弯形针刀治疗屈指肌腱狭窄性腱鞘炎临床观察

Curving Acupotomy for Trigger Finger

目的:观察弯形针刀治疗屈指肌腱狭窄性腱鞘炎(TF)的疗效。方法:屈指肌腱狭窄性腱鞘炎患者共177例(199指),随机分为治疗组60例(68指),对照Ⅰ组58例(65指),对照Ⅱ组59例(66指)。治疗组采用弯形针刀法,对照Ⅰ组采用直形针刀法,对照Ⅱ组采用局部封闭法。结果:治疗组总有效率100%,对照Ⅰ组为72.4%,对照Ⅱ组为69.5%。治疗组疗效优于两对照组(P<0.01)。三组术后即刻VAS评分下降比较,差异无统计学意义(P>0.05);术后3个月VAS评分比较,治疗组下降程度优于两对照组(P<0.05)。与术前比较,三组术后即刻体征及术后3个月体征均有明显改善(P<0.05),治疗组体征改善程度优于两对照组(P<0.05)。结论:弯形针刀治疗屈指肌腱狭窄性腱鞘炎损伤小,操作简便,可作为临床治疗Ⅱ、Ⅲ度TF的首选方法。

Objective：To observe the therapeutic efficiency of acupotomy for trigger finger（TF）. Methods：A total of 177 patients （199 fingers）with TF were randomized into 3 groups： curving acupotomy group （60 patients ,68 fingers）, straight aeupotomy group（58,65 ）, and local blocking group（ 59,66 ）. Visual analog scale （VAS） scores were used to evaluate the symptoms. Results：The curative rate in the curving acupotomy group was 100%, significantly higher than that in the straight acupotomy group （72.4%）and in the local blocking group（69.5% ） , P 〈 0.01. The VAS scores right after opertion were not significantly different in the 3 groups（ P 〉 0.05 ）. The VAS score was markedly lower in the curving acupotomy group than that in the other 2 group in postoperative 3 months （ P 〈 0.05 ）. The signs were improved in all 3 groups right after operation and 3 months later as compared to those before treatment, better in the curving acupotomy group （ P 〈 0.05 ）. Conclusion：The curving acupotomy for TF is with minor injury and simple procedures. It may be used as the treatment of choice for stage Ⅱ and Ⅲ TF.