| 1 Objective:to investigate the clinical efficacy and safety of the treatment of external humeral epicondylitis with the main therapeutic method and theory of "motion" in the treatment of palace tendons manipulation combined with elbow joint functional exercise.2 Methods:Sixty patients with external humeral epicondylitis included in the outpatient department of WangJing hospital were divided into experimental group(n-30)and control group(n=30)by random number table method.In the experimental group,the treatment was performed with palace tendons method,poking and rolling combined with elbow joint functional exercise.The patients were asked to participate in manipulative treatment once every other day for a course of treatment lasting for two weeks,with a total of 7 times of treatment.Elbow exercises twice a day,once in the morning and once in the evening,15 times each time,for two weeks.The control group was treated with external use of diclofenac acid diethylamine emulsion and wrist elbow brake.Diclofenac acid diethylamine emulsion ointment about 2-3g coated about 2-3g to the affected area,and repeatedly apply it for about 5 minutes,or inform the patient to feel the skin of the painful part becomes red and hot in the process of applying the ointment,one course of treatment.every two weeks,once every other day,a total of 7 times.Elbow protection braking:the elbow protection is fixed according to the thickness of the forearm and the measured circumference of the patient,and the elbow protection is worn continuously for 2 weeks.Local pressure value of elbow joint,HSS score,HSS2 score,clinical efficacy observation,adverse reactions and safety observation were observed.3 Results:3.1 The basic information of patients in the two groups:age,gender,disease duration and other data were analyzed,and the age T test P of the two groups was 0.302 and the disease course T test P was 0.861,both of which were greater than 0.05.There was no significant difference between the two groups and no statistical significance,which could be compared.The P value of gender chi-square test in the two groups was 0.50.All data tests(P>,0.05)had no statistical significance and could be compared.3.2 The scores of the two groups of patients before and after treatment were analyzed by variance.Paired T test was used to compare the tenderness values in the two groups,P test group=0.00,P control group=0.00;The tenderness values between the two groups were compared by T test of two independent samples,P=0.015.P<0.05,there were significant differences between the two groups,with statistical significance.After treatment,the tenderness value of the experimental group was 4.21±0.58,and the tenderness value of the control group was 3.88±0.44,both of which were higher than that before treatment.Both of the two treatment methods could improve the tenderness symptoms of patients with external humeral superior inflammation to some extent,and the improvement of the experimental group was better than that of the control group.At the first diagnosis,the third diagnosis,the fifth diagnosis and the seventh diagnosis,the statistical tenderness values of the two treatment groups were:test tenderness 1=3.08±0.72,test tenderness 2=3.59 ±0.58,test tenderness 3=3.96±0.6,test tenderness 4=4.21±0.58.For tenderness 1=2.95±0.89,for test tenderness 2=3.55±0.53,for tenderness 3=3.76±0.49,and for tenderness 4=3.88±0.44.All data were analyzed by anova,and the variance was homogenous,in line with the normal distribution.Repeated measurement anova was used to compare the tenderness values of the two groups at different time points,P=0.00,less than 0.05.Repeated measurement anova showed significant differences between the two groups,with statistical significance.Combined with the comparison profile of the two groups,it can be seen that the tenderness value of the two groups is in direct proportion to the number of treatments.The tenderness value increases with the increase of treatment times,and the symptoms of the patients are alleviated.The rising trend and upward appreciation of the experimental group are higher than that of the control group.3.3 After examination,the variance of HSS scores of the two groups was identical before and after treatment,which was in line with the normal distribution.Paired T test was used for comparison of HSS scores within the two groups,and independent sample T test was used for comparison of HSS scores between the two groups.Before and after treatment,the HSS scores of the experimental group were 68.4±4.73 and 85.57±5.59,respectively.Control group:67.67±5.55,82.63±7.08,paired T test P test group=0.00,P control group=0.00,independent sample T test P=0.08(P>0.05).HSS scores of the two groups were improved before and after treatment,and patients' functions were significantly improved.There was no significant difference in HSS scores between the experimental group and the control group.Two groups of patients with HSS score the first diagnosis,third,fifth,seventh clinical four different statistical HSS score point value,respectively is:remember try HSS I=68.4 ±4.73,HSS ?