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[1]何江濤,郭華,李眾毅,等.自體富血小板血漿痛點(diǎn)注射與小針刀松解治療肱骨外上髁炎的對(duì)比研究[J].中醫(yī)正骨,2019,31(03):5-8.
　HE Jiangtao,GUO Hua,LI Zhongyi,et al.A comparative study of injection of autologous platelet rich plasma in pain spots versus releasing with small knife needle for treatment of external humeral epicondylitis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(03):5-8.
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自體富血小板血漿痛點(diǎn)注射與小針刀松解治療肱骨外上髁炎的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年03期
頁碼:
5-8
欄目:
臨床研究
出版日期:
2019-03-20

文章信息/Info

Title:
A comparative study of injection of autologous platelet rich plasma in pain spots versus releasing with small knife needle for treatment of external humeral epicondylitis
作者:
何江濤; 郭華; 李眾毅; 王三木
(鄭州大學(xué)第五附屬醫(yī)院,河南 鄭州 450052)
Author(s):
HE Jiangtao; GUO Hua; LI Zhongyi; WANG Sanmu
The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China
關(guān)鍵詞:
網(wǎng)球肘;  肱骨外上髁炎;  富血小板血漿;  小刀針;  臨床試驗(yàn)
Keywords:
tennis elbow;  humeral external epicondylitis;  platelet rich plasma;  small knife needle;  clinical trial
摘要:
目的:比較自體富血小板血漿(platelet rich plasma,PRP)痛點(diǎn)注射與小針刀松解治療肱骨外上髁炎的臨床療效和安全性。方法:將50例符合要求的肱骨外上髁炎患者隨機(jī)分為2組,每組25例。PRP組采用自體PRP痛點(diǎn)注射治療,針刀組采用小針刀松解治療。PRP組均治療1次; 針刀組治療1次療效不佳者,于第2周再進(jìn)行1次小針刀松解治療。分別于治療前、治療結(jié)束后4周、12周評(píng)定患者的肘關(guān)節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評(píng)分和Mayo肘關(guān)節(jié)功能評(píng)分,同時(shí)觀察不良反應(yīng)及并發(fā)癥發(fā)生情況。結(jié)果:①一般情況。2組患者均完成治療及臨床觀察,均未出現(xiàn)不良反應(yīng)和并發(fā)癥。針刀組5例患者行2次小針刀松解治療,其余20例患者均僅治療1次。②肘關(guān)節(jié)疼痛VAS評(píng)分。時(shí)間因素和分組因素存在交互效應(yīng)(F=21.117,P=0.000)。2組患者的肘關(guān)節(jié)疼痛VAS評(píng)分總體比較,組間差異無統(tǒng)計(jì)學(xué)意義,即不存在分組效應(yīng)(F=8.960,P=0.785)。治療前后不同時(shí)點(diǎn)間VAS評(píng)分的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=19.471,P=0.000); 2組患者的VAS評(píng)分隨時(shí)間變化均呈降低趨勢(shì),但2組的降低趨勢(shì)不完全一致[PRP組:(7.26±1.41)分,(2.46±0.78)分,(2.12±0.63)分,F=7.632,P=0.000; 針刀組:(7.35±1.12)分,(3.27±0.83)分,(2.97±0.98)分,F=5.441,P=0.000]; 治療前2組患者的VAS評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.213,P=0.872); 治療結(jié)束后4周、12周時(shí),PRP組的VAS評(píng)分均低于針刀組(t=3.944,P=0.006; t=3.875,P=0.008)。③Mayo肘關(guān)節(jié)功能評(píng)分。時(shí)間因素和分組因素不存在交互效應(yīng)(F=0.985,P=0.377)。PRP組的Mayo肘關(guān)節(jié)功能評(píng)分總體高于針刀組,存在分組效應(yīng)(F=18.363,P=0.000)。治療前后不同時(shí)點(diǎn)間Mayo評(píng)分的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=322.722,P=0.000); 2組患者的Mayo評(píng)分隨時(shí)間變化均呈增加趨勢(shì),且2組的增加趨勢(shì)一致[PRP組:(33.40±5.14)分,(52.40±5.97)分,(71.60±7.60)分,F=5.848,P=0.019; 針刀組:(29.80±4.67)分,(46.80±9.99)分,(64.00±9.46)分,F=5.441,P=0.000]。結(jié)論:自體PRP痛點(diǎn)注射和小針刀松解治療肱骨外上髁炎,均能有效減輕患者的肘部疼痛、改善肘關(guān)節(jié)功能,安全性較高,但自體PRP痛點(diǎn)注射緩解疼痛的效果更好。
Abstract:
