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中华针灸电子杂志

中华针灸电子杂志 ›› 2021, Vol. 10 ›› Issue (04) : 133 -139. doi: 10.3877/cma.j.issn.2095-3240.2021.04.001

论著

电针促进腕关节三角纤维软骨复合体损伤运动功能康复的临床研究
张宁宁1, 郭长利1, 张弘毅1, 卢泽南2, 何曼2, 陈超3, 王华军4,†()   
  1. 1. 067000　承德医学院公共体育部
    2. 067000　承德医学院附属医院康复医学科
    3. 510630　广州，暨南大学附属第一医院运动医学科
    4. 510515　广州，南方医科大学中医药学院外科教研室
  • 收稿日期:2020-01-11 出版日期:2021-10-15
  • 通信作者: 王华军
  • 基金资助:
    河北省体育局资助项目(20201012); 广州市科技计划重大项目(201604020095)

Effects of electro-acupuncture in wrist triangular fibrocartilage complex repair

Ningning Zhang1, Changli Guo1, Hongyi Zhang1, Zenan Lu2, Man He2, Chao Chen3, Huajun Wang4,†()   

  1. 1. Department of Public Sports, Chengde Medical College, Chengde 067000, China
    2. Department of Rehabilitation Medicine, The Affiliated Hospital of Chengde Medical College, Chengde 067000, China
    3. Department of Sports Medicine, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
    4. Department of Orthopedics, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China
  • Received:2020-01-11 Published:2021-10-15
  • Corresponding author: Huajun Wang
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张宁宁, 郭长利, 张弘毅, 卢泽南, 何曼, 陈超, 王华军. 电针促进腕关节三角纤维软骨复合体损伤运动功能康复的临床研究[J/OL]. 中华针灸电子杂志, 2021, 10(04): 133-139.

Ningning Zhang, Changli Guo, Hongyi Zhang, Zenan Lu, Man He, Chao Chen, Huajun Wang. Effects of electro-acupuncture in wrist triangular fibrocartilage complex repair[J/OL]. Chinese Journal of Acupuncture and Moxibustion(Electronic Edition), 2021, 10(04): 133-139.

目的

观察电针治疗腕关节三角纤维软骨复合体(TFCC)损伤的临床疗效。

方法

选择2017年1月至2019年1月承德医学院附属医院收治TFCC损伤行保守治疗的患者168例，根据就诊顺序随机纳入患者，依据患者有无电针治疗分成治疗组78例和对照组90例，治疗组采用电针配合常规物理治疗，对照组只进行常规物理治疗。对照组物理治疗每日3次，每次15 min。治疗组在物理治疗的基础上每日行电针治疗1次，每次20 min，7 d为1个疗程，每隔3~4日行下1个疗程，共治疗3个疗程。治疗组分别为治疗前(T0)、治疗1周后电针第1个疗程后(T1)、电针组第3个疗程后(T2)、末次随访(T3)时记录2组患者的疼痛视觉模拟评分(VAS)，Mayo改良的腕关节评分(MMWS)，上肢功能评定量表(DASH)得分，患者腕关节自评量表(PRWE)得分及治疗相关不良反应，组间差异比较采用两独立样本t检验分析，从而评价电针治疗TFCC损伤的临床疗效。

结果

2组患者平均随访18个月，在治疗前(T0)时VAS、MMWS、DASH、PRWE评分无统计学差异(t＝0.276、1.641、1.345、1.278，P均>0.05)。T1、T2比较，治疗组4项评分均优于对照组，差异均有统计学意义[t(T1)＝3.696、4.230、4.537、4.929，P均<0.05)；t(T2)＝3.535、6.365、7.772、7.616，P均<0.05]。T3时，治疗组与对照组VAS评分比较无统计学差异(t＝1.218，P>0.05)，治疗组MMWS、DASH、PRWE评分均优于对照组，差异均有统计学意义(t＝7.339、11.288、5.632，P均<0.05)。治疗过程中均未发生治疗相关的严重并发症。

结论

电针配合常规物理治疗对TFCC损伤腕关节疼痛缓解及功能恢复安全有效。

关键词: 电针, 物理治疗, 三角纤维软骨复合体
Objective

To observe the clinical efficacy of electro-acupuncture in the treatment of wrist triangular fibrocartilage complex (TFCC) injury.

