| Tennis elbow is also known as outside on the humerus condyle,elbow Lateral pain syndrome,much as a result of long-term cumulative repeated tensile tendons,cause the forearm muscles and tendons of micro damage,formation of local strain,extensor tendon degeneration caused by an elbow Lateral tendons of the department of disease(Lateral here tendinopathy,LET).Tennis elbow crowd of more extensive,although called "tennis elbow",but not give priority to with tennis player,who may be only 5-10%of the humerus condyle inflammation associated with tennis on the outside.The disease oc curs in repeated forcibly stretch wrist activity workers or athletes,especially the frequent forcibly rotating the forearm,such as mixing,tennis player,a violinist,dig carpentry,etc.,in the majority with 40-50 adult onset and the incidence of male tennis player than women,but men and women ratio is basically the same in the general population.Arm pain symptoms are more likely to have the advantage,there are many advantages of arm force and relevant.Western medicine thinks that the main pathogenic mechanism of tennis elbow is excessive use of wrist extensor muscle group,to lead the condyle to the muscles and tendons small trauma,long-term accumulation and cannot be repaired,tendon degeneration,chronic aseptic inflammation,pain and eventually cause elbow lateral department.Excessive use of wrist extensor muscle group can cause micro damage,tendon injuries after treatment or care undeserved can cause tendon matrix environment deteriorating,continuity of collagen fiber bundle fracture,loose structure,cracks,thus local tissue "myxoid" or"hyaline".Although tennis elbow,also known as outside on the humerus condyle inflammation,but tennis elbow is a kind of their own limitations of aseptic inflammation,90%of patients after treatment,on its own repair can be recovered.Tennis elbow,however,its time to repair cycle is long,the pain unbearable,the recurrence rate is high,easy to form the intractable tennis elbow,increase the difficulty of treatment.Clinical treatment is given priority to with conservative therapy,including pain relief drugs,local steroid injection,extracorporeal shock wave therapy,exercise therapy,such as elbow guards.TCM holds that tennis elbow is due to trauma,strain,cold origin resistance result in elbow qi grinds to closed,collaterals YuZu,delay time,general clauses pain.Or ferrite deficiency,blood not rong jin,nourishes bones and muscles not effectively for a long time,no glory,pain.Treatment of traditional Chinese medicine was "bi" the history is long,has formed its own unique theory and clinical practice,in the process of treatment of tennis elbow,overall is the surgery in western medicine,hormone therapy,such as shock wave therapy side effects,low recurrence rate,complication and no bad,get the favour of many patients.Therefore,this research mainly from the clinical effect of medical treatment of tennis elbow.Objective:Because of acupuncture and jar therapy has the unique superiority in the treatment of tennis elbow,two kinds of therapy combined with good clinical results have been achieved in the clinical treatment.This topic research combining with acupuncture and tank treatment of tennis elbow patients' treatment,the pure traditional acupuncture for comparison,carries on the clinical randomized controlled trials,to explore the clinical effect of treatment of tennis elbow and possible mechanism of action,for clinical doctor provides a preferred treatment in the treatment of tennis elbow.Method:TCM clinics in Hong Kong tsuen wan oh recruit to accord with the standard test in 60 cases of patients with tennis elbow as the research object.Will divide the research object,according to the principle of randomized grouping test group and control group 30 cases each.Group of tennis elbow with traditional acupuncture combined with easy jar therapy.First on one side limbs routine acupuncture is the acupuncture point,li 11 o,outside clearance,hand three mile,or valley,branch lander,ZhongZhu.The specifications for the 0.25 mm x 50 mm "hua tuo" brand disposable sterile acupuncture needle,needle when the patient is sitting position,limb forearm flat on the treatment table,conventional 75%alcohol after disinfection,Pierce points quickly,after acupuncture needling of flat or level of skill,retaining needle for 30 minutes.Easy tank after the needle treatment,hold tank after discharge air,along the forearm held by hand,and the sun by the adsorption of two cans,and cooperate with the tank brace technique,namely the forearm rotation and hands clench fist flex movement,both inside and outside for 10 minutes.The next treatment 1,10 to 1 course of treatment.The control group only for the above traditional acupuncture therapy,treatment methods and procedures consistent with the experimental group.Before treatment to all included in the test cases include simple experimental group and control group before trial treatment condition evaluation,evaluation of the project including the JO A elbow function score,ADL daily life activities ability score,clinical symptom integral simplified McGill pain questionnaire,limb pain points four project indicators,the highest temperature infrared imaging and analysis into the object of gender and age distribution,to ensure that the research object of baseline is consistency.In tennis elbow for 15 min after the first treatment,patients with the SF-MPQ scale of VAS score scale as evaluation criteria and the infrared thermal imaging detection was carried out on the afifected area,the analgesic effect of instant curative effect evaluation,to explore the analgesic effect of real-time analysis of two kinds of therapies.The whole course of 10 days after the treatment,after treatment in patients with tennis elbow JOA elbow function score,ADL daily life activities ability score,clinical symptom integral simplified McGill pain questionnaire,limb pain points again score the highest temperature infrared imaging measurement,by comparing the basis of the index before treatment,statistics and analysis the curative effect of two methods of treatment.After completion of treatment a month,in the form of telephone interview or to participate in all treatment of tennis elbow follow-up,patients with follow-up record daily life activities ability,and ADL scale scores used to evaluate the long-term curative effect.Results:The clinical research,a total of 60 patients with tennis elbow into the experimental research,actively cooperate with patient during treatment,no weed out or loss in the process of the whole test cases.According to the principle of randomized clinical trials,experimental group and treatment group,30 cases of two groups of patients carries on the statistical analysis of the distribution of gender,age,had no statistical difference(P>0.05),the experimental group and treatment group of patients on the sex structure,age distribution consistency is better.Into test all cases including experimental group and the