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  

Clinical Study of Refractory Lateral Epicondylitis with Arthroscopic Surgery and Comprehensive Treatment of Traditional Chinese Medicine

作　　者：宁凡友 王冲 王楠 孔丽 许海燕 NING Fanyou;WANG Chong;WANG Nan;KONG Li;XU Haiyan(Department of Superior Extremities,Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan China)

机构地区：[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

出　　处：《中国中医骨伤科杂志》2020年第11期18-21,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：河南省中医药科学研究专项课题(2016ZY2080)。

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。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.

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 

分 类 号：R681.7[医药卫生—骨科学]