[1]林晓彤,吴宇峰,彭杰威.威枫骨科外洗散薰洗联合神经肌肉电刺激对前交叉韧带重建术后膝关节功能恢复的影响[J].中医正骨,2023,35(05):8-13.
　LIN Xiaotong,WU Yufeng,PENG Jiewei.Effects of steaming and washing therapy with Weifeng Guke(威枫骨科)external washing powder combined with neuromuscular electrical stimulation on knee function recovery after anterior cruciate ligament reconstruction[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(05):8-13.
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威枫骨科外洗散薰洗联合神经肌肉电刺激对前交叉韧带重建术后膝关节功能恢复的影响()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年05期
页码:
8-13
栏目:
临床研究
出版日期:
2023-05-20

文章信息/Info

Title:
Effects of steaming and washing therapy with Weifeng Guke(威枫骨科)external washing powder combined with neuromuscular electrical stimulation on knee function recovery after anterior cruciate ligament reconstruction
作者:
林晓彤; 吴宇峰; 彭杰威
(中山市中医院,广东 中山 528401)
Author(s):
LIN Xiaotong; WU Yufeng; PENG Jiewei
Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528401,Guangdong,China
关键词:
前交叉韧带重建术;  薰洗疗法;  神经肌肉电刺激疗法;  康复;  关节功能
Keywords:
anterior cruciate ligament reconstruction;  steaming washing therapy;  neuromuscular electrical stimulation;  rehabilitation;  joint function
摘要:
目的:观察威枫骨科外洗散薰洗联合神经肌肉电刺激(neuromuscular electrical stimulation,NMES)对前交叉韧带(anterior cruciate ligament,ACL)重建术后膝关节功能恢复的影响。方法:将60例拟接受单侧ACL重建术的患者随机分为联合组和常规组。由同一团队医生实施ACL重建术后,常规组采用常规康复训练联合NMES治疗,联合组在常规组干预措施基础上采用威枫骨科外洗散薰洗。比较2组患者的膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、膝关节主动活动度、大腿周径萎缩指数、Lysholm膝关节评分及综合疗效。结果:①膝关节疼痛VAS评分。术后1 d时,2组患者膝关节疼痛VAS评分的差异无统计学意义[(6.00,1.25)分,(6.00,3.00)分,Z=-0.241,P=0.809]; 术后4周和术后8周时,联合组的膝关节疼痛VAS评分均低于常规组[术后4周:(3.00,1.00)分,(4.00,2.00)分,Z=-2.710,P=0.007; 术后8周:(2.00,1.00)分,(3.00,1.00)分,Z=-3.294,P=0.001]。2组患者术后4周和术后8周时的膝关节疼痛VAS评分均较术后1 d时降低(联合组:χ2=1.067,P=0.000; χ2=1.833,P=0.000; 常规组:χ2=0.900,P=0.001; χ2=1.800,P=0.000),术后8周时的膝关节疼痛VAS评分均较术后4周时降低(联合组:χ2=0.767,P=0.009; 常规组:χ2=0.900,P=0.001)。②膝关节主动活动度。术前1 d时,2组患者膝关节主动活动度的差异无统计学意义[(100.50°,28.25°),(104.50°,22.50°),Z=0.015,P=0.988]; 术后4周和术后8周时,联合组的膝关节主动活动度均大于常规组[术后4周:(116.50°,5.00°),(110.00°,10.00°),Z=5.057,P=0.000; 术后8周:(135.00°,4.25°),(135.00°,5.00°),Z=1.990,P=0.047]。2组患者术后4周和术后8周时的膝关节主动活动度均较术前1 d时增大(联合组:χ2=0.967,P=0.011; χ2=2.183,P=0.000; 常规组:χ2=0.933,P=0.016; χ2=1.900,P=0.000),术后8周时的膝关节主动活动度均较术后4周时增大(联合组:χ2=1.217,P=0.001; 常规组:χ2=1.267,P=0.001)。③大腿周径萎缩指数。术前1 d时,2组患者大腿周径萎缩指数的差异无统计学意义[(4.49±1.59)%,(4.28±2.17)%,t=0.429,P=0.669]; 术后8周时,联合组的大腿周径萎缩指数小于常规组[(3.13±0.80)%,(3.72±1.27)%,t'=2.145,P=0.036]; 术后8周时,2组患者的大腿周径萎缩指数均较术前1 d时减小(联合组:t=6.404,P=0.000; 常规组:t=2.626,P=0.014)。④Lysholm膝关节评分。术前1 d时,2组患者Lysholm膝关节评分的差异无统计学意义[(60.47±17.11)分,(62.23±19.21)分,t=0.376,P=0.708]; 术后8周时,联合组的Lysholm膝关节评分高于常规组[(84.80±3.49)分,(78.37±5.90)分,t'=5.157,P=0.000]。术后8周时,2组患者的Lysholm膝关节评分均较术前1 d时增高(联合组:t=7.637,P=0.000; 常规组:t=4.067,P=0.000)。⑤综合疗效。术后8周时,联合组综合疗效优22例、良4例、中3例、差1例,常规组综合疗效优11例、良9例、中8例、差2例; 联合组的综合疗效优于常规组( R^-联合组=24.97,R^-常规组=36.03; Z=2.715,P=0.007)。结论:威枫骨科外洗散薰洗联合NMES能促进ACL重建术后早期膝关节功能恢复,提高康复治疗效果。
Abstract:
Objective:To observe the effects of steaming and washing therapy with Weifeng Guke(威枫骨科,WFGK)external washing powder combined with neuromuscular electrical stimulation(NMES)on knee function recovery after anterior cruciate ligament reconstruction(ACLR).Methods:Sixty patients who would undergo unilateral ACLR were selected as the subjects and were randomly divided intocombination treatment group and conventional treatment group by using random digits table,30 cases in each group.All patients in the 2 groups were treated with unilateral ACLR by the same surgeons,followed by the same conventional rehabilitation training and NMES,more-over,the patients in combination treatment group were further treated with steaming and washing therapy with