[1]宋海波,刘宏,王剑锋,等.中药薰洗联合踝关节功能锻炼在Pilon骨折 术后康复中的应用[J].中医正骨,2013,25(10):31-34.
　Song Haibo*,Liu Hong,Wang Jianfeng,et al.Application of Chinese herbal steaming and washing therapy combined with ankle joint function exercises to postoperative rehabilitation of pilon fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(10):31-34.
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中药薰洗联合踝关节功能锻炼在Pilon骨折 术后康复中的应用()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期数:
2013年10期
页码:
31-34
栏目:
临床研究
出版日期:
2013-10-30

文章信息/Info

Title:
Application of Chinese herbal steaming and washing therapy combined with ankle joint function exercises to postoperative rehabilitation of pilon fractures
作者:
宋海波1; 刘宏2; 王剑锋1; 顾豪杰1; 凌志丹1
1.浙江省海宁市中医院,浙江 海宁 314400;
2.浙江省立同德医院,浙江 杭州 310012
Author(s):
Song Haibo*; Liu Hong; Wang Jianfeng; Gu Haojie; Ling Zhidan.*
Traditional Chinese Medicine Hospital of Haining city,Haining 314400,Zhejiang,China
关键词:
胫骨骨折 Pilon骨折 薰洗 运动疗法 中医康复
Keywords:
Tibial fractures;  Pilon fractures;  Steaming washing therapy;  Exercise therapy;  Rehabilitation(TCM)
摘要:
目的:探讨中药薰洗联合踝关节常规功能锻炼在Pilon骨折术后康复中的作用。方法:将40例Pilon骨折术后患者随机分为治疗组和对照组,每组20例。治疗组于术后2周采用中药薰洗联合踝关节常规功能锻炼治疗,对照组于术后2周采用踝关节常规功能锻炼治疗。比较2组患者治疗前及治疗开始后7 d、21 d踝关节疼痛、功能、活动度评分及临床综合疗效。结果:①踝关节疼痛评分。不同时间点间踝关节疼痛评分的差异有统计学意义(F=12.433,P=0.029); 2组患者踝关节疼痛评分的组间差异总体上有统计学意义(t=3.079,P=0.002),进一步比较显示治疗开始后7 d、21 d治疗组踝关节疼痛评分均高于对照组[(21.23±7.55)分,(13.59±7.24)分,t=2.258,P=0.024;(40.22±9.56)分,(30.31±8.52)分,t=2.211,P=0.027]; 时间因素与分组因素存在交互效应(F=3.647,P=0.040)。②踝关节功能评分。不同时间点间踝关节功能评分的差异有统计学意义(F=5.645,P=0.032); 2组患者踝关节功能评分的组间差异总体上有统计学意义(t=2.211,P=0.027),进一步比较显示治疗开始后7 d、21 d治疗组踝关节功能评分均高于对照组[(15.01±3.62)分,(10.31±3.07)分,t=2.015,P=0.044;(25.49±4.10)分,(15.99±4.52)分,t=2.370,P=0.018]; 时间因素与分组因素存在交互效应(F=4.481,P=0.029)。③踝关节活动度评分。不同时间点间踝关节活动度评分的差异有统计学意义(F=5.223,P=0.031); 2组患者踝关节活动度评分的组间差异总体上有统计学意义(t=2.035,P=0.042),进一步比较显示治疗开始后7 d、21 d治疗组踝关节活动度评分均高于对照组[(12.14±1.40)分,(8.65±1.52)分,t=2.017,P=0.044;(15.87±2.18)分,(10.71±2.05)分,t=2.300,P=0.021]; 时间因素与分组因素存在交互效应(F=4.480,P=0.029)。④临床综合疗效。2组患者临床综合疗效比较,治疗组优于对照组(Z=-2.268,P=0.040)。结论:在Pilon骨折术后康复中采用中药薰洗联合踝关节常规功能锻炼治疗,可以减轻踝关节疼痛,改善踝关节功能及活动度,疗效确切,值得临床推广应用。
Abstract:
Objective:To investigate the role of Chinese herbal steaming and washing therapy combined with ankle joint function exercises in the postoperative rehabilitation of pilon fractures.Methods:Forty patients with pilon fractures were randomly divided into two groups after the surgery,20 cases in each group.Patients in the treatment group were treated with Chinese herbal steaming and washing therapy combined with ankle joint function exercises 2 weeks after the surgery,while the others in the control group were treated with conventional ankle joint function exercises 2 weeks after the surgery.The scores of pain,function,activity of ankle joints were compared between the 2 groups before the treatment and 7 and 21 days after