颈椎关节整复治疗肱骨外上髁炎的临床研究
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摘要
目的：
探索1疗程以内的颈椎关节整复治疗肱骨外上髁炎的临床疗效,并进行总结,为下一步制定出科学、规范性的手法治疗方案奠定基础。
方法：
本研究采用单纯随机对照方法,以肱骨外上髁炎的患者为研究对象,应用林氏定点旋转扳法整复颈椎关节,观察治疗前后近期疗效及相关参数情况。即时疗效评定选用VAS评分尺,近期疗效运用肘部疾患治疗效果评定标准(JOA)。采用单纯随机“常规方法”对照评价,评价1疗程以内颈椎关节整复治疗肱骨外上髁炎的临床疗效,进行总结。
成果：
符合纳入标准的64例患者,经治疗1个疗程后,治疗组与对照组自身治疗前后比较,P<0.05,有显著性差异；治疗组的总有效率达到93.7%,对照组的总有效率达到81.25%；两者的临床治愈率比较：治疗组显效率达81.2%,对照组53.1%。治疗组与对照组治疗后(积分差值)相比,P=0.03<0.05,有显著性差异。两组治疗后患者的症状体征、生活质量总积分均有所上升,经统计学分析,两组治疗前后自身比较,P<0.05,两组治疗后积分差值比较,P<0.05。
结论：
林氏定点旋转扳法整复颈椎关节在治疗肱骨外上髁炎疗效优于传统手法,尤其是对有明显颈椎退行性变的肱骨外上髁炎患者的疼痛、肘关节功能、肌力的改善较对照组更加显著。
Objective
The specified-located cervical rotation manipulation, summarized by professor Lin Yingqiang, is convenient to operate and will achieve outstanding clinic effects, academic and social values. By comparing with the traditional Tui Na manipulations, this study mainly discuses the validity and safety of cervical rotation manipulation in treating radiohumeral epicondylitis. And the standardization of operation is discussed as well.
Methods
A randomized control study was applied,64cases accorded with in-taking standard were randomly divided into treatment group and control group. The treatment group were treated by the specified-located cervical rotation manipulation, as the control group treated by regular Tui Na method. Clinical manifestation, physical sign and living quality score were observed pre and post treatment. Then quantify the observation indexes, estimating the therapeutic effects according to the score.
Results
64cases was accorded with in-taking standard. After one period of treatment, there were statistically significant of both groups, compared with themselves, P<0.05. The total effective rate of control group is93.7%. The clinical cure rate comparing:the cure rate of treatment group81.25%is also statistically better than control group53.1%. Comparing the integration differential, there is statistically significance between two groups, P<0.05. Not only the clinical manifestation, but also the physical sign and living quality score increased after treatments. The results of statistical analysis showed significant difference (P<0.05) between two groups compared with themselves before and after treatment, compared with each other after treatment, P<0.05.
Conclusion
The therapeutic effects of radiohumeral epicondylitis treated by specified-located cervical rotation manipulation is superior to traditional method, and this method is especially significantly better than the control group in improving the symptom of pain, muscle weakness, and the quality of life and work.
探索1疗程以内的颈椎关节整复治疗肱骨外上髁炎的临床疗效,并进行总结,为下一步制定出科学、规范性的手法治疗方案奠定基础。
方法：
本研究采用单纯随机对照方法,以肱骨外上髁炎的患者为研究对象,应用林氏定点旋转扳法整复颈椎关节,观察治疗前后近期疗效及相关参数情况。即时疗效评定选用VAS评分尺,近期疗效运用肘部疾患治疗效果评定标准(JOA)。采用单纯随机“常规方法”对照评价,评价1疗程以内颈椎关节整复治疗肱骨外上髁炎的临床疗效,进行总结。
成果：
符合纳入标准的64例患者,经治疗1个疗程后,治疗组与对照组自身治疗前后比较,P<0.05,有显著性差异；治疗组的总有效率达到93.7%,对照组的总有效率达到81.25%；两者的临床治愈率比较：治疗组显效率达81.2%,对照组53.1%。治疗组与对照组治疗后(积分差值)相比,P=0.03<0.05,有显著性差异。两组治疗后患者的症状体征、生活质量总积分均有所上升,经统计学分析,两组治疗前后自身比较,P<0.05,两组治疗后积分差值比较,P<0.05。
结论：
林氏定点旋转扳法整复颈椎关节在治疗肱骨外上髁炎疗效优于传统手法,尤其是对有明显颈椎退行性变的肱骨外上髁炎患者的疼痛、肘关节功能、肌力的改善较对照组更加显著。
Objective
The specified-located cervical rotation manipulation, summarized by professor Lin Yingqiang, is convenient to operate and will achieve outstanding clinic effects, academic and social values. By comparing with the traditional Tui Na manipulations, this study mainly discuses the validity and safety of cervical rotation manipulation in treating radiohumeral epicondylitis. And the standardization of operation is discussed as well.
Methods
A randomized control study was applied,64cases accorded with in-taking standard were randomly divided into treatment group and control group. The treatment group were treated by the specified-located cervical rotation manipulation, as the control group treated by regular Tui Na method. Clinical manifestation, physical sign and living quality score were observed pre and post treatment. Then quantify the observation indexes, estimating the therapeutic effects according to the score.
