弹拨手法为主结合小夹板固定对小儿拇指狭窄性腱鞘炎的疗效及拇指功能活动障碍的影响  

Curative Effect of Plucking Technique Combined with Small Splint Fixation on Pediatric Thumb Stenosing Tenosynovitis and Its Influence on Thumb Dysfunction

作　　者：李涛[1] 漆伟[1] LI Tao;QI Wei(Traditional Chinese Medicine Hospital of Chongqing Orthopedic,Chongqing 400010,China)

机构地区：[1]重庆市中医骨科医院,重庆400010

出　　处：《四川中医》2020年第10期193-195,共3页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:观察以弹拨手法为主且与小夹板固定相结合的治疗方法应用于小儿拇指狭窄性腱鞘炎的临床效果,以及对患儿的拇指功能活动障碍的影响。方法:将本院2016年5月至2019年5月收治的80例拇指狭窄性腱鞘炎患儿纳入研究,依据随机数字表法及治疗方案的差异分为常规组(n=40例)与研究组(n=40例)。常规组接受双氯芬酸二乙胺乳胶剂涂抹患处治疗,研究组接受弹拨手法为主结合小夹板固定治疗。比较两组临床疗效,治疗前后的患指腱鞘厚度、疼痛程度以及主动活动范围。结果:研究组总有效率为95%,高于常规组总有效率80%,差异具有统计学意义(P<0.05);两组患者治疗前的腱鞘厚度相比差异无统计学意义(P>0.05),且各组治疗后的腱鞘厚度均显著低于治疗前,差异有统计学意义(P<0.05),治疗后研究组的腱鞘厚度显著低于常规组,差异具有统计学意义(P<0.05);两组患者治疗前完成抓物、夹筷子、拧瓶盖时的VAS评分比较无统计学差异(P>0.05);治疗后研究组抓物、夹筷子、拧瓶盖VAS评分均显著低于常规组,差异具有统计学意义(P<0.05),两组患者治疗后较治疗前的各项VAS评分均降低,差异具有统计学意义(P<0.05);治疗前两组患者的TAM优良率差异无统计学意义(P<0.05),治疗后两组的TAM优良率均较治疗前显著提升,差异有统计学意义(P<0.05);治疗后研究组的TAM优良率显著高于常规组,差异有统计学意义(P<0.05)。结论:弹拨手法为主结合小夹板固定治疗小儿拇指狭窄性腱鞘炎疗效显著,可显著促进患儿拇指生理屈伸功能恢复正常,缓解患儿疼痛。Objective:To investigate the clinical effect of the treatment method based on plucking technique combined with small splint fixation on pediatric thumb stenosing tenosynovitis and its influence on thumb dysfunction.Methods:80 children with thumb stenosing tenosynovitis treated in the hospital between May 2016 and May 2019 were enrolled in the study.They were divided into routine group(n=40)and study group(n=40)by the random number table method.The routine group were treated with diclofenac diethylamine emulgel applied to the affected area,and the study group were treated with the plucking technique combined with small splint fixation.The clinical effect,thickness of the tendon sheath of the affected finger,pain degrees and ranges of active motion before and after treatment were compared between the two groups.Results:The total response rate of the study group(95%)was higher than that of the routine group(80%)(P<0.05).There was no statistically significant difference in the thickness of the tendon sheath between the two groups before treatment(P>0.05).After treatment,the thickness of the tendon sheath in each group was significantly decreased,and it was significantly smaller in the study group than the routine group(P<0.05).There was no significant difference in VAS scores between the two groups before treatment(P>0.05).After treatment,VAS scores of both groups were significantly decreased(P<0.05).There was no statistically significant difference in the excellent and good rate of TAM between the two groups before treatment(P<0.05).After treatment,the excellent and good rates of TAM in both groups were significantly increased,and the rate in the study group was significantly higher than that in the routine group(P<0.05).Conclusion:Plucking technique combined with small splint fixation is effective in treating pediatric thumb stenosing tenosynovitis.It can significantly promote the recovery of the flexion and extension of the thumb and relieve the pain of the child.

关 键 词：弹拨手法 小夹板固定 小儿拇指狭窄性腱鞘炎 功能活动障碍 

分 类 号：R244.1[医药卫生—针灸推拿学]