不同中医辨证分型网球肘超声表现与浮针治疗效果  

Ultrasonic manifestations of tennis elbow with different traditional Chinese medicine syndrome differentiation and therapeutic effect of Fu's subcutaneous needling

作　　者：田树元[1] 赵娴 李新伟[2] 白钰 余永红[1] TIAN Shuyuan;ZHAO Xian;LI Xinwei;BAI Yu;YU Yonghong(Department of Medical Ultrasound,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China;Department of Acupuncture,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China;Hospital of Hangzhou Dianzi University,Hangzhou 310018,China)

机构地区：[1]浙江省立同德医院超声医学科,浙江杭州310012 [2]浙江省立同德医院针灸科,浙江杭州310012 [3]杭州电子科技大学校医院,浙江杭州310018

出　　处：《中国医学影像技术》2023年第11期1610-1614,共5页Chinese Journal of Medical Imaging Technology

基　　金：浙江省中医药优秀青年人才基金基项目(2019ZQ005)。

摘　　要：目的 观察不同中医辨证分型网球肘超声表现及浮针治疗效果。方法 纳入60例中医辨证分型明确并接受浮针治疗的网球肘患者,观察疗效并比较不同疗效患者之间网球肘证型及超声表现差异。结果 浮针治疗后网球肘治愈率为31.67%(19/60)、显效率为43.33%(26/60),总体有效率75.00%(45/60),无效率25.00%(15/60)。不同疗效患者之间,肌腱厚度、肌腱评分(包括回声、钙化及有无撕裂)及肌腱内血流评分差异均有统计学意义(P均<0.05);浮针用于伸肌总腱较薄、肌腱评分较低及血流评分较高者疗效更佳。治愈率、显效率及无效率在风寒阻络型网球肘分别为47.62%(10/21)、42.86%(9/21)及9.52%(2/21),在湿热内蕴型分别为31.58%(6/19)、57.89%(11/19)及10.53%(2/19),在气血亏虚型分别为15.00%(3/20)、30.00%(6/20)及55.00%(11/20)。3种证型之间,疗效、患侧伸肌总腱钙化比例及肌腱血流评分差异均有统计学意义(P均<0.05);风寒阻络型、湿热内蕴型疗效均优于、而患侧伸肌总腱钙化比例低于气血亏虚型,其肌腱血流评分则高于气血亏虚型(P均<0.05)。结论 超声显示伸肌总腱较薄、肌腱内低回声区面积小、钙化少、无肌腱撕裂及血供的网球肘经浮针治疗效果较好,其证型多为风寒阻络型及湿热内蕴型。Objective To explore ultrasonic manifestations of tennis elbow with different traditional Chinese medicine syndrome differentiation and therapeutic effect of Fu's subcutaneous needling.Methods Totally 60 patients with tennis elbow who underwent Fu's subcutaneous needling after traditional Chinese medicine syndrome differentiation were enrolled.Ultrasonic manifestations of patients with different syndromes were observed,and the efficacies of Fu's subcutaneous needling were comparatively evaluated.Results The cure rate of Fu's subcutaneous needling for treating tennis elbow was 31.67%(19/60),the remarkable effective rate was 43.33%(26/60),the overall effective rate was 75.00%(45/60)and the ineffective rate was 25.00%(15/60).There were significant differences of tendon thickness,tendon score(including echoes,calcification,and presence or absence of tears),muscle fiber continuity and blood flow score among patients with different efficacies(all P<0.05).Patients with thinner total extensor tendons,lower tendon scores and higher blood flow scores had better treatment outcomes.The cure rate,remarkable effective rate and ineffective rate of wind-cold blocking collateral type was 47.62%(10/21),42.86%(9/21)and 9.52%(2/21),respectively,of patients with internal retention of damp-heat type was 31.58%(6/19),57.89%(11/19)and 10.53%(2/19),respectively,while of patients with deficiency of both qi and blood type was 15.00%(3/20),30.00%(6/20)and 55.00%(11/20),respectively.There were significant differences of therapeutic efficacies,calcification ratio of the common extensor tendon as well as tendon blood flow scores among 3 type syndromes of tennis elbows(all P<0.05).The therapeutic efficacy of Fu's subcutaneous needling for wind-cold blocking collateral type and internal retention of damp-heat type were better than,but the calcification ratio of extensor muscle tendon was lower than those of deficiency of both qi and blood type,and their tendon blood flow scores of were higher than the latter(all P<0.05).Conclusion The therapeuti

关 键 词：网球肘 针刺治疗 超声检查 辨证论治 

分 类 号：R686.1[医药卫生—骨科学] R455.1[医药卫生—外科学]