肱骨外上髁炎的中西医研究进展

Progress in Traditional Chinese and Western Medicine Research on Epiepicondylitis of the Humerus

摘要: 肱骨外上髁炎(网球肘)是因前臂伸肌总腱反复牵拉导致的慢性无菌性炎症，以肘关节外侧疼痛、握力下降为特征，常见于拧毛巾、提重物等动作诱发。好发人群包括网球，羽毛球运动员、长期从事重复性肘部活动的职业群体，以及中老年人。现代医学采用阶梯式治疗，急性期以休息、冰敷、非甾体抗炎药及局部封闭为主；慢性期结合物理治疗、支具制动及康复训练；保守治疗无效者行关节镜下肌腱松解术。针灸推拿作为中医特色疗法，在本病治疗中显示独特优势。中医理论认为本病属“肘劳”范畴，病机为气血瘀滞、筋脉失养。针灸选取阿是穴、曲池、手三里等穴位，结合电针、温针及刺络拔罐，可调节局部炎症因子表达，改善微循环，激活内源性镇痛系统。推拿手法可松解肌腱粘连，恢复肘部力学平衡，配合中药熏洗增强舒筋活络功效。中西医结合方案疗效更优，优于单一疗法。相较于单纯西医治疗，针灸推拿具有整体调节、微创安全的特点，尤其适用于慢性期及术后康复。本文聚焦于针灸推拿治疗肱二头肌长头腱肌腱炎的研究进展，以推动该疗法的临床规范化应用。

Abstract: Epihumeral epicondylitis (tennis elbow) is a chronic aseptic inflammation caused by repeated traction of the extensor tendon of the forearm, characterized by pain on the outer side of the elbow joint and decreased grip strength. It is commonly induced by movements, such as twisting towels and lifting heavy objects. The high-risk groups include tennis and badminton players, professional groups engaged in repetitive elbow activities for a long time, and middle-aged and elderly people. Modern medicine adopts a step-by-step treatment approach, with rest, ice compress, nonsteroidal anti-inflammatory drugs, and local blockade as the main treatments during the acute phase; During the chronic phase, comprehensive management involves combining physical therapy, immobilization with braces, and rehabilitation training to optimize functional recovery; Patients who fail conservative treatment should undergo arthroscopic tendon release surgery. Acupuncture and moxibustion and massage, as the characteristic treatment of traditional Chinese medicine, show unique advantages in the treatment of this disease. According to traditional Chinese medicine theory, this disease belongs to the category of “elbow fatigue”, and the pathogenesis is stagnation of qi and blood, and loss of muscle and pulse nourishment. Acupuncture and moxibustion selects Ashi, Quchi, Shousanli and other points, combined with electroacupuncture, warm acupuncture and blood letting puncture and cupping, which can regulate the expression of local inflammatory factors, improve microcirculation and activate the endogenous analgesia system. Tuina massage can release tendon adhesions, restore mechanical balance of the elbow, and enhance the effect of relaxing tendons and activating collaterals with traditional Chinese medicine fumigation and washing. The combination of traditional Chinese and Western medicine has better therapeutic effects than monotherapy. Compared with simple western medicine treatment, acupuncture and moxibustion and massage has the characteristics of overall regulation and minimally invasive safety, especially suitable for chronic stage and postoperative rehabilitation. This article focuses on the research progress of acupuncture and moxibustion and massage in the treatment of tendinitis of the long head of biceps brachii to promote the clinical standardized application of this therapy.