中药热敷联合针刀松解术治疗肘关节外源型挛缩

Chinese Herbal Medicine Combined with Needle Knife Release in the Treatment of Exogenous Elbow Contracture

目的观察中药热敷联合针刀松解术治疗肘关节外源型挛缩的临床疗效。方法选取2015年3月—2016年3月我院门诊收治的19例外源型肘关节挛缩患者为研究对象,采用院内制剂热敷一号外敷早晚各1次,每外敷1周进行针刀松解术1次,4次为1个疗程,连续进行4周,同时指导患者进行适当的功能锻炼。通过比较治疗前后肘关节屈伸活动范围、旋转活动度及肘关节Mayo(Mayo elbow performance score,MEPS)功能评分评价疗效。结果 19例患者术后随访时间8~12个月,平均8.7个月。术前患肘屈伸活动度为(64.6±12.0)、术后3个月改善为(109.3±13.8);术前旋转角度为(83.0±10.1),术后3个月改善为(129.8±9.3);术前Mayo评分为(70.8±9.1),术后改善为(86.4±7.9);治疗前后差异具有统计学意义(P<0.05),术后3个月随访术后3个月优7例,良9例,中3例,优良率84.21%,日常生活能力显著提高。结论中药热敷联合针刀松解术创伤小、恢复快,可有效改善肘关节活动度治疗肘关节外源性挛缩,具有较高的临床应用价值。

Objective To observe the clinical effect of Chinese herbal medicine combined with needle knife release in the treatment of exogenous elbow contraeture. Methods 19 cases of exogenous elbow contraeture patients from March 2015 to March 2016 in outpatient of our hospital were selected as the objects. Patients used hospital preparation hot compress one on the morning and evening of a time, each one week for a needle knife release surgery one time. 4 times was a Course of treatment, which continued for 4 weeks. At the same time, patients were guided to do appropriate functional exercise. The efficacy of the elbow flexion and extension range, the rotational activity and the Mayo elbow performance score （MEPS） were evaluated before and after treatment. Results 19 patients were followed-up for 8 to 12 months, an average of 8.7 months. Before operation, the elbow flexion and extension range was （64.0±12.0） , and it was （109.3±13.8） at 3 months after operation. Before operation, rotation angle was （83.0 ±10.1） , and it was （129.8±9.3） in 3 months after operation （P 〈0.05） . There were 7 cases （3 months） after 3 months of follow-up, and the difference was statistically significant （P 〈0.05） . Before operation, the Mayo score was （70.8±9.1） , and it was （86.4±7.9） after operation. The difference had statistical significance. After following-up three months, 7 cases were excellent, 9 eases were good, 3 cases were medium, the excellent rate was 84.21%, and the daily living ability significantly improved. Conclusion Chinese herbal medicine combined with needle knife release surgery has small trauma and fast recovery, can effectively improve the elbow joint activity, and has a high clinical value.