| Objective:By dissecting the corresponding tissues of the supinator muscle,the "three-line localization method" was used to locate the positions of the deep branch of the radial nerve entering and exiting the supinator muscle.The correlation between the positions of the two nerve entrapment points and the pathogenesis of the supinator syndrome was analyzed,and the simple surface projection of the entrapment point was found.To explore the value of using filiform needle to puncture the compression point in improving the clinical symptoms of supinator syndrome.Methods:1.10 formalin-fixed adult cadaveric forearms were dissected to fully reveal the position relationship between the posterior group of forearm muscles and the radial nerve in the forearm.Meanwhile,the tissue types of pronator tendon arch were observed.Then,three points of external humeral epondylar,olecranon of ulna and Lister nodule of radial styloid were used as the triangle vertices for connecting and fixing.The "three-line positioning method" was used to mark the triangular region,and the distances between the points at which the deep branch of the left and right radial nerve penetrated the pronator muscle at the forearm and the points at which it penetrated the pronator muscle and the three sides of the triangle were measured.All the measured results were averaged by three measurements.2.Forty-eight outpatients and inpatients who met the diagnostic criteria of supination muscle syndrome from January 2020 to January 2021 were collected.All patients underwent physical examination and EMG examination of both upper limbs,and the corresponding clinical symptoms and EMG results were recorded.Stochastic indicator in 48 patients were randomly divided into control group and observation group and control group,24 cases in the control group used the conventional acupuncture method takes li 11 point,hand the three mile point,on the acupuncture point,the acupuncture point,outside the cave,valley point on acupuncture,observation group in the control group on the basis of the application part through treatment,two groups of patients were 40 minutes,acupuncture treatment for 6 days a week,every day After 4 weeks of treatment,the corresponding indexes were observed for data analysis.Results:1.The tendinous structure of the supination tendinous arch of the forearm has 14 limbs,accounting for 70%,the mixed structure has 4 limbs,accounting for 20%,and the membranous structure has 2 limbs,accounting for 10%.The tendinous tissue structure of the lower margin of the flexor of the forearm was 11 limbs(55%),the muscular tissue structure was 5 limbs(25%),the mixed tissue structure was 3 limbs(15%),and the membranous tissue structure was 1 limb(5%).2.By comparing the values of L1-L9 on both sides of female forearm measured by "three-line positioning method",P>0.05 was obtained,and the difference was not statistically significant.Similarly,by comparing the values of L1-L9 on both sides of male forearm,P>0.05 was obtained,and the difference was not statistically significant.3.The average length(mm)of female forearm from L1 to L9 is:40.36±0.53,208.47±1.16,220.76±2.47,16.48±0.76,16.17±0.16,54.93±0.56,8.72±0.31,15.71±0.19,39.54±0.42.The average length(mm)of both sides of male forearm from L1 to L9 is:66.40±0.62,234.61±1.66,254.49±2.60,18.15±0.60,16.44±0.21,59.51±1.18,10.17±0.44,22.50±0.22,55.78±0.54.For women,the L4/L2 value is about 0.08,the L4/L5 value is about 1.02,the L6/L2 value is about 0.26,and the L7/L6 value is about 0.16.For men,the L4/L2 value is about 0.08,the L4/L5 value is about 1.10,the L6/L2 value is about 0.25,and the L7/L6 value is about 0.17.4.Among the 48 patients,48 patients(100%)had pain symptoms,43patients(89.6%)had numbness symptoms,and 39 patients(81.3%)had decreased muscle strength symptoms.5.The comparison of pain grading in the control group before and after treatment(P=0.032,P < 0.05)was statistically significant,while comparison of pain grades in the observation group before and after treatment(P=0.000,P< 0.05)was statistically significant,that is,both groups were effective;Comparison of pain grades between the two groups after treatment(P=0.045,P < 0.05)was statistically significant,the observation group was better than the control group.The comparison of numbness grading in the control group before and after treatment(P=0.037,P < 0.05),the difference was statistically significant;comparison of numbness grades in the observation group before and after treatment(P=0.000,P < 0.05),the difference was statistically significant,that is,both groups were effective;Comparison of numbness grades between the two groups after treatment(P=0.039,P < 0.05)was statistically significant,the observation group was better than the control group.The comparison of muscle strength grading in the control group before and after treatment(P=0.046,P < 0.05)was statistically significant,while the comparison of muscle strength grading in the observation group before and after treatment(P=0.000,P < 0.05)was statistically significant,that is,both groups were effective;The comparison of muscle strength grading between the two groups after treatment was statistically significant(P=0.027,P <0.05),and the observation group was superior to the control group.6.The total effective rate was 79.2%(19/24)in the control group and91.7%(22/24)in the observation group.The difference between the control group and the observation group was statistically significant(P=0.047,P <0.05),indicating that the effect of the observation group was better than that of the control group.Conclusion:1.Through the muscle tendon after tissue dissection spin after spin bow and supination edge of muscle is easy to cause conformity of deep branch of radial nerve,can be either direct pressure and its anatomical organization nature itself can be other causes of indirect oppression,the interpretation of spin after muscle syndrome pathogenesis and the choice of treatment method has a certain guiding significance.2.By applying the "three line positioning method" and the measurement of numerical calculation,into the deep branch of radial nerve Frohse bow D point of loci and deep branch of radial nerve wear a spiral locus E point of the edge of the muscle to be applied after bone degree measure method of traditional Chinese medicine combined with the thumb with body inch method on simple positioning,forearm take a neutral position,curve elbow 90 ° state,Into the deep branch of radial nerve spin after tendon bow sites point D is located in the distal humerus epicondyle outside a horizontal refers to(1inch),1 horizontal radial volar refers to the position of(1 inch),through the deep branch of radial nerve muscle after spinning nozzles renamed interosseous dorsal nerve locus E point located in the distal humerus epicondyle outside four horizontal(3 inches),radial dorsal half the location of the cross means(0.5 inch),And this simple positioning method can be applied to both the left and right sides of both men and women.3.The filiform needle penetration therapy at the two study sites showed significant clinical effects.This method has a good application prospect and can be used as a new treatment method in the comprehensive treatment system,which has positive therapeutic significance in improving the corresponding symptoms and signs and promoting the functional recovery of patients. |
PDF Full Text Request