[1]陈张,王晓东,寇智君,等.理筋手法联合探穴针罐法治疗陈旧性踝关节扭伤的临床研究[J].中医正骨,2021,33(03):20-25.
　CHEN Zhang,WANG Xiaodong,KOU Zhijun,et al.A clinical study of sinew adjusting manipulation combined with acupuncture-cupping therapy for treatment of old ankle sprain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(03):20-25.
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理筋手法联合探穴针罐法治疗陈旧性踝关节扭伤的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年03期
页码:
20-25
栏目:
临床研究
出版日期:
2021-03-20

文章信息/Info

Title:
A clinical study of sinew adjusting manipulation combined with acupuncture-cupping therapy for treatment of old ankle sprain
作者:
陈张; 王晓东; 寇智君; 詹强
(1.浙江中医药大学附属第三医院,浙江 杭州 310005; 2.浙江中医药大学附属广兴医院,浙江 杭州 310007; 3.杭州市儿童医院,浙江 杭州 310014)
Author(s):
CHEN Zhang; WANG Xiaodong; KOU Zhijun; ZHAN Qiang
1.The Third Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,Zhejiang,China;2.Guangxing Hospital Affiliated to Zhejiang Chinese Medicine University,Hangzhou 310007,Zhejiang,China;3.Hangzhou Children’s Hospital,Hangzhou 310014,Zhejiang,China
关键词:
踝关节;  扭伤和劳损;  针刺疗法;  拔罐;  肌肉骨骼手法
Keywords:
ankle joint;  sprains and strains;  acupuncture therapy;  cupping therapy;  musculoskeletal manipulations
摘要:
目的:观察理筋手法联合探穴针罐法治疗陈旧性踝关节扭伤的临床疗效。方法:将符合要求的76例陈旧性踝关节扭伤患者随机分为2组,每组38例。联合治疗组采用理筋手法联合探穴针罐法治疗,理筋手法组单纯采用理筋手法治疗。理筋手法和探穴针罐法均隔日治疗1次,连续治疗6次为1个疗程,共治疗1个疗程。分别于治疗前及治疗结束后,采用疼痛视觉模拟量表(visual analogue scale,VAS)评分评价踝部疼痛情况,采用美国足与踝关节协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足功能评分评价患足功能,计算踝关节活动度评分,并根据MRI检查结果评估患足韧带、肌腱及骨损伤情况。结果:①踝部疼痛VAS评分。治疗前,2组患者踝部疼痛VAS评分比较,组间差异无统计学意义[(6.42±2.68)分,(6.70±2.22)分,t=-0.865,P=0.643]; 治疗结束后,2组患者踝部疼痛VAS评分均较治疗前降低(t=-8.532,P=0.000; t=-4.235,P=0.007),联合治疗组的踝部疼痛VAS评分低于理筋手法组[(1.48±1.24)分,(2.24±1.42)分,t=-3.246,P=0.021]。②AOFAS踝与后足功能评分。治疗前,2组患者AOFAS踝与后足功能评分比较,组间差异无统计学意义[(48.23±12.46)分,(47.54±13.35)分,t=-1.435,P=0.546]; 治疗结束后,2组患者AOFAS踝与后足功能评分均高于治疗前(t=-36.756,P=0.000; t=-24.146,P=0.012),联合治疗组的AOFAS踝与后足功能评分高于理筋手法组[(72.16±18.14)分,(61.33±13.48)分,t=-5.473,P=0.015]。③踝关节活动度评分。治疗前,2组患者踝关节活动度评分比较,组间差异无统计学意义[(3.92±2.45)分,(3.88±2.33)分,t=-0.743,P=0.632]; 治疗结束后,2组患者踝关节活动度评分均高于治疗前(t=3.945,P=0.011; t=4.586,P=0.021),且2组患者踝关节活动度评分的组间差异无统计学意义[(8.33±1.55)分,(7.35±2.03)分,t=0.547,P=0.085]。④患足韧带、肌腱及骨损伤情况。MRI检查结果显示,治疗结束后联合治疗组的患足韧带损伤改善情况优于理筋手法组(χ2=4.266,P=0.039),2组患者的肌腱及骨损伤改善情况组间差异均无统计学意义(χ2=2.595,P=0.107; χ2=0.517,P=0.472)。结论:理筋手法联合探穴针罐法治疗陈旧性踝关节扭伤,在减轻踝部疼痛症状、提高患足功能、改善患足韧带损伤方面的效果优于单纯理筋手法,但两者在改善踝关节活动度及肌腱、骨损伤方面的效果无明显差异。
Abstract:
Objective:To observe the clinical curative effects of sinew adjusting manipulation combined with acupuncture-cupping therapy for treatment of old ankle sprain.Methods:Seventy-six patients with old ankle sprain enrolled in the study were randomly divided into combination therapy group and monotherapy group,38 cases in each group.The patients in combination therapy group were treated with sinew adjusting manipulation and acupuncture-cupping therapy,while the patients in monotherapy group were merely treated with sinew