control group,before the trial treatment still need to all cases of illness,the evaluation is simple evaluation project including JOA elbow function score,ADL daily life activities ability score,clinical symptoms integral,simplify the McGill pain questionnaire,limb pain points four project indicators,the highest temperature infrared imaging to observe the patient's illness condition.Before treatment experiment was carried out on the experimental study of patients JOA knee function score,experimental group and control group before treatment scores compared with no statistical difference(P>0.05),and can think JOA score before treatment in both groups have no statistical difference,elbow limited activities before the treatment is consistent ADL daily life activities ability score is the evaluation of patients with elbow disorders affect daily life self-care ability.Experimental group and control group before treatment scores compared with no statistical difference(P>0.05),two groups of patients with tennis elbow daily life self-care ability is consistent.Is a doctor of patients with clinical symptoms integral physical examination of objective quantitative evaluation score.Healer to the study of experimental group and the treatment group was incorporated into test object inspection and give objective evaluation of clinical symptoms,the experimental group and control group before treatment scores compared with no statistical difference(P>0.05),known for the treatment of two groups of patients before clinical symptom severity.SF-MPQ rating questionnaire includes three contents,respectively in the level of pain,pain in patients with visual grading,current pain degree from three aspects,comprehensive evaluation of the patient's pain.Two groups of patients before treatment of PRI,VAS,PPI scores compared with no statistical difference(P>0.05),and explain the pain degree of consistency of two groups of patients is good.Infrared imager highest temperature measured in patients with elbow pain points,is the pain of local inflammation more intuitive quantitative evaluation index.Two groups of patients before treatment of local maximum temperature compared with no statistical difference(P>0.05),shows that the two groups before treatment in patients with local skin temperature close to pain.All treated patients with tennis elbow.15 min after the first treatment,VAS score immediately,and statistical analysis.For the first time after the treatment,the experimental group and control group before and after treatment were compared,are statistically significant differences(P<0.01),suggesting acupuncture plus easy jar therapy and acupuncture therapy can improve the patient's VAS score alone.Experimental group and control group compared with the VAS score difference between groups are statistically significant differences(P<0.01),suggesting acupuncture plus easy jar therapy in patients with tennis elbow VAS score method to improve the degree of is better than.single acupuncture treatment group of improvement.After the treatment(temperature for the first time,the experimental group and control group before and after treatment were compared,are statistically significant differences(P<0.01),suggesting acupuncture plus easy jar therapy and acupuncture therapy alone can make tennis elbow injury in patients with local skin temperature is reduced.Experimental group and control group(improved temperature is compared between group,experimental group pain points to improve temperature difference is more apparent,contrast was statistically significant(P<0.01),that is,acupuncture plus easily jar therapy in patients with tennis elbow local pain points improved temperature higher than simple acupuncture treatment.All subjects completed the first course of treatment after the statistical analysis of the indicators.Contrast analysis of two groups before and after treatment of JOA functional rating scale score,daily life activities ability ADL scale score,clinical symptoms integral,simplify McGill pain questionnaire in the score the highest temperature,pain points,but also between experimental group and the control group between the group of statistical analysis,compare the merits of the two methods of clinical treatment.Treatment after 1 months follow-up by telephone or interview in daily life activities ability evaluation of ADL scale,two treatment methods to evaluate the long-term therapeutic effect.Treatment function of JOA scores of two groups after treatment,daily life activities ability ADL scale score,clinical symptoms integral,simplify the McGill pain questionnaire of the highest temperature in the ratings,pain points of experimental group and control group after treatment was the score of the improved significantly(P<0.01),suggesting acupuncture plus easy jar therapy and simple acupuncture therapy has a good therapeutic effect.Treatment group after treatment further statistical analysis and contrast between the way of data,the experimental group than control group in JOA rating scale difference change is more significant(P<0.01);Experimental group ADL scale score difference compared with control group improved(P<0.05);Patients clinical symptoms integral differential between improvement and the improvement of the control group had no statistical difference(P>0.05);Group to simplify McGill pain questionnaire of PRI,VAS,PPI scores compared with the control group had no statistical difference(P>0.05);Experimental group before and after treatment(the highest temperature difference compared with control group no significant difference(P>0.05).Follow-up of ADL scale comparison between group,experimental group ADL grading scores higher than the control group,with statistical significance(P<0.05).Experimental group compared to control group,while in the course of treatment efficacy of clinical symptoms integral,simplify the McGill pain questionnaire,and the pain points of infrared imaging temperature have no obvious difference between the two groups,but group's advantage is:after the treatment for the first time VAS score and the improvement of the pain points of infrared imaging temperature,treatment efficacy of JOA elbow function scale and the improvement of ADL scale,and the long-term curative effect of the improvement of ADL scale.The experimental therapy can produce better analgesic effect of instant,to better promote the elbow function recovery after treatment,and for the treatment and forward the improvement of the ability of daily life activities.Conclusion:(1)simple acupuncture treatment and acupuncture combined with easy jar therapy can improve tennis elbow JOA elbow function score,ADL daily life activities ability score,clinical symptoms integral,simplify the McGill pain questionnaire scores and the highest temperature(local,effective treatment of tennis elbow;(2)the acupuncture combined with easy jar therapy instant analgesic effect and the long-term curative effect is superior to simple acupuncture. |
PDF Full Text Request