗效更好。
Abstract:
Objective:To analyze the curative effect of the refractory lateral epicondylitis with arthroscopic surgery and comprehensive treatment of traditional Chinese medicine(TCM). Methods:120 patients with the refractory lateral epicondylitis were divided into two groups from December 2016 to March 2018. 60 patients with the refractory lateral epicondylitis were treated by arthroscopic release, and the other 60 patients were treated by comprehensive treatment of TCM. The VAS score, the Mayo score of elbow joint function, and the Verhaar score at the last follow-up were compared between the two groups at 4 weeks, 6 months, and 12 months after treatment. Results:All the patients obtained 12 months clinical follow up after treatment.The pain VAS score and the Mayo score of elbow joint function after treatment in arthroscopic surgery group and comprehensive treatment of TCM group were significantly improved compared to before treatment. Moreover, the VAS scores in the arthroscopic surgery group were lower than those in the comprehensive treatment of TCM group at 4 weeks, 6 months, and 12 months after treatment.The Mayo score of elbow joint function in the arthroscopy group was higher than that in the TCM group at 6 and 12 months after treatment. The Verhaar score in arthroscopy group was better than TCM group at last follow-up, these differences were statistically significant(P<0.05). Conclusion:The arthroscopic release and TCM are reasonable and effective method for the refractory lateral epicondylitis. The comprehensive treatment of TCM can avoid surgical trauma and is more easily accepted by patients, but the therapeutic effect is slightly poor. Arthroscopic minimally invasive surgery is more thorough in cleaning and loosening the extensor carpi radialisbrevis tendon, with better effect.

参考文献/References:

[1] AHMAD Z, SIDDIQUI N, MALIK S S,et al.Lateral epicondylitis:a review of pathology and management[J].Bone Joint J,2013,95(9):1158-1164.
[2] WASEEM M, NUHMANI S, RAM C S,et al.Lateral epicondylitis:a review of the literature[J].J Back Musculoskelet Rehabil,2012,25(2):131-142.
[3] 王金伟,鲁谊.非手术治疗肱骨肱骨外上髁炎的研究进展[J].中华肩肘外科电子杂志,2016,4(2):123-126.
[4] 唐剑邦,高大伟,吴宇峰,等.改良Nirschl法治疗难治性肱骨外上髁炎[J].中华创伤杂志,2016,32(4):325-326.
[5] 黄立羡,张富洪.肌骨超声定位体外冲击波联合皮针治疗顽固性肱骨外上髁炎的疗效观察[J].中国骨与关节损伤杂志,2019,34(11):1209-1210.
[6] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994.
[7] 汪凡.针灸结合推拿治疗网球肘20例疗效观察[J].浙江中医杂志,2014,49(6):444.
[8] 代飞,向明.肱骨外上髁炎病因与发病机制的研究进展[J].中华肩肘外科电子杂志,2017,5(2):142-144.
[9] 王玉龙,王平,刘爱峰,等.旋牵过伸法配合展筋乳治疗肱骨外上髁炎52例[J].中国中医骨伤科杂志,2013,21(7):13-14.
[10] 鲁谊.网球肘的研究进展[J].中华肩肘外科电子杂志,2017,2(5):158.
[11] NIRSCHL R P.The epidemiology and health care burden of tennis elbow:a population-based study[J].Ann Transl Med,2015,3(10):133.
[12] 孙树椿,孙之镐.中医筋伤学[M].北京:人民卫生出版社,2001:82.
[13] 蔡玉梅,黄文燕,郑继范.麦粒灸配合针刺治疗肱骨外上髁炎临床观察[J].上海针灸杂志,2012,31(10):746-747.
[14] GRIFKA J, BOENKE S, KRAMER J.Endoscopic therapy in epicondylitis radialis humeri[J].Arthroscopy,1995,11(6):743-748.
[15] 曹汐,杨渝平.顽固性网球肘关节镜治疗的研究进展[J].中国微创外科杂志,2018,18(3):260-266.

备注/Memo

备注/Memo:
基金项目:河南省中医药科学研究专项课题(2016ZY2080)通信作者 E-mail:ningfanyou@163.com(收稿日期:2020-04-18)
更新日期/Last Update: 2020-11-10