内热针刀治疗肱骨外上髁炎的临床效果

Clinical effect of internal heated needle knife in the treatment of external humeral epicondylitis

目的探讨内热针刀治疗肱骨外上髁炎的临床效果。方法选择2018年9月至2019年4月收治的60例肱骨外上髁炎患者为研究对象,将其随机分为三组。内热针刀组(20例,20肘)采用内热针刀治疗,内热针组(20例,21肘)采用内热针治疗,局部封闭组(20例,21肘)采用局部痛点激素注射治疗。分析三组患者的治疗情况,比较三组患者治疗不同时间的肘关节VAS评分、Mayo肘功能评分、综合疗效及复发情况。结果三组患者均未出现不良反应和并发症。治疗前及治疗后2周、3个月、6个月,患者的肘关节VAS评分具有显著差异,存在时间效应(P<0.05);三组的肘关节VAS评分存在分组效应(P<0.05);时间因素和分组因素同样存在交互效应(P<0.05)。治疗后6个月,三组的Mayo肘功能评分均较治疗前显著降低(P<0.05),但组间差异无统计学意义(P>0.05);内热针刀组的Mayo肘功能评分显著低于局部封闭组(P<0.05);内热针刀组与内热针组的Mayo肘功能评分无显著差异(P>0.05)。内热针刀组、内热针组及局部封闭组的治疗总有效率分别为95.00%、80.00%、55.00%,三组的治疗总有效率比较,差异具有统计学意义(P<0.05)。治疗后6个月末次随访时,内热针刀组、内热针组及局部封闭组的复发例数分别为1、3及7例(复发率为5.00%、15.00%、35.00%),三组的复发率比较,差异具有统计学意义(P<0.05)。结论内热针刀治疗肱骨外上髁炎效果良好,复发率低,值得临床推广应用。

Objective To investigate the clinical effect of internal heated needle knife in the treatment of external humeral epicondylitis.Methods From September 2018 to April 2019,60 patients with external humeral epicondylitis were selected as study objects and randomly divided into three groups.Internal heated needle knife group(20 cases,20 elbows)was treated with internal heated needle knife,internal heated needle group(20 cases,21 elbows)was treated with internal heated needle,and local blocking group(20 cases,21 elbows)was treated with local pain point therapy with hormone injection.The treatment of the three groups were analyzed,and the VAS scores,Mayo elbow function scores at different time of treatment,comprehensive efficacy and recurrence of the three groups were compared.Results There were no adverse reactions and complications in the three groups.Before treatment,at 2 weeks,3 months and 6 months after treatment,there were significant differences in the VAS scores of elbow joint in patients,with time effect(P<0.05);there was group effect in the VAS score of elbow joint of the three groups(P<0.05);there was also interaction effect between time factors and group factors(P<0.05).Six months after treatment,the Mayo elbow function scores of the three groups were significantly lower than those before treatment(P<0.05),but there was no significant difference among the groups(P>0.05);the Mayo elbow function score of the internal heated needle knife group was significantly lower than that of the local blocking group(P<0.05);there was no significant difference in Mayo elbow function score between the internal heated needle knife group and the internal heated needle group(P>0.05).The total effective rates of treatment in the internal heated needle knife group,internal heated needle group and local blocking group were 95.00%,80.00%and55.00%respectively,and the difference of total effective rates of treatment among the three groups was statistically significant(P<0.05).At the end of 6 months follow-up,the number of recurrence cases in the internal heated needle group,internal heated needle group and local blocking group were 1 case,3 cases and 7 cases(recurrence rate were5.00%,15.00%,35.00%),the difference of recurrence rate among the three groups was statistically significant(P<0.05).Conclusion The internal heated needle knife has a good effect on external humeral epicondylitis,with low recurrence rate,which is worthy of clinical promotion and application.