荣肌揉筋手法治疗成人肱骨髁间骨折术后肘关节僵硬

Rongji Roujin(荣肌揉筋) manipulation for treatment of postoperative elbow joint stiffness in adults with humeral intercondylar fracture

目的:观察荣肌揉筋手法治疗成人肱骨髁间骨折术后肘关节僵硬的临床疗效。方法:将84例成人肱骨髁间骨折患者随机分为2组,每组42例,分别采用荣肌揉筋手法和传统手法治疗。每日治疗1次,每次20 min,10 d为1个疗程,疗程间休息2 d,连续治疗6个疗程。分别于治疗前和治疗6个疗程后记录并比较2组患者肘关节屈伸活动度和美国特种外科医院(hospital for special surgery,HSS)肘关节功能评分。结果:部分患者未能坚持完成全部疗程而脱落,其中荣肌揉筋手法组8例、传统手法组10例。治疗前2组患者肘关节屈曲活动度、HSS肘关节功能评分比较,组间差异均无统计学意义[48.76°±9.84°,53.76°±7.81°,t=0.391,P=0.697;(43.84±11.62)分,(44.73±12.15)分,t=0.437,P=0.752]。治疗6个疗程后,荣肌揉筋手法组肘关节屈曲活动度与传统手法组比较,差异无统计学意义(123.57°±9.24°,113.27°±7.14°,t=1.357,P=0.235);HSS肘关节功能评分高于传统手法组[(93.28±8.74)分,(73.82±8.18)分,t=3.412,P=0.037];2组肘关节屈曲活动度、HSS肘关节功能评分均高于治疗前(t=0.542,P=0.024;t=0.614,P=0.042;t=0.561,P=0.025;t=0.576,P=0.031)。结论:荣肌揉筋手法和传统手法均能增加肘关节活动范围,改善肘关节功能;但是在改善肘关节功能方面,荣肌揉筋手法的疗效优于传统手法。

Objective：To observe the curative effect of Rongji Roujin（ 荣肌揉筋 , R JR J） manipulation for treatment of postoperative el- bow joint stiffness in adults with humeral intereondylar fracture. Methods： Eighty-four patients with humeral intereondylar fracture were ran- domly divided into 2 groups ,42 cases in each group. The patients were treated with RJRJ manipulation therapy（ group A）and traditional ma- nipulation therapy （group B）respectively for consecutive 6 course of treatment, 10 days for each course with a 2-day rest -insertion between courses and once a day for 20 minutes at a time. The elbow flexion-extension range and Hospital for Special Surgery（HSS） elbow perform- ance scores were recorded and compared between the 2 groups before the treatment and after 6 - course treatment. Results： Eight patients in group A and 10 patients in group B dropped out and the treatment were finished in other patients. There was no statistical difference in el- bow flexion-extension range and HSS elbow performance scores between the 2 groups before the treatment（48.76 ±9.84 vs 53.76 ± 7.81 degrees, t = 0. 391 ,P = 0. 697 ;43.84 ± 11.62 vs 44.73 ±12.15 points,t = 0. 437, P = 0. 752 ）. After 6 - course treatment, there was no statistical difference in the elbow flexion-extension range between the 2 groups（ 123.57±9.24 vs 113.27±7.14 degrees, t = 1. 357, P = 0. 235 ） and HSS elbow performance scores were higher in group A compared to group B （ 93.28±8.74 vs 73.82±8. 18 points,t = 3. 412,P = 0.037 ）. Both elbow flexion -extension range and HSS elbow performance scores were higher after 6-course treatment compared to pre-treatment in the 2 groups（t = 0. 542,P = 0. 024;t = 0. 614, P = 0. 042;t = 0. 561, P = 0. 025;t = 0. 576, P = 0. 031 ）. Conclusion：Both RJRJ manipulation therapy and traditional manipulation therapy can increase the elbow flexion-extension range and improve the elbow performance, however, the former surpasses the latter in improving the elbow performance, so it is worthy of popularizing in clinic.