局部注射麻醉药及皮质类固醇复合康复训练治疗肱骨外上髁炎的临床观察

Clinical observation on the efficacy of local injection of anesthetic and corticosteroid combined with rehabilitation training in treatment of patients with external humeral epicondylitis

目的观察局部注射麻醉药及皮质类固醇复合康复训练治疗肱骨外上髁炎的，陆床效果。方法选择40例疼痛时间在1～4周的肱骨外上髁炎患者，随机分成局部注射组（B组，n=20）和局部注射复合康复训练组（BR组，n=20）。B组仅接受肱骨外上髁0．5％利多卡因＋甲强龙20mg注射治疗（1次／周，共2周）治疗。BR组接受肱骨外上髁同样药物注射治疗（1次／周，共2周）复合康复训练（3次／天，5分钟／次，共2周）治疗。观察两组治疗后第1、2、4、8周的局部疼痛感、局部压痛、屈肘负重的疼痛视觉模拟评分。观察两组治疗后4周和8周时疼痛症状复发率。结果两组治疗后第1周和第2周时疼痛程度较治疗前显著降低（P〈0．05），但两组间无显著性差异（P〉0．05）。治疗后第4周和第8周时BR组疼痛程度明显低于B组（P〈0．05）。治疗后4周和8周时BR组疼痛复发率明显低于B组（P〈0．05）。结论局麻药局部注射联合康复训练治疗可以有效控制肱骨外上髁炎患者的局部疼痛，改善功能活动状态，长期疗效稳定。

Objective To observe the therapeutic effect of local injection of anesthetic and corticosteroid combined with rehabilitation training in treatment of patients with external humeral epicondylitis. Methods Forty cases of external humeral epicondylitis with duration of pain ranged from 1 week to 4 weeks were included in this study,20 of them were randomly allocated in group B,they received local injection of 0. 5%lidocaine and 20 mg methylprednisolone（ once a week for two weeks） for treatment of external humeral epicondylitis and other 20 patients in group BR received same local injection（ once a week for two weeks） combined with rehabilitation training（ three times a day,once for five minutes and two weeks as a course） for treatment of external humeral epicondylitis. Visual Analogue Scale（ VAS） of the local pain（ LA）,local pressing pain（ LPP）,and pain of elbow flexing and weight bearing（ EFWBP） in 1,2,4 and 8 weeks after the treatment had been recorded and compared. The rates of recurrence for LA,LPP and EFWBP in 4 and 8 weeks after the treatment were observed and compared. Results The intensity of pain in1 and 2 weeks after the treatment was significantly lower than that before the treatment in both groups（ P〈0. 05）,but the difference was not significant between these two groups（ P〈0. 05）. The intensity of pain in patients of group BR in 4 and 8 weeks after treatment was significantly lower than that of patients in group B（ P〈0. 05）. The recurrence rates of LA,LPP,and EFWBP at 4 and 8 weeks after the treatment in group BR were significantly lower than those in group B（ P〈0. 05）. Conclusion Local injection of anesthethetic combined with rehabilitation training is effective in controlling the local pain,improving the movement and keeping a long- term stable therapeutic effect in patients with external humeral epicondylitis.