WFGK external washing powder.The knee pain visual analogue scale(VAS)score,active range of motion(ROM)of knee,atrophy index of thigh circumference,Lysholm knee score(LKS)and total clinical outcome were compared between the 2 groups.Results:①There was no statistical difference in knee pain VAS score between the 2 groups at postoperative day 1((6.00,1.25)vs(6.00,3.00)points,Z=-0.241,P=0.809).The knee pain VAS score was lower in combination treatment group compared to conventional treatment group at postoperative week 4 and 8(postoperative week 4:(((3.00,1.00)vs(4.00,2.00)points,Z=-2.710,P=0.007; postoperative week 8:(2.00,1.00)vs(3.00,1.00)points,Z=-3.294,P=0.001),and it decreased in the 2 groups at postoperative week 4 and 8 compared to postoperative day 1(combination treatment group:χ2=1.067,P=0.000; χ2=1.833,P=0.000; conventional treatment group:χ2=0.900,P=0.001; χ2=1.800,P=0.000),and it was lower at postoperative week 8 compared to postoperative week 4 in the 2 groups(combination treatment group:χ2=0.767,P=0.009; conventional treatment group:χ2=0.900,P=0.001).②There was no statistical difference in knee active ROM between the 2 groups at preoperative day 1((100.50,28.25)vs(104.50,22.50)degrees,Z=0.015,P=0.988).The knee active ROM was greater in combination treatment group compared to conventional treatment group at postoperative week 4 and 8(postoperative week 4:(116.50,5.00)vs(110.00,10.00),Z=5.057,P=0.000; postoperative week 8:(135.00,4.25)vs(135.00,5.00),Z=1.990,P=0.047),and it increased in the 2 groups at postoperative week 4 and 8 compared to preoperative day 1(combination treatment group:χ2=0.967,P=0.011; χ2=2.183,P=0.000; conventional treatment group:χ2=0.933,P=0.016; χ2=1.900,P=0.000),and it was greater at postoperative week 8 compared to postoperative week 4 in the 2 groups(combination treatment group:χ2=1.217,P=0.001; conventional treatment group:χ2=1.267,P=0.001).③There was no statistical difference in atrophy index of thigh circumference between the 2 groups at preo-perative day 1(4.49±1.59 vs 4.28±2.17%,t=0.429,P=0.669).The atrophy index of thigh circumference was lower in combination treatment group compared to conventional treatment group at postoperative week 8(3.13±0.80 vs 3.72±1.27%,t'=2.145,P=0.036),and it decreased in the 2 groups at postoperative week 8 compared to preoperative day 1(combination treatment group:t=6.404,P=0.000; conventional treatment group:t=2.626,P=0.014).④There was no statistical difference in LKS between the 2 groups at preoperative day 1(60.47±17.11 vs 62.23±19.21 points,t=0.376,P=0.708).The LKSs were higher in combination treatment group compared to conventional treatment group at postoperative week 8(84.80±3.49 vs 78.37±5.90 points,t'=5.157,P=0.000),and it increased in the 2 groups at postoperative week 8 compared to preoperative day 1(combination treatment group:t=7.637,P=0.000; conventional treatment group:t=4.067,P=0.000).⑤The total clinical outcome was evaluated at postoperative week 8.Twenty-two patients obtained an excellent result,4 good,3 fair and 1 poor in combination treatment group; while 11 ones obtained an excellent result,9 good,8 fair and 2 poor in conventional treatment group.The total clinical outcome was better in combination treatment group compared to conventional treatment group(R^-combination treatment group=24.97,R^-conventional treatment group=36.03; Z=2.715,P=0.007).Conclusion:The steaming and washing therapy with WFGK external washing powder combined with NMES can promote the early knee function recovery and improve the rehabilitation effects after ACLR.

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通讯作者:吴宇峰 E-mail:figo54@163.com
更新日期/Last Update: 1900-01-01