小针刀加手法松解治疗屈指肌腱狭窄性腱鞘炎30例临床观察  

Clinical Observation on Treating 30 Cases of Stenosing Tenosynovitis with Acupotomy and Manipulation

作　　者：朱俊腾[1] 陈金辉[1] 黄俊风[1] 黄漫为[1] 罗贤伟 邱冰莹 

机构地区：[1]莆田学院附属医院,福建莆田351100 [2]莆田市中医医院,福建莆田351100 [3]莆田学院,福建莆田351100

出　　处：《风湿病与关节炎》2018年第2期19-21,25,共4页Rheumatism and Arthritis

基　　金：莆田学院2015年校内科研立项项目(2015046)

摘　　要：目的:观察小针刀加手法松解治疗屈指肌腱狭窄性腱鞘炎的临床疗效。方法:将90例屈指肌腱狭窄性腱鞘炎患者随机分为治疗组、对照1组和对照2组,每组30例。治疗组给予小针刀加手法松解治疗,对照1组给予局部封闭注射治疗,对照2组给予传统外科手术治疗,观察术后即时及术后4,8,12周3组的临床疗效、视觉模拟评分法(VAS)评分、关节活动度。结果:治疗组的总有效率在术后即时及术后4,8,12周均高于对照1组、对照2组(P<0.05)。与术前比较,3组术后即时VAS评分均降低,术后4,8,12周治疗组降低,差异有统计学意义(P<0.05);术后8,12周,治疗组VAS评分低于对照1组和对照2组,差异有统计学意义(P<0.05)。在关节活动度方面,3组患者术后即时,术后4,8,12周关节均较治疗前升高,差异均有统计学意义(P<0.05);术后12周,治疗组高于对照1组和对照2组,差异有统计学意义(P<0.05)。3组患者术后未见明显不良反应。结论:与局部封闭注射、传统外科手术方法比较,小针刀加手法松解对屈指肌腱狭窄性腱鞘炎具有良好术后即时临床疗效,能够持续减轻患者疼痛、提高患指活动度,值得临床推广。Objective:To observe the clinical curative effect of acupotomy and manipulation for the treatment of stenosing tenosynovitis.Methods:Ninety cases of stenosing tenosynovitis were randomly divided into a treatment group and two control groups(control group1 and control group 2),30 cases in each group.The treatment group was treated with acupotomy and manipulation therapy,the control group 1 was treated with local block injection,and the control group 2 was treated with traditional surgical treatment.The clinical efficacy,visual analogue scale(VAS)score and joint activity were observed immediately after operation and 4,8,and 12 weeks after operation in the 3 groups.Results:Immediately and 4,8,and 12 weeks after operation,the total effective rate in the treatment group was higher than that of the control groups(P < 0.05).Compared with those before operation,the VAS scores of the three groups were decreased immediately after operation,and those of the treatment group after 4,8,12 weeks of operation,and the difference was statistically significant(P < 0.05).After 8 and 12 weeks of operation,the VAS scores of the treatment group were lower than those of the other control groups,and the difference was statistically significant(P < 0.05).The joint activity of the three groups was higher than that before treatment either immediately after operation or 4,8,12 weeks after that and the difference wasstatistically significant(P < 0.05).After 12 weeks of operation,the VAS scores of the treatment group were higher than those of the other control groups,and the difference was statistically significant(P < 0.05).Therewas no obvious adverse reaction after operation in the three groups.Conclusion:Compared with local injection and traditional surgery,acupotomy and manipulation have a good and immediate curative effect,continuously reducing patients' pain,improving patient activity,which is worthy of clinical promotion.

关 键 词：屈指肌腱狭窄性腱鞘炎 小针刀 手法松解 临床疗效 

分 类 号：R246.9[医药卫生—针灸推拿学]