针刀疗法治疗肘管综合征的作用机制及研究进展

The Mechanism and Research Progress of Acupuncture Knife Therapy in Treating Cubital Tunnel Syndrome

摘要: 肘管综合征(Cubital Tunnel Syndrome, CuTS)是尺神经在肘部尺神经沟内受到卡压而引起的一系列感觉、运动功能障碍的临床症候群，又称迟发性尺神经炎。作为上肢最常见的周围神经卡压性疾病之一，其发病率仅次于腕管综合征，严重影响着患者，尤其是体力劳动者的手部功能、日常工作与生活质量。该病病因复杂，临床表现多样，诊断与治疗策略尚存诸多争议，早期精准干预与合理治疗方案的选择对预后至关重要。因此，系统梳理肘管综合征的诊疗进展，特别是探索针刀等微创治疗手段的作用机制与临床价值，对于优化临床决策、改善患者预后具有重要的理论与实践意义。通过系统检索与筛选，共获得20篇相关文献，包括临床研究、综述、Meta分析及专家共识。其中，关于针刀疗法的直接研究文献虽较少，但相关微创治疗理念、解剖学基础及中西医结合疗法文献为探讨其作用机制提供了重要参考。本文将围绕肘管综合征的基础认识、诊断评估、传统与微创治疗进展等方面进行综述，并重点探讨针刀疗法的作用机制与应用现状，最后总结现有研究的不足与未来方向。

Abstract: Cubital Tunnel Syndrome (CuTS) is a clinical condition characterized by sensory and motor disturbances resulting from compression of the ulnar nerve within the cubital tunnel at the elbow joint. Also referred to as tardy ulnar neuropathy, CuTS ranks among the most prevalent peripheral nerve compression disorders in the upper extremity, with an incidence second only to that of Carpal Tunnel Syndrome. It significantly impairs hand function, occupational performance, and overall quality of life, particularly in individuals engaged in manual labor. The etiology of CuTS is multifactorial, and its clinical presentation varies widely. Controversies persist regarding optimal diagnostic criteria and treatment approaches. Early and accurate intervention, along with the appropriate selection of therapeutic strategies, plays a critical role in determining patient outcomes. Therefore, a systematic review of recent advances in the diagnosis and management of Cubital Tunnel Syndrome—particularly the exploration of minimally invasive techniques such as needle knife therapy—is of considerable theoretical and practical importance for refining clinical decision-making and enhancing prognosis. Through a comprehensive literature search and screening process, 20 relevant publications were identified, including clinical studies, review articles, meta-analyses, and expert consensus statements. While direct research on needle knife therapy remains limited, existing evidence on minimally invasive principles, anatomical foundations, and integrated traditional Chinese and Western medical approaches provides valuable insights into its potential mechanisms of action. This article aims to summarize current understanding of CuTS, encompassing diagnostic evaluation, conventional treatment modalities, and emerging minimally invasive interventions, with a particular focus on the mechanism and clinical application of needle knife therapy. Furthermore, it will highlight limitations in the current body of research and propose directions for future investigation.