自体富血小板血浆痛点注射与小针刀松解治疗肱骨外上髁炎的对比研究  

A comparative study of injection of autologous platelet rich plasma in pain spots versus releasing with small knife needle for treatment of external humeral epicondylitis

作　　者：何江涛 郭华[1] 李众毅 王三木 HE Jiangtao;GUO Hua;LI Zhongyi;WANG Sanmu(The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China)

机构地区：[1]郑州大学第五附属医院,河南郑州450052

出　　处：《中医正骨》2019年第3期5-8,13,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:比较自体富血小板血浆(platelet rich plasma,PRP)痛点注射与小针刀松解治疗肱骨外上髁炎的临床疗效和安全性。方法:将50例符合要求的肱骨外上髁炎患者随机分为2组,每组25例。PRP组采用自体PRP痛点注射治疗,针刀组采用小针刀松解治疗。PRP组均治疗1次;针刀组治疗1次疗效不佳者,于第2周再进行1次小针刀松解治疗。分别于治疗前、治疗结束后4周、12周评定患者的肘关节疼痛视觉模拟量表(visual analogue scale,VAS)评分和Mayo肘关节功能评分,同时观察不良反应及并发症发生情况。结果:①一般情况。2组患者均完成治疗及临床观察,均未出现不良反应和并发症。针刀组5例患者行2次小针刀松解治疗,其余20例患者均仅治疗1次。②肘关节疼痛VAS评分。时间因素和分组因素存在交互效应(F=21. 117,P=0. 000)。2组患者的肘关节疼痛VAS评分总体比较,组间差异无统计学意义,即不存在分组效应(F=8. 960,P=0. 785)。治疗前后不同时点间VAS评分的差异有统计学意义,即存在时间效应(F=19. 471,P=0. 000); 2组患者的VAS评分随时间变化均呈降低趋势,但2组的降低趋势不完全一致[PRP组:(7. 26±1. 41)分,(2. 46±0. 78)分,(2. 12±0. 63)分,F=7. 632,P=0. 000;针刀组:(7. 35±1. 12)分,(3. 27±0. 83)分,(2. 97±0. 98)分,F=5. 441,P=0. 000];治疗前2组患者的VAS评分比较,差异无统计学意义(t=0. 213,P=0. 872);治疗结束后4周、12周时,PRP组的VAS评分均低于针刀组(t=3. 944,P=0. 006; t=3. 875,P=0. 008)。③Mayo肘关节功能评分。时间因素和分组因素不存在交互效应(F=0. 985,P=0. 377)。PRP组的Mayo肘关节功能评分总体高于针刀组,存在分组效应(F=18. 363,P=0. 000)。治疗前后不同时点间Mayo评分的差异有统计学意义,即存在时间效应(F=322. 722,P=0. 000); 2组患者的Mayo评分随时间变化均呈增加趋势,且2组的增加趋势一致[PRP组:(33. 40±5. 14)分,(52. 40±5. 97)分,(71. 60±7. 60)分,F=Objective:To compare the clinical curative effects and safety of injection of autologous platelet rich plasma(PRP)in pain spots versus releasing with small knife needle in the treatment of external humeral epicondylitis. Methods:Fifty patients with external humeral epicondylitis were enrolled in the study and were randomly divided into PRP group and acupotomy group,25 cases in each group.The patients in PRP group were treated with injection of autologous PRP in pain spots only once,while the patients in acupotomy group were treated with releasing with small knife needle once and those who obtained poor curative effect got another release in the next week.The elbow pain visual analogue scale(VAS)scores and the Mayo elbow function scores were evaluated before the treatment and at 4 and 12 weeks after the end of the treatment respectively.Moreover,the adverse reactions and complications were observed. Results:The treatment and clinical observation were finished successfully in all patients,and no adverse reactions and complications were found in the 2 groups.The small knife needle releases were performed on 20 patients once and on 5 patients twice in acupotomy group.There was interaction between time factor and group factor in elbow pain VAS scores( F=21.117,P =0.000).There was no statistical difference in elbow pain VAS scores between the 2 groups in general,in other words,there was no group effect( F=8.960,P =0.785).There was statistical difference in elbow pain VAS scores between different timepoints before and after treatment,in other words,there was time effect( F=19.471,P = 0.000).The elbow pain VAS scores presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the decreasing trend of elbow pain VAS scores(PRP group:7.26+/-1.41,2.46+/-0.78,2.12+/-0.63 points, F=7.632,P =0.000;acupotomy group:7.35+/-1.12,3.27+/-0.83,2.97+/-0.98 points, F=5.441,P =0.000).There was no statistical difference in elbow pain VAS scores between the 2 groups before the

关 键 词：网球肘 肱骨外上髁炎 富血小板血浆 小刀针 临床试验 

分 类 号：R246.9[医药卫生—针灸推拿学]