| 引用本文: |
李佃波,姜孟家,丁洪磊,崔述生.小针刀联合腕踝针对桡骨茎突狭窄性腱鞘炎患者的疗效及炎性因子的影响[J].湖南中医药大学学报,2023,43(6):1110-1116[点击复制] |
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| 小针刀联合腕踝针对桡骨茎突狭窄性腱鞘炎患者的疗效及炎性因子的影响 |
| 李佃波,姜孟家,丁洪磊,崔述生 |
| (北京市鼓楼中医医院推拿科, 北京 100009;北京市鼓楼中医医院名医馆, 北京 100009) |
| 摘要: |
| 目的 探究小针刀联合腕踝针对桡骨茎突狭窄性腱鞘炎患者的疗效及炎性因子的影响。方法 纳入2019年1月至2020年6月142例桡骨茎突狭窄性腱鞘炎为研究对象，采用随机数字表法将其分为对照组及观察组，每组71例。对照组给予腕踝针治疗，观察组给予小针刀联合腕踝针治疗。统计两组治疗疗效、治疗后6个月的复发率及治疗期间不良反应发生情况，比较两组治疗前后中医证候积分、腕关节活动度、炎性因子[C反应蛋白（C-reactive protein, CRP）、白细胞介素-6（interleukin-6, IL-6）、肿瘤坏死因子-α（tumor necrosis factor-α, TNF-α）、白细胞介素-1β（interleukin-1β, IL-1β）] 水平、无名指掌侧指固有动脉血流动力学[收缩期峰值流速（peak systolic velocity, PSV）、舒张末期流速（end diastolic velocity, EDV）、搏动指数（pulsatility inde, PI）、阻力指数（resistive index, RI）] 及腕关节肿胀程度，采用视觉模拟评分法（visual analogue scales, VAS）、Cooney腕关节评分、Quinell评分评价患者治疗前后关节疼痛程度及腕关节功能。结果 观察组总有效率高于对照组（P<0.05）。治疗后，两组中医证候积分、Quinell评分均低于治疗前，且观察组中医证候积分及Quinell评分低于对照组（P<0.05）；两组Cooney评分高于治疗前，且观察组高于对照组（P<0.05）。治疗2周及治疗1个月后两组VAS评分均低于治疗前（P<0.05），两组VAS评分对比差异无统计学意义（P>0.05）。治疗后，两组CRP、IL-6、TNF-α及IL-1β水平均低于治疗前，且观察组低于对照组（P<0.05）；两组腕关节桡倾、尺偏、背伸及掌屈角均大于治疗前，且观察组大于对照组（P<0.05）；两组PSV、EDV、PI及RI值均大于治疗前，且观察组大于对照组（P<0.05）；两组桡骨茎突处肿胀程度低于治疗前，且观察组低于对照组（P<0.05）。两组复发率及不良反应发生率对比，差异无统计学意义（P>0.05）。结论 对桡骨茎突狭窄性腱鞘炎患者给予小针刀联合腕踝针治疗，可提高治疗疗效，降低机体炎症水平，并能改善患者腕关节功能，增加局部血流灌注，且安全性高。 |
| 关键词: 小针刀|腕踝针|VAS评分|Cooney腕关节评分|腕关节活动度|炎性因子 |
| DOI：10.3969/j.issn.1674－070X.２０23.06.024 |
| 投稿时间：2022-12-07 |
| 基金项目:国家重点研发计划（中医药现代化研究）项目（2018YFC1704102）。 |
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| Curative effects of small needle-knife combined with wrist-ankle acupuncture on patients with stenosing tendovaginitis radial styloid and the influence of inflammatory factors |
| LI Dianbo,JIANG Mengjia,DING Honglei,CUI Shusheng |
| (Department of Massage, Beijing Gulou Hospital of Chinese Medicine, Beijing 100009, China;Famous Doctor's Hall, Beijing Gulou Hospital of Chinese Medicine, Beijing 100009, China) |
| Abstract: |
| Objective To explore the curative effects of small needle-knife combined with wrist-ankle acupuncture on patients with stenosing tendovaginitis radial styloid and the influence of inflammatory factors. Methods A total of 142 cases of stenosing tendovaginitis radial styloid from January 2019 to June 2020 were included as the research objects. Then they were divided into control group and observation group by random number table method, with 71 cases in each group. The control group was given wrist-ankle acupuncture, while the observation group was treated with small needleknife combined wrist-ankle acupuncture. The curative effects, the recurrence rate at 6 months after treatment, and adverse reactions during treatment of the two groups were recorded. Meanwhile, the TCM pattern scores, wrist joint range of motion, levels of inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β)] , the hemodynamics of proper ppalmar digital artery of the ring finger [peak systolic flow velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), resistive index (RI)], and swelling degree of wrist joint were compared between two groups. The visual analogue scale (VAS), Cooney wrist scores, and Quinell scores were used to evaluate wrist joint function and the degree of joint pain before and after treatment. Results The total effective rate of observation group was higher than that of control group (P<0.05). After treatment, TCM pattern scores and Quinell scores of both groups were lower than those before treatment, and the above two scores of observation group were lower than those of control group (P<0.05). The Cooney scores of both groups were higher than those before treatment, and the scores in observation group was higher than those in control group (P<0.05). After 2 weeks and 1 month of treatment, the VAS scores were lower than those before treatment (P<0.05), and there was no statistically significant difference between two groups (P>0.05). After treatment, the levels of CRP, IL-6, TNF-α, and IL-1β in two groups were lower than those before treatment, and the above levels in observation group was lower than those in control group (P<0.05); the radial inclination, ulnar deviation, dorsal extension and palm flexion angles of the wrist in both groups were larger than those before treatment, and the above angles in observation group was larger than those in control group (P<0.05); the values of PSV, EDV, PI, and RI in both groups were higher than those before treatment, and the above values in observation group was higher than those in control group (P<0.05); the swelling degree of radial styloid was lower in both groups than that before treatment, and the degree in observation group was lower than that in control group (P<0.05). There was no statistically significant difference in recurrence rate and adverse reaction rate between two groups (P>0.05). Conclusion Treating stenosing tendovaginitis radial styloid with small needle-knife combined with wrist-ankle acupuncture can achieve better curative effects and higher safety, reduce the level of inflammation, increase local blood perfusion, and improve wrist joint function. |
| Key words: small needle-knife|wrist-ankle acupuncture|VAS scores|Cooney wrist joint scores|wrist joint range of motion|inflammatory factors |
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