| BackgroundOutside on the humerus condyle inflammation,commonly known as tennis elbow,elbow is one of the most common injuries,have to the disease for about half of the play tennis,so the name.The pain of the disease with elbow lateral part of the brawn,tenderness,grip,wrist,forearm supination activity outside humerus condyles pain as the main performance of chronic injury sex disease.This disease is middle-aged idiopathic disease,according to clinical statistic,on the outside of the humerus condyle inflammation patients is about 40 years old,the more the disease prevalence rate between 1%and 3%,after 40,50 years old age group before the highest incidence of a disease,especially the aged 42 to 46 women group,the incidence can be as high as 10%.See more at long engaged in the work of the special middle-aged,along with the modern work and life for computers,mobile phones and other electronic products increasingly deepening dependence of long time working at his desk,facing the computer,handheld mouse,play mobile phone,cause bad posture,elbow injuries,such as improper protection reasons,leading to the humerus condyle inflammation incidence rising up outside,and has a younger trend.Induced the disease for the first time can be caused by improper elbow a pull,acute injuries,but most of the patients of chronic strain process,from a wide range of single direction,exertion of pain pain gradually.Patients often in extracting weight,clothes,rotating screw driver,unscrew wine bottle or lift the teapot pouring water,sweep the floor,the dull ache in elbow lateral or pain;Some symptoms was not significant,scenery,after a few months can heal itself;However the heavier patients,constant pain,arm weakness,and even a drop on the ground,when in the forearm pronation,often because of the pain and restricted movement,repeated attacks,seriously affect the patients’ work and life.Modern medicine thinks whether acute injury or chronic strain cause disease,the direct factors outside on the humerus condyle inflammation were injured before the forearm pronation in a more,extensor group of sudden or long-term contract,partial fibrous tissue machine,the neurovascular bundle,tendon lead to repeated,regular stimulation.Because most patients do not need to accept the surgical treatment,pathological physiological data is less so,outside the humerus epicondyle extensor tendon always around to check the scar tissue formation is certainly pathological changes.Its pathophysiologic mechanism,there are four main kinds of theories,including blood vessels,nerve bundle,extensor tendon to check conformity of theory of damage theory,theory of degeneration,annular ligament injury after inflammation,branch of radial nerve involvement theory,the theory of synovial incarcerated.Generally accepted theory on the outside of the humerus condyle muscle group to the local degeneration,seepage,adhesion,etc.,the formation of aseptic inflammation,its pathological changes is called lateral stretch wrist tendons start tearing,scarring,total extensor tendon in bursa phlogistic,outside humerus epicondyle periostitis,bone is phlogistic,humerus oar joint plica hyperplasia,hypertrophy,neurovascular bundle of fascia,as well as the annular ligament degeneration and so on.In Chinese medicine,"the theory of element section ask thorns" records:"disease in the muscle,pain,cramps section can not line,called jin bi",on the outside so the humerus condyle inflammation can belong to the "jin","poliomyelitis" category,because its elbow pain,elbow movement dysfunction,also known as the "elbow pain","elbow pain".TCM holds that the disease is mainly caused by chronic strain,much by ferrite vital qi,deficiency of qi and blood,wind,cold,descent origin and bizu after reinforcement,or blood disease without honor tendons,bones and muscles alongwith.According to the etiology and pathogenesis,points have cold winding resistance,the deficiency of qi and blood,hot and humid embodiment three syndrome types.Treatment,the method of TCM treatment of this disease is numerous,the mainstream treatment methods include:pure filiform needle acupuncture,cupping,ordinary moxibustion,warm acupuncture,ginger moxibustion,fire insulation and reinforcement technique,floating needle,needle knife,acupoint injection,etc.The ginger moxibustion therapy combined with ginger and cold insulation moxibustion WenYangTong vein,line has the effect of invigorating qi,warm the channels,can improve microcirculation,to achieve the purpose of anti-inflammatory analgesic.Milli fire needle is modified on the basis of traditional fire needle and take advantage of,not only can play a traditional fire needle can be directly into lesions and reflex point,quickly eliminate or improve local tissue pathological changes,speed up the circulation and metabolism,promote the advantages of