Results
64cases was accorded with in-taking standard. After one period of treatment, there were statistically significant of both groups, compared with themselves, P<0.05. The total effective rate of control group is93.7%. The clinical cure rate comparing:the cure rate of treatment group81.25%is also statistically better than control group53.1%. Comparing the integration differential, there is statistically significance between two groups, P<0.05. Not only the clinical manifestation, but also the physical sign and living quality score increased after treatments. The results of statistical analysis showed significant difference (P<0.05) between two groups compared with themselves before and after treatment, compared with each other after treatment, P<0.05.
Conclusion
The therapeutic effects of radiohumeral epicondylitis treated by specified-located cervical rotation manipulation is superior to traditional method, and this method is especially significantly better than the control group in improving the symptom of pain, muscle weakness, and the quality of life and work.
引文
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[6]刘维屏.推拿整复治疗网球肘80例[J].现代中西医结合杂志,2008.17(21)：3314—3315
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[2]马友盟,吴山.颈椎手法配合局部推拿治疗上肢疾病的临床研究[J].颈腰痛杂志,2007,28(5)：413-414
[3]王国军,应彬彬,李东.推拿治疗肱骨外上髁炎36例.江西中医药.[J],38(12)：63
[4]蔡琴,陈继春.手法治疗肱骨外上髁炎68例的体会[J].按摩与导引.2000,16(4)：41
[5]魏红星.手法治疗网球肘30例临床分析[J].中医外治杂志,2004.13(5)：27
[6]刘维屏.推拿整复治疗网球肘80例[J].现代中西医结合杂志,2008.17(21)：3314—3315
[7]郑卫国.点穴推拿治疗肱骨外上髁炎[J].中医正骨,2004,16(6)：56
[8]黄谦.针刺治疗肱骨外上髁炎25例[J].中国中医骨伤科杂志,2004,(3)：36
[9]袁中君,丁淼.针刺经外奇穴一间、陷谷治疗肱骨外上髁炎[J].中国临床康复,2003,7(8)：1358
[10]肖劲.针刺手部全息穴位和手部反射区治疗网球肘60例临床观察[J].针灸临床杂志,2003,(6)：50
[11]张继红,冯赞红,赵晓霞.温针灸治疗肱骨外上髁炎30例[J].中国针灸,2004,24(7)：498
[12]陈红明.温针灸治疗肱骨外上髁炎52例[J].中国民间疗法,2003,11(11)：5
[13]李占东,刘浙燕.齐刺加艾灸治疗肱骨外上髁炎35例临床疗效观察[J].中国针灸,1999,(8)：473
[14]顾生平,火针治疗肱骨外上髁炎120例临床观察[J].针灸临床杂志,2002,19(10)：26
[15]史兴东,火针治疗肱骨外上髁炎76例Ⅰ临床观察[J].吉林中医药,2001,(4)：50
[16]张恨水,张旭平.艾炷麦粒灸治疗肱骨外上髁炎98例疗效观察[J].浙江中医学院学报,1998,22(6)：44
[17]石虎杰.发泡灸治疗肱骨外上髁炎20例体会[J].甘肃中医,2003,16(3)：35
[18]高素秋.天灸治疗肱骨外上髁炎100例[J].江苏中医,1999,20(6)：39
[19]郭元琦,陈丽仪.埋线治疗网球肘疗效观察[J].河北中医,2008,30(1)：30
[20]刘轶,李晓梅,于漾.针刀治疗肱骨外上髁炎疗效观察[J].辽宁中医杂志,2003,30(1)：60
[21]刘春山.薛立功,张海荣等.新铍针治疗肱骨外上髁炎36例[J].中国针灸,2002,22(11)：725
[22]罗功名.穴位注射治疗肱骨外上髁炎40例临床观察[J].湖北中医杂志,2003.25(2)：6
[23]宋理萍.艾灸结合穴位注射治疗肱骨外上髁炎50例疗效观察[J].新中医,2003,35(4)：48-49
[24]韩根言,韩留言.穴位注射治疗肱骨外上髁炎142例[J].广西中医药,1996,19(1)：52
[25]胡芳,张向阳.针推并用治疗肱骨外上髁炎29例分析[J].针灸临床杂志,200B,19(12)：11—12
[26]尤家军.封闭疗法配合推拿治疗肱骨外上髁炎65例[J].实用中西医结合临床,2008.8(Ⅰ)：50
[27]麦庆春.罗健.单纯痛点封闭与并用推拿治疗肱骨外上髁炎的疗效对比分析[J].中国临床康复,2000,6(2)：270
[28]谢国平,许学猛,鲁海.中药局部注射和推拿与封闭治疗赃骨外上髁炎的临床比较研究[J].按 摩与导引,2008,24(2)：8—9
[29]王哲.按摩配合展筋丹治疗肱骨外上髁炎38例[J].河南中医,2006,26(2)：59
[30]许小静,陈瑞萍.推拿配合药物外用治疗肱骨外上髁炎56例[J].河北中医,2004,26(7)：551
[31]范荣伟,杨潇然,宋红霞,耿桂玲.膏药外敷耳穴贴压治疗肱骨外上髁炎[J].河北中医,2008,30(1)：30
[32]Bunata RE,Brown DS, Caplo RJ. Anatomic factors relased to the cause of tennis eblow [J]Bone Joint Surg Am,2007,89:1955-63.
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