尺神经松解皮下前置术联合补阳还五汤加减治疗肘管综合征临床研究

Clinical Study on the Treatment of Cubital Tunnel Syndrome with Ulnar Nerve Release Subcutaneous Preposition Combined with Modified Yang-Supplementing and Five-Returning Decoction

目的:观察尺神经松解皮下前置术联合补阳还五汤加减治疗肘管综合征(cubital tunnel syndrome,CTS)的临床疗效。方法:选取2015年8月至2021年11月日照市中医医院骨科住院治疗的CTS患者53例,按照随机数字表法分为对照组26例和观察组27例。对照组给予尺神经松解皮下前置术治疗,术后留置引流条,并给予石膏外固定3周,甲钴胺注射液治疗1周,1周后给予甲钴胺片口服3周,观察组在对照组治疗的基础上加用补阳还五汤加减治疗。观察两组临床疗效、中医证候评分、上肢功能恢复情况、手指功能恢复情况、尺神经恢复情况及尺神经肌电图情况。结果:观察组有效率为92.59%,对照组有效率为84.62%,观察组有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后中医证候评分低于对照组,差异有统计学意义(P<0.05);观察组治疗后上肢功能评定表评分低于对照组,手指功能评分高于对照组,差异有统计学意义(P<0.05);观察组尺神经功能评分高于对照组,差异有统计学意义(P<0.05);观察组尺神经运动功能测定、感觉功能测定均高于对照组,差异有统计学意义(P<0.05)。结论:尺神经松解皮下前置术联合补阳还五汤加减可以显著改善中度及重度肘管综合征患者临床症状,促进上肢功能、手指功能及尺神经损伤的恢复,提高尺神经电反射的敏感度。

Objective:To observe the clinical efficacy of ulnar nerve release subcutaneous preposition combined with Modified Yang-Supplementing and Five-Returning Decoction on cubital tunnel syndrome(CTS).Methods:A total of 53 CTS patients who were hospitalized in The Orthopedics Department of Rizhao Traditional Chinese Medicine Hospital from August 2015 to November 2021 were selected and divided into the control group with 26 cases and the observation group with 27 cases according to the random number table method.The control group was treated with subcutaneous anterior transposition of the ulnar nerve,the drainage strip was retained after the operation,and plaster external fixation was given for 3 weeks.The mecobalamin injection was given for one week,and then Mecobalamin Tablets were taken orally for 3 weeks.The observation group was additionally treated with Modified Yang-Supplementing and Five-Returning Decoction on the basis of the control group.The clinical efficacy,TCM syndrome scores,upper limb function recovery,finger function recovery,ulnar nerve recovery and ulnar nerve electromyography were observed in the two groups.Results:The effective rate of the observation group was 92.59%,while that of the control group was 84.62%.The effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the TCM syndrome scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05);The upper limb function evaluation table score of the observation group was lower than that of the control group,while the finger function score was higher than that of the control group,and all the differences were statistically significant(P<0.05);The score of ulnar nerve function in the observation group was significantly higher than that in the control group,and all the dfferences were statistically significant(P<O.05);The motor function and sensory function of the ulnar nerve in the observation group were significantly higher than those in the control group,and all the differences were statistically significant(P<0.05).Conclusion:Ulnar nerve release subcutaneous preposition combined with Modified Yang-Supplementing and Five-Returning Decoction can significantly improve the clinical symptoms of patients with moderate and severe CTS,promote the recovery of upper limb function,finger function and ulnar nerve injuryand improve the sensitivity of ulnar nerve electric reflex.