局部封闭与体外冲击波治疗肱骨外上髁炎的疗效对比

目的比较局部封闭与体外冲击波治疗肱骨外上髁炎的疗效。方法选择复旦大学附属中山医院于2017年7月1日—2018年6月30日门诊收治并诊断为肱骨外上髁炎的患者40例,随机分为局部封闭治疗组和体外冲击波治疗组,每组各20例。局部封闭治疗组患者接受曲安奈德混悬液的局部注射治疗;体外冲击波治疗组患者接受体外冲击波治疗,共6个疗程,每个疗程间隔7 d。分别于治疗结束后第4、12周采用疼痛VAS评分和上肢功能障碍评定量表(DASH量表)评估疗效。结果局部封闭治疗组与体外冲击波治疗组患者的性别构成、年龄、病程的差异均无统计学意义(P值均>0.05)。体外冲击波治疗组患者治疗后第4周疼痛VAS评分、DASH量表评分分别为2.6(1.2,4.5)、25.0(7.5,33.3)分,较治疗前的5.0(2.9,6.2)、30.8(17.7,38.3)分均有改善,差异均有统计学意义(Z=-3.825、-2.527,P值均<0.05);治疗后第12周疼痛VAS评分、DASH量表评分分别为2.0(0.5,4.0)、10.8(5.2,29.2)分,较治疗前均有改善,差异均有统计学意义(Z=-3.875、-...     

肱骨外上髁炎的封闭治疗

目的探讨肱骨外上髁炎的局部封闭治疗效果。方法对60例患者随机分为封闭组和对照组,均行TDP肘部照射和肘部制动的基础治疗。封闭组40例中,西医组20例采取肱骨外上髁局部肌筋膜内西药封闭疗法;中医组20例采取肱骨外上髁局部中药封闭疗法。对照组20例予口服强的松片、消炎痛片治疗。结果3周为1疗程评定。封闭组40例,治愈37,好转3例,无效0例,有效率100％,总治愈率92．5％,西医组治愈率90．0％,中医组治愈率95．0％;对照组20例,治愈9,好转6例,无效5例,有效率75％,治愈率45％。结论肱骨外上髁炎局部封闭疗法效果良好,中药封闭组同西药封闭组均有优势。     

小针刀配合手法治疗肱骨外上髁炎86例

肱骨外上髁炎,又名肘外侧疼痛综合症,俗称网球肘.是指肱骨外上髁腕伸肌肌腱起点处的无菌性炎症而言.中医称之为"肘劳"、"肘痛".临床以腕关节无力,肘关节外侧疼痛、肱骨外上髁腕伸肌群附着处压痛,疼痛可放射至前臂或上臂,也可见肘部微肿,用力握拳及前臂旋转或提拿重物时疼痛加重为主要表现.     

显微手术与小针刀治疗顽固性肱骨外伤髁炎对比研究

自2001年10月至2003年1月，我们对37例38臂顽固性肱骨外上髁炎进行显微松解、切断微神经支手术，同时对41例43臂进行小针刀治疗，术后早期活动，现报道如下。     

小针刀加封闭治疗肱骨外上髁炎

肱骨外上髁炎是临床常见病和多发病,主要由肱骨外上髁伸肌总肌腱起点处的慢性损伤性炎症所致,病变虽不重,但影响上肢功能,目前临床治疗效果较差.我科门诊于2005年5月-2007年5月小针刀加封闭治疗肱骨外上髁炎48例,取得满意疗效,现报告如下.     

手法结合穴位注射治疗肱骨外上髁炎32例疗效观察

肱骨外上髁炎又称网球肘，是一种常见的慢性劳损性疾病。笔采用手法结合穴位注射治疗肱骨外上髁炎32例，取得了较好的疗效，现报道如下。     

针刀封闭推拿治疗肱骨外上髁炎68例

目的观察针刀封闭推拿治疗肱骨外上髁炎的疗效。方法将68例患者均采用小针刀松解,配合内服治伤胶囊,局部注射,理筋手法推拿治疗,并加强功能锻炼。结果治愈56例,好转9例,无效3例,总有效率95 .6%。结论小针刀配合推拿、封闭治疗肱骨外上髁炎,简便易行、疗效可靠、创伤小、痛苦少,患者宜于接受。     

压痛点封闭治疗肱骨外上髁炎497例

目的探讨压痛点封闭治疗肱骨外上髁炎的临床疗效。方法应用强的松龙、维生素B12、利多卡因压痛点封闭治疗肱骨外上髁炎497例。结果总有效率98%,无效2%。结论压痛点封闭治疗肱骨外上髁炎疗效满意。     

