显微镜下微创松解联合术后口服坚骨胶囊治疗肘管综合征的效果研究

Study on the therapeutic effect of minimally invasive release under microscope combined with postoperative oral administration of Jiangu capsules on cubital tunnel syndrome

目的探讨口服坚骨胶囊在肘管综合征患者显微镜下微创松解术后中的应用效果,旨在对该疾病治疗研究提供借鉴。方法选择2022年1月—2023年4月河北省沧州中西医结合医院收治的肘管综合征患者94例,采用随机数字表法分为观察组(47例)和对照组(47例)。2组均行尺神经前置手术,对照组采用显微镜下微创松解术治疗,观察组联合术后口服坚骨胶囊治疗,2组均完成4周治疗,比较2组治疗有效率、尺神经传导速度、潜伏期、波幅、白细胞介素-1(IL-1)、神经生长因子(NGF)、运动、感觉功能及视觉模拟疼痛(VAS)评分。结果观察组有效率为95.74%(45/47),高于对照组[82.98%(39/47),χ^(2)=4.029,P=0.045]。干预4周后,观察组尺神经传导速度、波幅及NGF水平高于对照组(均P<0.05);潜伏期及IL-1水平低于对照组(均P<0.05)。2组干预4周后运动和感觉功能改善,疼痛得到缓解;观察组拇食指握力[(3.73±0.56)kg vs.(2.85±0.45)kg]和示中指握力[(5.78±0.94)kg vs.(4.64±0.87)kg]高于对照组(均P<0.05);上肢功能障碍测定量表[(26.95±4.19)分vs.(36.39±5.51)分]及VAS评分[(1.03±0.43)分vs.(3.26±0.52)分]低于对照组(均P<0.05)。结论显微镜下微创松解联合术后口服坚骨胶囊能提高肘管综合征的治疗有效率,有助于改善尺神经传导速度、IL-1及NGF水平,提高患者运动和感觉功能,减轻患者疼痛,值得推广应用。

Objective To investigate the application effect of oral Jiangu capsules in minimally invasive release of elbow tunnel syndrome patients under microscope,It aims to provide reference for research on the treatment of the disease.Methods A total of 94 patients with cubital tunnel syndrome from January 2022 to April 2023 were selected as study subjects,and randomly divided into two groups of 47 patients each.Both groups underwent anterior ulnar nerve surgery,while the control group underwent minimally invasive release surgery under a microscope.The observation group received postoperative oral treatment with Jiangu capsules.Both groups completed 4 weeks of treatment,and efficacy,ulnar nerve conduction velocity,latency,amplitude,interleukin-1(IL-1),nerve growth factor(NGF),motor function,sensory function and visual analogue scale(VAS)scores were compared between the two groups.Results The efficacy rate of the observation group after 4 weeks of intervention was 95.74%(45/47),which was higher than that of the control group[82.98%(39/47),χ^(2)=4.029,P=0.045];after 4 weeks of intervention,ulnar nerve conduction velocity,amplitude and NGF levels were higher in the observation group than in the control group(all P<0.05).The incubation period and IL-1 levels were lower than in the control group(all P<0.05).After 4 weeks of intervention,motor and sensory functions were improved in both groups,and pain was relieved.The grip strength of the index finger[(3.73±0.56)kg vs.(2.85±0.45)kg]and middle finger[(5.78±0.94)kg vs.(4.64±0.87)kg]in the observation group was higher than in the control group(both P<0.05).DASH[(26.95±4.19)points vs.(36.39±5.51)points]and VAS[(1.03±0.43)points vs.(3.26±0.52)points]scores were lower than in the control group(both P<0.05).Conclusion Minimally invasive microscopic release combined with postoperative oral administration of Jiangu Capsule can improve the efficacy rate of patients with cubital tunnel syndrome,help improve ulnar nerve conduction velocity,IL-1 and NGF levels,improve motor and sensory functions,and alleviate pain in patients.It is worth promoting and using.