摘要
目的研究弧刃针治疗中重度拇指屈指肌腱狭窄性腱鞘炎的安全性及有效性。方法收集符合纳入标准的中重度拇指屈指肌腱狭窄性腱鞘炎患者62例,采用随机数字表法将患者1∶1分配至弧刃针组与针刀组,其中弧刃针组31例,采用弧刃针治疗,针刀组31例,给予传统针刀松解术治疗。两组均治疗1次。记录患者治疗前、治疗后各时期(1周、2周、4周)及24周后随访时的疼痛数字评分(Numberal rating scale,NRS)、指间关节活动度(Range of motion,ROM)、Quinell分级以及疾病的疗效评分(Wangxuechang diease efficacy score,WDES),评估治疗效果。结果62例患者治疗后24W随访时,两组病人Quinell分级对比,弧刃针组优于针刀组(P<0.05);疾病的疗效评分(WDES)总有效率:弧刃针组96.77%,针刀组83.87%,弧刃针组的临床总有效率优于针刀组(P<0.05);治疗后,两组疼痛数字评分(NRS)、关节活动度(ROM)均明显改善,且随时间进展,改善程度越大(P<0.05);且治疗后1周、2周、4周及24周时间点的组间比较显示,弧刃针在改善疼痛、关节活动度方面优于针刀组(P<0.05)。结论弧刃针45°腱鞘切开松解术与传统针刀松解术治疗中重度拇指屈指肌腱狭窄性腱鞘炎均有效,但弧刃针45°腱鞘切开松解术在改善疼痛、指间关节活动度和安全性方面优势明显。
Objective To study the safety and effectiveness of arc edge needle therapy for moderate to severe tenosynovitis of the flexor digitorum tendon in the thumb.Methods A total of 62 patients with moderate to severe stenosing tenosynovitis of the flexor digitorum thumb who met the inclusion criteria were collected.The patients were randomly assigned 1:1 to the arc edge needle group and the needle knife group using a random number table method.Among them,31 patients in the arc edge needle group were treated with arc edge needles,while 31 patients in the needle knife group were treated with traditional needle knife release surgery.Both groups were treated once.Record the number rating scale(NRS),range of motion(ROM),Quinell grade,and disease efficacy score(WDES)of patients before and after treatment at various stages(1 week,2 weeks,4 weeks),and at follow-up after 24 weeks to evaluate the treatment effect.Results During the 24 weeks follow-up of 62 patients after treatment,the Quinell grading comparison between the two groups showed that the arc edge needle group was better than the needle knife group(P<0.05);The total effective rate of disease efficacy score(WDES)was 96.77%in the arc edge needle group and 83.87%in the needle knife group.The clinical total effective rate of the arc edge needle group was better than that of the needle knife group(P<0.05);After treatment,both groups showed significant improvement in pain numerical score(NRS)and joint range of motion(ROM),and the degree of improvement increased over time(P<0.05);And the inter group comparison at 1 week,2 weeks,4 weeks and 24 weeks time points after treatment showed that the curved blade needle was superior to the needle knife group in improving pain and joint mobility(P<0.05).Conclusion Both the 45°tenosynovitis incision and release surgery with arc edge needle and traditional needle knife release surgery are effective in treating moderate to severe tenosynovitis of the thumb flexor digitorum tendon.However,the 45°tenosynovitis incision and release surgery with arc edge needle has significant advantages in improving pain,interphalangeal joint mobility,and safety.
作者
马迎存
孟颖博
王学昌
张董喆
孙雅丽
程少丹
Ma Yingcun;Meng Yingbo;Wang Xuechang;Zhang Dongzhe;Sun Yali;Cheng Shaodan(Henan Provincial Hospital of Traditional Chinese Medicine,the Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450002,China;Henan University of Chinese Medicine Arc Edge Needle Therapy Research Institute,Zhengzhou 450018,China;Shenzhen Pingle Orthopedic Hospital,Shenzhen Pingshan District Traditional Chinese Medicine Hospital,Shenzhen 518000,China;School of Orthopedics and Traumatology,Henan University of Chinese Medicine,Zhengzhou 450018,China;Shanghai Guanghua Integrated Traditional Chinese and Western Medicine Hospital,Shanghai 200052,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2024年第1期268-274,共7页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
河南省科学技术厅河南省科技攻关计划(社会发展领域)支持项目(172102310322):新型医疗器械弧刃针刀的研发及在筋伤疼痛疾病的应用,负责人:王学昌
关键词
弧刃针
针刀
狭窄性腱鞘炎
腱鞘切开松解术
Arc edge needle
Needle knife
Stenosing tenosynovitis
Tenosynovectomy release
作者简介
通讯作者:孟颖博,中医师,主要研究方向:中医骨伤。