浮针结合电针治疗网球肘的疗效观察

目的观察浮针结合电针治疗网球肘的疗效。方法将100例网球肘患者随机分为3组,分别接受浮针(n=30)、电针组(n=30)和浮针结合电针(n=40)的综合治疗。3周后观察疗效。结果(1)3组均获较好疗效。(2)浮针结合电针组的治愈率优于浮针组和电针组。结论浮针结合电针可提高单纯浮针或单纯电针对网球肘的治愈率。     

网球肘的成因及其与解剖结构的关系

目的从解剖学的角度来分析、探讨“网球肘”运动损伤的机制,最大限度的预防“网球肘”的发生。方法选择新乡医学院2003级、2004级、2005级本科学生和职工共计1 168人进行问卷调查和访问。结果1 168人中,432人患有不同程度的“网球肘”,高达36.98%,其中尺侧副韧带损伤63.42%,桡侧副韧带损伤31.25%,多部位损伤5.32%。结论在“网球肘”运动损伤中,尺侧副韧带损伤发生率较高,根据肘部解剖结构分析,“网球肘”是可以预防的。     

富血小板血浆治疗肱骨外上髁炎的效果

目的 探讨富血小板血浆治疗肱骨外上髁炎的临床效果.方法 回顾性分析连续收治并采用富血小板血浆治疗的肱骨外上髁炎患者23例的临床资料.富血小板血浆采用二次离心法提取,注射于患侧肱骨外上髁痛点,比较治疗前和治疗后1 d及1、3、6、12个月的视觉模拟评分(VAS)、前臂-肩-手功能障碍评分(QuickDASH)、上肢功能评分(UEFS),评估治疗后肘关节的功能.结果 所有患者治疗后无不良反应,治疗前患者VAS、QuickDASH、UEFS评分与治疗后1 d及1、3、6、12个月相比,呈逐渐降低趋势,差异有统计学意义(P<0.05).结论 富血小板血浆是对肱骨外上髁炎安全、有效的治疗方式.     

体外冲击波治疗网球肘的临床研究

[目的]观察体外冲击波对网球肘的疗效.[方法]应用国产ESWO冲击波骨科治疗机治疗网球肘68例,随机分为观察组32例和对照组36例.观察组以痛点为中心,行体外冲击波疗法;对照组行按摩、药物、功能锻炼治疗.[结果]治疗后第4周,视觉模拟评分(VAS)评分,两组间比较差异无显著性意义.治疗后第8周和第12周,观察组有效率8...     

A randomized controlled trial of exercise versus wait-list in chronic tennis elbow (lateral epicondylosis)

Abstract

Background. Chronic tennis elbow (lateral epicondylosis) is a common disorder. Like other chronic soft-tissue pain conditions it is often difficult to treat successfully. The effects of exercise have been discussed, but no convincing evidence has been put forward so far, and a simple protocol for exercise is lacking.

Aims of the study. This study is a randomized, controlled, clinical trial of the effect of exercise versus expectation (wait-list) on pain, muscle strength, function, and quality of life in patients with long-standing lateral epicondylosis.

Methods. Eighty-one subjects with tennis elbow lasting for more than 3 months were randomly allocated to an exercise group (n = 40) or a reference group (n = 41). The exercise group performed daily exercise, with weekly load increase, for 3 months. The reference group was wait-listed, but otherwise followed in the same way. Outcome measures were pain during maximum voluntary muscle contraction (Cozen's test) and pain during maximum muscle elongation with a load (modified Empty-can-test); muscle strength was measured with a Chatillon MSE 100 hand-held dynamometer, and the Disability of the Arm, Shoulder and Hand (DASH) and the Gothenburg Quality of Life questionnaires.

Results. The exercise group had greater and faster regression of pain, both during muscle contraction and muscle elongation, than the reference group (p = 0.0005 and p = 0.0016, respectively). There was a non-significant muscle strength difference between the groups, but no differences regarding DASH scores or quality of life measures.

Conclusions. Exercise appears to be superior to expectation in reducing pain in chronic lateral epicondylosis.     

A randomized controlled trial of exercise versus wait-list in chronic tennis elbow (lateral epicondylosis)

Background

Chronic tennis elbow (lateral epicondylosis) is a common disorder. Like other chronic soft-tissue pain conditions it is often difficult to treat successfully. The effects of exercise have been discussed, but no convincing evidence has been put forward so far, and a simple protocol for exercise is lacking.

Aims of the study

This study is a randomized, controlled, clinical trial of the effect of exercise versus expectation (wait-list) on pain, muscle strength, function, and quality of life in patients with long-standing lateral epicondylosis.

Methods

Eighty-one subjects with tennis elbow lasting for more than 3 months were randomly allocated to an exercise group (n = 40) or a reference group (n = 41). The exercise group performed daily exercise, with weekly load increase, for 3 months. The reference group was wait-listed, but otherwise followed in the same way. Outcome measures were pain during maximum voluntary muscle contraction (Cozen''s test) and pain during maximum muscle elongation with a load (modified Empty-can-test); muscle strength was measured with a Chatillon MSE 100 hand-held dynamometer, and the Disability of the Arm, Shoulder and Hand (DASH) and the Gothenburg Quality of Life questionnaires.

