当归四逆汤加味联合温针齐刺治疗肱骨外上髁炎疗效及对疼痛介质和近期预后的影响

Effect of modified Danggui Sini Decoction combined with warm triple needling on lateral epicondylitis of humerus and its effect on pain mediators and short-term prognosis

关键词:  肱骨外上髁炎  当归四逆汤加味  温针齐刺  疼痛介质  预后

Key words:  lateral epicondylitis of humerus  modified Danggui Sini Decoction  warm triple needling  pain mediators  prognosis

摘要:

[目的] 探讨当归四逆汤加味联合温针齐刺治疗风寒阻络型肱骨外上髁炎（LE）的临床疗效。[方法] 选择84例LE患者，按照随机数字表法分为研究组（42例）和对照组（42例），对照组予以温针齐刺治疗，研究组予以中药当归四逆汤加味联合温针齐刺治疗。比较两组治疗前后疼痛视觉模拟评分（VAS）、Mayo肘关节功能评分（MEPS）、无痛握力（PFG）、压痛阈值（PPT），并比较两组治疗前后血清P物质（SP）、缓激肽、前列腺素E2（PGE2）、β-内啡肽（β-ET）水平；疗程结束后对两组随访6个月，应用Verhaar网球肘疗效评价系统评估两组近期预后，比较两组6个月临床疗效。[结果] 治疗后研究组疼痛VAS评分低于对照组（P<0.01），MEPS评分、PFG、PPT均高于对照组（P<0.01），血清SP、缓激肽、PGE2水平低于对照组，β-ET水平高于对照组（P<0.01），6个月临床疗效优于对照组（P<0.05），差异均有统计学意义。[结论] 当归四逆汤加味联合温针齐刺可有效调节疼痛介质释放，缓解疼痛，提高肘关节功能水平，改善近期预后，治疗风寒阻络型LE效果显著。

Abstract:

[Objective] To investigate the clinical effect of modified Danggui Sini Decoction combined with warm triple needling in the treatment of lateral epicondylitis(LE) of humerus with wind cold obstructing collaterals.[Methods] The 84 patients with LE were randomly divided into study group (42 cases) and control group (42 cases). The control group were treated with warm triple neadlong and the study group were treated with modified Danggui Sini Decoction combined with warm triple needling. The visual analogue of pain (VAS),Mayo Elbow function score (MEPs),painless grip strength (PFG) and tenderness threshold (PPT) were compared between the two groups before and after treatment,and the serum substance P (SP),bradykinin,prostaglandin E2 (PGE2) and β-Endorphins (β-ET) level were compared. After the course of treatment,the two groups were followed up for 6 months,Verhaar tennis elbow efficacy evaluation system was used to evaluate the short-term prognosis of the two groups,and the clinical efficacy in 6 months of the two groups was compared.[Results] The VAS score of pain of the study group was lower than that of the control group (P<0.01),the MEPs score,PFG and PPT were higher than those of the control group(P<0.01),and the levels of serum SP,bradykinin and PGE2 were lower than those of the control group,the level of β-ET was higher than that of the control group(P<0.01),and the clinical effect in 6 months was better than that of the control group (P<0.05).[Conclusion] Modified Danggui Sini Decoction combined with warm triple needling can effectively regulate the release of pain mediators,relieve pain,improve the level of elbow function,improve the short-term prognosis,and it has a significant therapeutic effect on LE with wind cold obstructing collaterals.