local repair,more because of its fine needle body,easy operation,less pain,without the advantages of the risk of cross contamination is accepted by patients.So far there is no any kind of exploration method is proved effective for tennis elbow absolutely.Is currently the most widely clinical use of western medicine treatment for local injections,closed treatment,injectable drugs include corticosteroids,botulinum toxin,sodium hyaluronate,autologous blood and cells in tissue engineering,etc.The therapy can relieve pain temporarily,but the recurrence rate is higher.Function training in patients with self function has an important role in the recovery process,among them with behavioral interventions and functional exercise are more important.Etc.The study found that the slow and gradual centrifugal movement exercises and short side of the wrist extensor static pull up outside humerus condyle practice can effectively relieve patients pain and improve the function of the elbow,easy operating practice for patients.And correct family self exercise can save time,patients without rehabilitation treatment and assist physicians,is advantageous for the patients with early and self treatment at any time.Therefore,this study to cold resistance winding up outside,deficiency of qi and blood,humerus condyle inflammation patients as the research object,according to elbow lateral patients pain and injury of elbow joint function,to adopt loose joint training treatment,on the basis of exploring recommend her fire to the ginger moxibustion in reducing pain in patients with elbow lateral,improve the function of patients with elbow differences,such as optimizing good clinical curative effect,high security,simple and cheap complex therapy,and provide theoretical basis for the clinical promotion.Methods:1.Literature research:Through literature research,the system summarizes the modern medicine and traditional Chinese medicine on the outside of the humerus condyle inflammatory disease category,epidemiological characteristics,etiology,pathology,the general situation of the study mechanism and treatment of pain.2.Through literature study,the system summarized in recent years on the outside of traditional Chinese medicine treatment of humerus condyle phlogistic hot research direction,main treatment methods and their characteristics were analyzed,and provide reference for clinical doctors to select the suitable treatment.3.clinical study:By conducting fire needle combined with loose joint training complex treatment of cold resistance,deficiency of qi and blood,humerus condyle inflammation on the outside of clinical trials,and loose and ginger moxibustion combined with insulation joint training,observe different means of intervention on the patients with symptoms of pain relief and improve the situation,the function improvement,etc.4.On the outside looking for clinical prevention and treatment of humerus condyle inflammation of quick,easy,cheap,good effect of optimizing treatment to provide guidance and reference.Results:(1)clinical curative effect comparison:milli fire needle group total effective rate was 93.75%,ginger moxibustion group total effective rate was 90.00%.After a Wilcoxon rank and inspection,Z=1083.4,P＝0.042(<0.05),compared the statistically difference between the two groups of clinical curative effect..Is here the clinical curative effect of fire needle combined with loose joint training was superior to that of every other ginger moxibustion combined with loose joint training.(2)analgesic effect comparison:above the analgesic effect of fire needle group were more than 59.38%,lie between the analgesic effect of ginger group than 50%had marked effect,nano fire needle treatment group total effective rate was 90.63%,the analgesic effect of ginger moxibustion group was 86.67%,and after Wilcoxon rank and inspection,Z=11125.6,P＝0.04,indicate that the analgesic effect in patients with similar between the two groups have statistical significance,fire needle combined with loosening,training the analgesic effect of treatment group is superior to every other ginger moxibustion combined with loose joint training.(3)the comparison of the observation indexes before and after treatment(SF-McGill scale comparison:with the extension of treatment time,the two groups of patients with SF-McGil 1 scale scores were significantly lower,comparing two after Bonferroni correction,SF-McGill scale total score at 2 weeks and 4 weeks after treatment than before treatment were significantly decreased(P<0.05).In 2 weeks and 4 weeks after treatment,according to the comparison between the two groups of fire needle combined with loose joint training treatment group total score was significantly lower than every other ginger moxibustion combined with loose joint training group(P<0.05).Two groups of SF-McGill scale scores in the treatment of all items 2 weeks and 4 weeks after treatment were different degree of decline,4 weeks after treatment of these patients were pain more significant improvement.And comparison between groups showed:2 weeks after treatment,fire needle treatment group of VAS,PPI,and the scores of the three components were significantly lower than ginger moxibustion group,after treatment of 4 weeks to reach,fire needle treatment group of VAS,PPI two components of the score was significantly lower than ginger moxibustion group,and the score of this item in no obvious difference between the two groups.