Results

The exercise group had greater and faster regression of pain, both during muscle contraction and muscle elongation, than the reference group (p = 0.0005 and p = 0.0016, respectively). There was a non-significant muscle strength difference between the groups, but no differences regarding DASH scores or quality of life measures.

Conclusions

Exercise appears to be superior to expectation in reducing pain in chronic lateral epicondylosis.     

长圆针治疗网球肘106例临床疗效观察

目的：观察长圆针治疗网球肘的临床疗效。方法：将106例患者随机分为治疗组（长圆针组）和对照组（单纯针刺组）。长圆针组采用在肱骨外上髁周边,手三里次和通过经筋辨证而查到的,手三阳经筋上的其它结筋病灶点上定点,先关刺再恢刺解结。每周1次,连做3次,总疗程共计21天。针刺组采取阿是穴、曲池、肘醪、手三里、合谷等针刺治疗每天1次,7天1疗程,连做3个疗程,共计21天。统计疗效。结果：长圆针组治愈50例,针刺组治愈40例,2组治愈率经统计学处理差异有显著性意义（P〈0．05）。结论：长圆针治疗网球肘（肱骨外上髁炎）,治愈率优于针刺治疗。     

针刺颈夹脊穴治疗顽固性网球肘临床疗效观察

目的观察针刺颈夹脊穴配合经验穴、阿是穴、手三里穴、一间穴结合中药熏洗治疗网球肘（肱骨外上髁炎）即时止痛的临床效果。方法将90例患者随机分为治疗组和对照组,每组45例,对照组采用局部取穴结合中药熏洗治疗;治疗组在对照组基础上针刺颈夹脊穴治疗。观察2组即时止痛效果、疼痛视觉模拟评分（VAS）及临床疗效。结果治疗组总有效率为91.1%,对照组总有效率为80.0%,治疗组临床疗效优于对照组（P〈0.05）;治疗组止痛的即时显效率73.3%,优于对照组的51.1%（P〈0.01）;2组治疗后VAS评分均较治疗前减少（P均〈0.01）,且治疗组较对照组VAS评分降低更明显（P〈0.05）。结论针刺颈夹脊穴配合局部取穴结合中药熏洗治疗顽固性网球肘,有较好的即时止痛效果,且疗效更为显著。     

Arnold-Chiari畸形合并脊髓空洞显微手术治疗的临床研究

目的 介绍Arnold-Chiari畸形合并脊髓空洞(ACM-SM)显微手术治疗的术式和注意点。方法 总结113例ACM-SM显微手术治疗的经验。结果 该组113例术后临床症状改善103例(91.15％)。并进行1年随访，获得随访102例，68例脊髓空洞消失，32例明显缩小。结论 在后颅窝减压基础上显微镜下松解小脑扁桃体与周围的粘连、恢复脊液循环是有效治疗ACM-SM的关键。     

肘关节镜下松解治疗肘关节僵硬的临床疗效

目的 初步探究肘关节镜下松解治疗肘关节僵硬的效果。方法 选取2018年6月1日至2021年5月31日行关节镜下肘关节松解的患者30例,其中男性19例,女性11例,年龄26~65岁,平均（45.6±4.3）岁。按照O'Driscoll四步法对肘关节僵硬进行松解,术后肘关节常规冰敷1周,术后第1天佩戴铰链支具,指导下进行屈伸功能锻炼。记录术前、术后1周、1个月、3个月肘关节的屈伸活动,比较术前与术后3个月患者肘关节活动度（range of motion,ROM）的变化,使用Mayo评分标准评价患肘功能恢复情况。结果 术后随访29例,失访1例,随访9~12个月,平均（10.6±1.4）个月。所有患者术后均未出现神经损伤症状、切口感染、肘关节异位骨化等并发症。肘关节平均最大ROM：术前63.30°±21.20°,术后1周77.82°±13.75°、术后1个月85.52°±11.32°、术后3个月110.19°±10.18°,术后1周、1个月、3个月的平均最大ROM与术前比较,差异均有统计学意义（P<0.05）。肘关节Mayo评分：术前（52.34±14.32）分、术后1周（63.48±10.35）分、术后1个月（73.44±8.77）分、术后3个月（80.43±13.74）分,术后1周、1个月、3个月的肘关节Mayo评分与术前Mayo评分比较,差异均有统计学意义（P<0.05）。结论 肘关节镜下松解治疗肘关节僵硬可改善肘关节活动度,早期促进肘关节功能恢复,利于早期开展功能锻炼和提高临床疗效。