Methods

168 patients with mild to moderate TFCC injury were retrospectively analyzed. They were divided into two groups according to whether or not they were treated with electro-acupuncture. The experimental group with 78 cases was treated with electro-acupuncture combined with routine physical therapy, while the control group with 90 cases was treated with routine physical therapy only. The control group received physical therapy 3 times a day, 15 min each time. Besides the same physical therapy, the experimental group was treated with electroacupuncture once a day, 20 min each; In both groups, 7 d was a course of treatment, and there were totally 3 courses, with an interval of 3~4 days between each course. Visual analogue scale (VAS), modified Mayo wrist score (MMWS score), DASH score (Disability of the Arm, Shoulder, Hand), PRWE score (Patient Reported Wrist Evaluation) and treatment-related adverse reactions were recorded before treatment (T0), one week after treatment (T1), all three courses of electro-acupuncture (T2) and the last follow-up (T3). To evaluate the clinical efficacy of electro-acupuncture in the treatment of TFCC injury, the above indicators were compared between groups using two independent samples t-test and within groups at different time points before and after treatment using repeated measures ANOVA.

Results

The average follow-up period was 18 months. There was no statistical difference between the two groups at T0 (t=0.276、1.641、1.345、1.278, all P>0.05). At T1 and T2, VAS, MMWS, DASH and PRWE scores in the experimental group were significantly different from those in the control group [t(T1)=3.696、4.230、4.537、4.929, all P<0.05); t(T2)=3.535、6.365、7.772、7.616, all P<0.05]. At T3, there was no significant difference in VAS scores between the experimental group and the control group (t=1.218, P>0.05). There were significant differences in MMWS, DASH and PRWE scores between two groups (t=7.339、11.288、5.632, all P<0.05). VAS and wrist function scores of the two groups were better than those in T0, and no serious complications related to treatment occurred during the treatment.

Conclusion

Electro-acupuncture combined with routine physical therapy is safe and effective in relieving wrist pain and restoring wrist function after TFCC injury.

Key words: Electroacupuncture, Rehabilitation therapy, Triangular fibrocartilage complex
表1 2组患者一般资料比较
组别 例数 年龄(岁，±s) 性别(男/女) 病程(月，±s) 随访时间(月，±s) 优势侧比例(例，%)
治疗组 78 30.5±6.3 47/31 21.3±6.1 16.6±4.2 51(65.4)
对照组 90 29.0±3.7 55/35 19.2±5.6 18.7±5.8 60(66.7)
统计值   t＝1.911 χ2＝0.013 t＝1.089 t＝1.929 χ2＝0.031
P值   >0.05 >0.05 >0.05 >0.05 >0.05
表2 2组患者治疗前后腕关节疼痛VAS评分水平的比较(分，±s)
组别 例数 治疗前 治疗1周时 电针3个疗程后 末次随访
治疗组 78 6.38±2.04 3.15±1.16 2.08±1.05 1.08±0.60
对照组 90 6.47±2.16 3.89±1.40 2.62±1.26 1.16±1.08
t值   0.276 3.696 2.990 0.581
P值   >0.05 <0.05 <0.05 <0.05
表3 2组患者治疗前后腕关节MMWS评分水平的比较(分，±s)
组别 例数 治疗前 治疗1周时 电针3个疗程后 末次随访
治疗组 78 48.49±8.61 66.28±10.63 79.89±14.36 86.17±10.13
对照组 90 50.78±9.36 59.11±11.23 65.98±13.92 73.44±12.07
t值   1.641 4.230 6.365 7.339
P值   >0.05 <0.001 <0.001 <0.001
表4 2组患者治疗前后腕关节DASH评分水平的比较(分，±s)
组别 例数 治疗前 治疗1周时 电针3个疗程后 末次随访
治疗组 78 39.22±8.12 21.35±6.89 12.24±4.28 9.14±3.17
对照组 90 37.35±9.67 26.51±7.73 19.20±6.83 16.18±4.65
t值   1.345 4.537 7.772 11.288
P值   >0.05 <0.001 <0.001 <0.001
表5 2组患者治疗前后腕关节PRWE评分水平的比较(分，±s)
组别 例数 治疗前 治疗1周时 电针3个疗程后 末次随访
治疗组 78 34.66±7.19 24.35±6.39 16.32±5.73 14.90±5.86
对照组 90 36.03±6.70 29.17±6.26 22.69±5.11 19.89±5.61
t值   1.278 4.929 7.616 5.632
P值   >0.05 <0.001 <0.001 <0.001
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