the beginning of treatment respectively.The total clinical curative effects were evaluated 21 days after the beginning of the treatment.Results:There was statistical difference in the ankle pain scores among different time points(F=12.433,P=0.029).There was statistical difference in the ankle pain scores between the 2 groups(t=3.079,P=0.002),and further comparison indicated that the ankle pain scores of treatment group were higher than those of control group 7 and 21 days after the beginning of the treatment(21.23+/-7.55 vs 13.59+/-7.24 points,t=2.258,P=0.024; 40.22+/-9.56 vs 30.31+/-8.52 points,t=2.211,P=0.027).There was interaction effect between time factor and grouping factor(F=3.647,P=0.040).There was statistical difference in the ankle function scores among different time points(F=5.645,P=0.032).There was statistical difference in the ankle function scores between the 2 groups(t=2.211,P=0.027),and further comparison indicated that the ankle function scores of treatment group were higher than those of control group 7 and 21 days after the beginning of the treatment(15.01+/-3.62 vs 10.31+/-3.07 points,t=2.015,P= 0.044; 25.49+/-4.10 vs 15.99+/-4.52 points,t=2.370,P=0.018).There was interaction effect between time factor and grouping factor(F=4.481,P=0.029).There was statistical difference in the ankle activity scores among different time points(F=5.223,P=0.031).There was statistical difference in the ankle activity scores between 2 groups(t=2.035,P=0.042),and further comparison indicated that the ankle activity scores of treatment group were higher than those of control group 7 and 21 days after the beginning of the treatment(12.14+/-1.40 vs 8.65+/-1.52 points,t=2.017,P=0.044; 15.87+/-2.18 vs 10.71+/-2.05 points,t=2.300,P=0.021).There was interaction effect between time factor and grouping factor(F=4.480,P=0.029).The treatment group surpassed the control group in the total clinical curative effect(Z=-2.268,P=0.040).Conclusion:It can alleviate the ankle pain and improve the ankle function and activity by application of Chinese herbal steaming and washing therapy combined with ankle joint function exercises in the postoperative rehabilitation of pilon fractures,and it is effective and worthy of popularizing in clinic.

参考文献/References:

[1] 王嵩峰,陈桂林.切开复位内固定结合外固定治疗胫骨Pilon骨折[J].中医正骨,2009,21(12):22-23.
[2] Rüedi TP,Buckley RE,Moran CG.骨折治疗的AO原则[M].危杰,刘璠,吴新宝,等译.2版.上海:上海科学技术出版社,2010:639-640.
[3] 中华医学会.临床诊疗指南:骨科分册[M].北京:人民卫生出版社,2009:31-32.
[4] 郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:349-353.
[5] Kofoed H,Stürup J.Comparison of ankle arthroplasty and arthrodesis.A prospective series with long-term follow-up[J].Foot,1994,4(1):6-9.
[6] 曹玉净,沈云辉,艾进伟.手法复位结合中药熏洗对踝关节骨折患者等速肌力的影响[J].上海中医药杂志,2007,41(9):65-66.

备注/Memo

备注/Memo:
2012-09-22收稿 2012-10-10修回
通讯作者:宋海波 E-mail:heble198567@163.com
更新日期/Last Update: 2013-10-30