=74.50 3.30 mm,try HSS ?=80.53±4.42,HSS ?=85.57 5.59 mm;For HSS ?=67.67±5.55,for HSS ?=72.97±3.16,for HSS ?=77.97 ±4.57,for HSS IV=82.63±7.08.All the data were tested to show homogeneity of variance and normal distribution.Repeated measurement anova was used for the comparison of HSS scores between the two groups at different time points,P=0.00,less than 0.05.The results of repeated measurement anova for the comparison of HSS scores between the two groups showed that there were significant differences between the two groups,with statistical significance.Combined with the HSS repeated measurement profile diagram,the HSS score of the two groups was in direct proportion to the number of treatments.The more the treatments,the higher the HSS score would be,the better the patients' function and symptoms would be,and the disease would tend to be cured.The rising trend and upward appreciation of the experimental group were higher than that of the control group.3.4 Before and after treatment,HSS2 scores of patients in the two groups were tested,with homogeneity of variance and normal distribution.Paired T test was used to compare HSS2 in the group,P test group=0.00,P control group=0.00;HSS scores between groups were compared by T test of two independent samples,P=0.026.HSS2(P<0.05),two groups within the group comparison,comparison between groups have significant difference,statistically significant,the experimental group HSS2 score=85.7±5.57,the control group after treatment pressure value=81.9±7.19,was HSS2 score value increased significantly,the two treatment methods have obvious improve humerus on subjective pain,dysfunction,inflammation patients group to improve the situation more clearly than in the control group.HSS2 score for the first two groups of patients diagnosis,third,fifth,seventh clinical statistical HSS2 score at four different time values are:try HSS2 ?=65.17±3.42,try HSS2 ?=72.4000±3.88,try HSS2 ?=81.03±3.76 try HSS2 ?=85.7 5.57 mm;For HSS2 I=64.17 ±4.9,to the HSS2 ?=71.07±4.15,for HSS2 ?=77.67 ±5.7,for HSS2 ?=81.9±7.19.All the data were tested to show homogeneity of variance and normal distribution.HSS2 scores of the two groups were compared at different time points by repeated measurement anova(P=0.00,less than 0.05),and the comparison of HSS2 scores between the two groups by repeated measurement anova showed that there were significant differences between the two groups,with statistical significance.Combined with the repeated measurement profile of HSS2,the HSS2 score in the two groups was in direct proportion to the number of treatments.The more the treatments,the higher the HSS2 score would be,the less symptoms the patients felt and the disease tended to heal.The rising trend and upward appreciation of the experimental group were higher than that of the control group.3.5 Rank-sum test for therapeutic efficacy of patients in the two groups,Z=-2.095,P=0.04,P<0.05.There were significant differences with statistical significance,and the treatment effect of the experimental group was better than that of the control group.3.6 Safety:no adverse reactions including swelling,skin abscess,skin infection,skin redness and fever,subcutaneous ecchymosis,pain,nerve injury,syncope,and pruritus were observed in all patients.The two treatment methods of palace bonesetting,poking,rolling,elbow functional exercise and elbow tenderness point external rubbing,elbow protection and external fixation are of high safety.4 Conclusion:The study on the treatment of external humeral epicondylitis by palace tendons manipulation,extrication and rolling combined with elbow joint functional exercise and the comparison of local and external application of futalin and elbow joint immobilization for the treatment of external humeral epicondylitis showed that both treatment methods could improve the symptoms and functional activities of LE patients.The operation of palace rib method is gentle and gentle,which makes patients more satisfied.The therapeutic effect of palace muscle manipulation is better and the safety is higher. |
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