| Object Tenovaginitis of flexor digitorum is a kind of aseptic inflammation, the most common etiology for chronic injury, such as a finger long fast activity, force activities, pain, tenderness and palm finger flexion limitation of activity are the main clinical manifestations of it. At the same time, activities usually happens when a patient to noise in the joints, so it is also called a "finger" or "trigger finger"(Trigger finger, TF) [1], in recent years, with the rapid popularization of computer and mobile phone, the incidence of the disease is increasing, and the age of onset decreased year by year. The purpose of this paper is, hand observation through autopsy flexor tendon sheath of anatomical structure of A1 ring, such as neural, vascular and refers to the fingers on both sides ofthe walking, the basic surface positioning accurate observation of the annular ligament of A1 loop, tenovaginitis of flexor digitorum anatomy reference for clinical acupotomy therapy, and on this basis, design two different kinds of needle acupotome therapy method tenovaginitis of flexor digitorum, namely the special oblique blade acupotome and I type No. 4 acupotome were loose, through the observation of treatment of two group improved the symptoms of the patients after one week and efficient and 3 months after the two groups of patients with efficiency and recurrence, mechanism analysis and compare of oblique edge Acupotomology tenovaginitis of flexor digitorum in treatment and advantage.Method 1, anatomy observation: Select 6 cases from the human upper limb specimens were formalin preservative treated specimens, on each finger flexor tendon width, A1 ring palm line and side of center of the measured neural, vascular distance, observation of A1 ring, tendon sheath, vincula tendinum anatomic morphological features; far lateral margin and distal and measurement of annular ligament of A1 ring palm transverse distance.2, clinical research: select 48 cases of tenovaginitis of flexor digitorum patients, all patients were in 2008 March-2015 year in March the Hubei traditional Chinese medicine university affiliated Yi Tang and acupotomy science HUANGJIAHU Hospital of Hubei University of traditional Chinese medicine clinic patients, each patient are in line with the "TCM disease diagnosis standard of curative effect in" diagnostic criteria for flexor muscle tenosynovitis, randomly and random number table, all the patients were divided into experimental group and control group, 24 cases in each group. The experimental group adopted special oblique blade acupotome treatment, the control group using I type needle acupotome treatment of No. 4, were treated for 1 times, the curative effect of 1 weeks and 3 months after the end of treatment to improve the evaluation, observe two groups of clinical comprehensive therapeutic effects, main symptoms and signs and do the scoring record, and all the data using statistical software for statistical the treatment has achieved.Results 1, anatomical specimens measuring: the average width of A1 ring: thumb for(5.5 ±0.1) mm; index finger for(7.2± 0.1) mm; the(7.1 ± 0.2) mm, the ring finger is(7.2 ± 0.1) mm, the littlefinger is(6.1± 0.2) Inm, the average width of overall is about 7.1mm. Surface localization of A1 ring is respectively: located in the distal A1 loop in transverse distal thumb metacarpophalangeal(3.1 ± 0.1) mm; in the index finger is located in middle transverse distal palm(5.1 ± 0.1) mm; in the middle finger and ring finger is located in the distal transverse palmar distal(3.2 ± 0.1) mm; on the little finger located in the palm distal cross Wen Yuanduan(2.2 ± 0.1) mm; A1 ring with the center line on both sides of the neuro vessel distance is(0.4 ± 0.1) mm. 2, results of clinical studies: 1 weeks after the 2.1 treatment, experimental group of 24 patients, 18 cases were cured; 6 cases effective, 0 cases ineffective; the cure rate was 75%, total effective rate was 100%; control group, 24 patients, 12 cases were cured, effective 8 cases, invalid 4 cases, the cure rate was 50%, the total the efficiency can reach 83.3%,. Comparison of two groups, statistically, there was significant difference(P < 0.05) were compared between the two groups before and after treatment group, statistically, the most significant difference(P<0.01).3 2.2 months after treatment, the experimental group of 24 patients, 20 cases were cured; effective 4 cases, invalid 0 cases; the total effective rate was 100%, the cure rate was 83.3%; the control group of 24 patients, 16 cases were cured, effective 6 cases, invalid 2 cases, the total efficiency of 66.67%. Comparison of two groups, statistically, there was significant difference(P < 0.05), the two groups after 3 months and 1 weeks after treatment, within group comparison, by statistically significant differences(P<0.05). The experimental group and the control groups, in the "pain" and "snapping" and "locking" and "callous" project score, after statistics processing, has the extremely significant difference(P<0.01). Statistical data shows, significantly better than the control group in treatment group, the clinical synthesis curative effect, with statistical significance.Conclusion 1, the flexor tendon sheath anatomical structure clear, A1 ring width, anatomic location, and both sides of the nerves and blood vessels of the distance can be measured; clear acupotome treatment mechanism of tenovaginitis of flexor digitorum, that is through open tendinous sheath A1, release the shackles of flexor tendon, the normal mechanical function recovery offlexor tendon sheath, the flexor tendon in tendon sheath freely, through a period of recovery, with finger force balance string mechanics anatomical system to recover. 2, special oblique edge needle acupotome treatment of tenovaginitis of flexor digitorum effect significantly, can significantly improve the clinical symptoms and signs of muscle flexor tenosynovitis of patients, and I type No. 4 needle acupotome therapy for this disease compared with acupotomy operation, more convenient, more complete lysis of adhesions. At the same time, the overall clinical curative effect is more significant, the cure rate is higher. 3, after a long period of clinical practice shows that the special oblique blade acupotome significant treatment tenovaginitis of flexor digitorum curative effect, and has a relatively simple operation, long-term effect is better than that of short, low recurrence rate advantages. Compared with the operation treatment, one hand to reduce patients pain, but also reduce the economic burden of patients, provides a new idea and method for the treatment of tenovaginitis of flexor digitorum, improve the life quality of the patients. |
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