ABSTRACT Objective:To compare the clinical curative effects and safety of injection of autologous platelet rich plasma(PRP)in pain spots versus releasing with small knife needle in the treatment of external humeral epicondylitis.Methods:Fifty patients with external humeral epicondylitis were enrolled in the study and were randomly divided into PRP group and acupotomy group,25 cases in each group.The patients in PRP group were treated with injection of autologous PRP in pain spots only once,while the patients in acupotomy group were treated with releasing with small knife needle once and those who obtained poor curative effect got another release in the next week.The elbow pain visual analogue scale(VAS)scores and the Mayo elbow function scores were evaluated before the treatment and at 4 and 12 weeks after the end of the treatment respectively.Moreover,the adverse reactions and complications were observed.Results:The treatment and clinical observation were finished successfully in all patients,and no adverse reactions and complications were found in the 2 groups.The small knife needle releases were performed on 20 patients once and on 5 patients twice in acupotomy group.There was interaction between time factor and group factor in elbow pain VAS scores(F=21.117,P=0.000).There was no statistical difference in elbow pain VAS scores between the 2 groups in general,in other words,there was no group effect(F=8.960,P=0.785).There was statistical difference in elbow pain VAS scores between different timepoints before and after treatment,in other words,there was time effect(F=19.471,P=0.000).The elbow pain VAS scores presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the decreasing trend of elbow pain VAS scores(PRP group:7.26+/-1.41,2.46+/-0.78,2.12+/-0.63 points,F=7.632,P=0.000; acupotomy group:7.35+/-1.12,3.27+/-0.83,2.97+/-0.98 points,F=5.441,P=0.000).There was no statistical difference in elbow pain VAS scores between the 2 groups before the treatment(t=0.213,P=0.872).The elbow pain VAS scores were lower in PRP group compared to acupotomy group at 4 and 12 weeks after the end of the treatment(t=3.944,P=0.006; t=3.875,P=0.008).There was no interaction between time factor and group factor in Mayo elbow function scores(F=0.985,P=0.377).The Mayo elbow function scores were higher in PRP group compared to acupotomy group in general,in other words,there was group effect(F=18.363,P=0.000).There was statistical difference in Mayo elbow function scores between different timepoints before and after treatment,in other words,there was time effect(F=322.722,P=0.000).The Mayo elbow function scores presented a time-dependent increasing trend in both of the 2 groups,and the 2 groups were consistent with each other in the increasing trend of Mayo elbow function scores(PRP group:33.40+/-5.14,52.40+/-5.97,71.60+/-7.60 points,F=5.848,P=0.019; acupotomy group:29.80+/-4.67,46.80+/-9.99,64.00+/-9.46 points,F=5.441,P=0.000).Conclusion:Both injection of autologous PRP in pain spots and releasing with small knife needle can effectively alleviate elbow pain and improve elbow function in the treatment of external humeral epicondylitis,moreover,they have high safty.However,the former surpasses the latter in relieving the elbow pain.

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通訊作者:何江濤 E-mail:[email protected](收稿日期:2018-12-17 本文編輯:李曉樂)
更新日期/Last Update: 2019-03-30