针刀配合塞来昔布胶囊治疗拇指狭窄性腱鞘炎39例临床观察

Clinical efficacy of acupotomy combined with celecoxib capsules in treatment of thumb stenosis tenosynovitis: an analysis of 38 cases

目的:观察针刀配合塞来昔布胶囊治疗拇指狭窄性腱鞘炎的临床疗效。方法:将77例拇指狭窄性腱鞘炎患者随机分为治疗组39例和对照组38例。对照组采用曲安奈德合利多卡因局部封闭治疗,治疗组采用针刀配合塞来昔布胶囊治疗。治疗后评估临床疗效,统计复发率,观察拇指4项特定功能活动[写字、拧瓶盖、抓物(3kg的重物)、夹持筷子]时的视觉模拟评分法(VAS)评分。结果:治愈率治疗组为71.79%,对照组为31.58%,2组比较,差异有统计学意义(P<0.05);随访6、12个月,治疗组复发率分别为0、3.75%,对照组复发率分别为25.00%、58.33%,2组比较,差异均有统计学意义(P<0.05);2组治疗后4项特定功能活动VAS评分均较治疗前降低,治疗组较对照组下降更明显,差异均有统计学意义(P<0.05)。结论:针刀配合塞来昔布胶囊治疗拇指狭窄性腱鞘炎,能有效改善患者的疼痛状况和拇指活动功能,效果优于局部封闭治疗。

Objective： To examine the clinical efficacy of acupotomy combined with celecoxib capsules in the treatment of thumb stenosis tenosynovitis. Methods： A total of 77 patients with thumb stenosis tenosynovitis were randomly divided into treatment group（ n = 39） and control group（ n = 38）. The control group was treated with triamcinolone acetonide plus lidocaine local blocking,and the treatment group was treated with acupotomy combined with celecoxib capsules. Clinical efficacy,relapse rate,and Visual Analog Scale（ VAS） score of the four specific functional activities of the thumb（ writing,cap twisting,item grabbing（ 3 kg）,and chopstick holding） were assessed following treatment. Results： The recovery rate was significantly higher in the treatment group（ 71. 79%） than in the control group（ 31. 58%）（ P 0. 05）. At 6-month and 12-month follow-ups,the relapse rate was significantly lower in the treatment group（ 0% and 3. 75%,respectively） than in the control group（ 25. 00% and 58. 33%,respectively）（ both P 0. 05）. In addition,VAS score of the four specific functional activities of the thumb was reduced in both groups following treatment,and the reduction was significantly greater in the treatment group than in the control group（ P 0. 05）. Conclusion： Acupotomy combined with celecoxib capsules can effectively improve pain and thumb activity and function,and is therefore superior to local blocking in the treatment of thumb stenosis tenosynovitis.