adjusting manipulation.The sinew adjusting manipulation and acupuncture-cupping therapy were performed 1 time every other day for 1 course of treatment,consecutive 6 times for each course.The ankle pain and injuried foot function were evaluated by using visual analogue scale(VAS)scores and American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot function scores respectively.Moreover,the ankle range of motion(ROM)scores were calculated,and the ligament,tendon and bone injuries of injuried foot were evaluated according to the MRI examination results before the treatment and after the end of the treatment respectively.Results:There was no statistical difference in ankle pain VAS scores between the 2 groups before the treatment(6.42±2.68 vs 6.70±2.22 points,t=-0.865,P=0.643).The ankle pain VAS scores were lower after the end of the treatment compared to pre-treatment(t=-8.532,P=0.000; t=-4.235,P=0.007),and the ankle pain VAS scores were lower in combination therapy group compared to monotherapy group(1.48±1.24 vs 2.24±1.42 points,t=-3.246,P=0.021).There was no statistical difference in AOFAS ankle-hindfoot function scores between the 2 groups before the treatment(48.23±12.46 vs 47.54±13.35 points,t=-1.435,P=0.546).The AOFAS ankle-hindfoot function scores were higher after the end of the treatment compared to pre-treatment(t=-36.756,P=0.000; t=-24.146,P=0.012),and the AOFAS ankle-hindfoot function scores were higher in combination therapy group compared to monotherapy group(72.16±18.14 vs 61.33±13.48 points,t=-5.473,P=0.015).There was no statistical difference in ankle ROM scores between the 2 groups before the treatment(3.92±2.45 vs 3.88±2.33 points,t=-0.743,P=0.632).The ankle ROM scores were higher after the end of the treatment compared to pre-treatment(t=3.945,P=0.011; t=4.586,P=0.021),and there was no statistical difference in ankle ROM scores between the 2 groups(8.33±1.55 vs 7.35±2.03 points,t=0.547,P=0.085).The MRI examination results demonstrated that the patients in combination therapy group got better improvement in ligament injury of injuried foot compared to the patients in monotherapy group after the end of the treatment(χ2=4.266,P=0.039),and there was no statistical difference in improvement in tendon and bone injury between the 2 groups(χ2=2.595,P=0.107; χ2=0.517,P=0.472).Conclusion:The combination therapy of sinew adjusting manipulation and acupuncture-cupping therapy surpasses the monotherapy of sinew adjusting manipulation in relieving foot pain,promoting foot function and improving ligament injury of injuried foot in treatment of old ankle sprain.However,there is no obvious difference between the two therapies in improving ankle ROM and injuries of tendon and bone.

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备注/Memo

备注/Memo:
基金项目:浙江省中医药科技计划项目(2017ZA150); 浙江中医药大学校级科研基金项目(2019ZY15)
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更新日期/Last Update: 1900-01-01