(2)the comparison of elbow function assessment:with the extension of treatment cycle,the two groups of patients with knee functional rating scale of each component scores were significantly higher(P<0.01),two compare the Bonferroni correction,the treatment group and control group patients’symptoms and signs,daily life project score at 2 weeks and 4 weeks after treatment,compared with before treatment were improved(P<0.05),among them 2 weeks after treatment symptoms and signs scores,milli fire needle group is significantly higher than every other ginger moxibustion treatment group(P<0.01),while daily life score after 2 weeks treatment milli fire needle treatment group at a disadvantage in the every ginger moxibustion treatment group(P<0.05),but after 4 weeks of treatment,two groups in terms of symptoms and signs,daily life,the same effect,there was no significant difference(P>0.05)(4)adverse reaction happening:in the process of treatment,the fine long hair fire needle group has three patients in needle had bleeding,hematoma phenomenon,after press stop bleeding,hematoma absorption,does not affect the treatment process,no treatment,needle breakage,burns,and other adverse events;Every ginger moxibustion group 1 patients in the treatment for the first time dizzy moxibustion reaction,improve after symptomatic treatment,does not affect the treatment process,there are 2 cases after moxibustion out the phenomenon of small blisters,after besmear brush safflower oil absorption by oneself,does not affect the treatment process,no infection,such as large area burn the rest of the adverse events.Conclusion:By analyzing clinical data processing,that fire needle combined with loosening,training to the ginger moxibustion combined with loose joint training can effectively treat type cold resistance winding up outside,deficiency of qi and blood,humerus condyle phlogistic,curative effect in analgesia,improve knee function in patients with obvious;Short-term observation fire needle combined with loose joint training better analgesia,loose and ginger moxibustion combined with insulation joint training better improve knee function;Long-term treatment with the analgesic effect of fire needle combined with loosening,training,improve the functional aspects,milli fire needle and separated moxibustion treatment effect,adhere to long-term loosening,training can improve symptoms,prevention of recurrence.Acupuncture treatment on outside humerus condyle inflammation effect is good,less adverse reaction,treatment costs are relatively low,simple and easy operation etc.,clinical physicians according to patients condition,the degree of compliance to choose the appropriate treatment for phlogistic,outside on the treatment of humerus condyle for syndrome differentiation type belongs to cold resistance network and gas anaemia empty on the outside of the humerus condyle inflammation,it is recommended to use fire needle combined with loose joint training treatment.This topic there are still some deficiencies:to observe the sample size is small,only into the cold resistance winding,deficiency of qi and blood,two patients with humerus condyle inflammation on the outside,not on the hot and humid type intrinsic outside humerus condyle to the exploration of this therapy,patients who are lesions on unilateral or bilateral sorting,comparative analysis and discussion,milli fire operation in acupuncture depth,the acupuncture point,the retaining needle time is not accurate,not set loose joint training group,is based on the loose joint training,combined with fire needle,ginger moxibustion treatment,insulation is better than pure loosening,training,and evaluation standards with more commonly used scale,grip strength change effect index lack of quantity,observe whether the choice of indicators and assessment tools is appropriate,comprehensive,needs further discussion and perfect.Should be increased by increasing sample size,so in the future and the group of comparison,analysis,reduce the error,to regulate the blessings of fire operation process,set up a simple loose joint training group for comparison of fine long hair on fire needle treatment outside the humerus condyle inflammation for further research. |
