中醫傷科調整橈骨手法對網球肘的初步療效評估

Preliminary study evaluating the effect of radial bone mobilization in Chinese Orthopaedics and Traumatology for tennis elbow

黃敬雯(Ching-Wen Huang) ； 黃新家(Hsin-Chia Huang) ； 楊宗憲(Tsung-Hsien Yang) ； 許中原(Chung-Yuan Hsu) ； 李科宏(Ko-Hung Lee)

《中醫藥雜誌》 29卷1期 (2018/06) Pp. 34-41

https://doi.org/10.3966/241139642018062901003

摘要

目的：為了瞭解傷科調整橈骨手法對於網球肘患者的臨床療效。方法：針對網球肘患者進行開放式、前瞻性療效評估研究，由門診招收手肘外側疼痛的患者，納入臨床表現及理學檢查符合網球肘診斷標準者，受試者每周接受兩次傷科手法治療，比較治療後對病人數字疼痛評估量表（Numeric Rating Scale, NRS）的改善程度。結果：本研究共納入16位患者。接受傷科手法治療一次後，工作時疼痛程度的減少達顯著差異（P=0.044）；接受第二次治療後，休息時疼痛程度、日常生活疼痛程度、疼痛頻率及疼痛持續時間達到顯著差異（P=0.02, P=0.001, P=0.004及P=0.005）；但由趨勢圖來看，疼痛改善的程度隨著治療次數逐漸減少。結論：傷科調整橈骨手法對網球肘患者疼痛程度有立即性的改善效果，但重複多次手法對於進一步疼痛緩解之效果趨緩，因此尚須考慮其他病理機轉導致疼痛。本研究無對照組、樣本數少，故尚需大規模隨機對照研究確認傷科調整橈骨手法對於網球肘之療效。

關鍵字

手法 ； 橈骨 ； 網球肘 ； 數字疼痛評估量表

並列摘要

Objectives: The purpose of this study is to establish the initial effects of radial bone mobilization on pain degree in subjects with tennis elbow. Materials and methods: This is an open-label, prospective trial, subjects with tennis elbow were enrolled in a TCM outpatient clinic. Subjects were treated twice weekly for 2 weeks. Numeric Rating Scale (NRS) was assessed before every treatment and follow up were obtained 2 weeks post-treatment. Results: NRS(working) decreased significantly from before therapy to after first treatment ( p=0.044). NRS(at rest), NRS(during daily activity), frequency and duration decreased significantly change from before therapy to after second treatment (p=0.02, p=0.001, p=0.004 and p=0.005), However, by the trend chart, we find that the improvement of pain decreased after receiving more treatment. Conclusion: Radial bone mobilization is a promising intervention modality for the treatment of patients with tennis elbow and can reduce pain immediately following treatment, but the improvement of pain decreased after receiving more treatment, so further mechanism need to be considered for best pain relief. Because of a possible placebo effect in this no control, preliminary study, radial bone mobilization warrants further study in randomized clinical trials to confirm its effectiveness for treating tennis elbow.

並列關鍵字

Traditional Chinese medicine ； radial bone mobilization ； tennis elbow ； Numeric Rating Scale

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