[1]李振,李学飞,沈高波,等.中药薰洗联合离心运动训练治疗非止点性跟腱炎[J].中医正骨,2020,32(08):69-71.
点击复制

中药薰洗联合离心运动训练治疗非止点性跟腱炎()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年08期
页码:
69-71
栏目:
临床报道
出版日期:
2020-08-20

文章信息/Info

作者:
李振1李学飞1沈高波1方源1刘全1崔龙慷2吴连国2
(1.浙江中医药大学第二临床医学院,浙江 杭州 310053; 2.浙江中医药大学附属第二医院,浙江 杭州 310005)
关键词:
跟腱 肌腱病 薰洗 运动疗法
摘要:
目的:观察中药薰洗联合离心运动训练治疗非止点性跟腱炎的临床疗效及安全性。方法:2018年9月至2019年12月,采用中药薰洗联合离心运动训练治疗非止点性跟腱炎患者28例。男20例,女8例。年龄25~50岁,中位数39岁。左侧12例,右侧16例。病程3~8周,中位数6周。中药薰洗,每次30 min,每日早晚各1次,共治疗4周。每日薰洗治疗结束后进行离心运动训练,根据锻炼时间及患者耐受情况,逐渐增加锻炼强度,共治疗12周。采用疼痛视觉模拟量表(visual analogue scale,VAS)评价跟腱疼痛程度,采用维多利亚体育研究中心跟腱评估量表评价跟腱功能,观察并发症发生情况。结果:本组28例患者,3例因不能耐受疼痛而改用其他方法治疗,25例按要求完成治疗。治疗结束后,跟腱疼痛VAS评分较治疗前降低[(6.12±1.01)分,(2.16±0.75)分,t=16.405,P=0.000],维多利亚体育研究中心跟腱评估量表评分较治疗前增高[(48.60±4.43)分,(72.92±4.46)分,t=-19.498,P=0.000]。25例患者均未出现跟腱断裂等并发症。结论:中药薰洗联合离心运动训练治疗非止点性跟腱炎,可以有效减轻跟腱疼痛、改善跟腱功能,且安全性较高。

参考文献/References:

[1] JANSSEN I,VAN DER WORP H,HENSING S,et al.Investigating achilles and patellar tendinopathy prevalence in elite athletics[J].Res Sports Med,2018,26(1):1-12.
[2] DE JONGE S,VAN DEN BERG C,DE VOS R J,et al. Incidence of midportion achilles tendinopathy in the general population[J].Br J Sports Med,2011,45(13):1026-1028.
[3] 中华医学会运动医疗分会足踝工作委员会.跟腱止点性腱病临床治疗专家共识[J].中国运动医学杂志,2019,38(10):829-833.
[4] 张铁良,王沛,马信龙.临床骨科学[M].3版.北京:人民卫生出版社,2012:814-815.
[5] 黄桂成.中医筋伤学[M].北京:中国中医药出版社,2016:143-145.
[6] VERRALL G M,DOLMAN B K,BEST T M.Applying physical science principles to mid-substance Achilles tendinopathy and the relationship to eccentric lengthening exercises[J].Scand J Med Sci Sports,2018,28(3):1159-1165.
[7] PALAZN-BRU A,TOMS-RODRÍGUEZ M I,MARES-GARCÍA E,et al.A reliability generalization meta-analysis of the Victorian Institute of Sport Assessment Scale for Achilles Tendinopathy(VISA-A)[J].Foot Ankle Int,2019,40(4):430-438.
[8] 廖立青,武凯,李义凯.封闭治疗跟腱炎的解剖学基础[J].中国运动医学杂志,2019,38(7):593-596.
[9] MOVIN T,GAD A,REINHOLT F P,et al.Tendon pathology in long-standing achillodynia.Biopsy findings in 40 patients[J].Acta Orthop Scand,1997,68(2):170-175.
[10] SCOTT A,BACKMAN L J,SPEED C.Tendinopathy:Update on pathophysiology[J].J Orthop Sports Phys Ther,2015,45(11):833-841.
[11] OHBERG L,LORENTZON R,ALFREDSON H.Neovascularisation in achilles tendons with painful tendinosis but not in normal tendons:an ultrasonographic investigation[J].Knee Surg Sports Traumatol Arthrosc,2001,9(4):233-238.
[12] DAKIN S G,NEWTON J,MARTINEZ F O,et al.Chronic inflammation is a feature of achilles tendinopathy and rupture[J].Br J Sports Med,2018,52(6):359-367.
[13] ZUO Q,QU F,LI N,et al.Eccentric exercise results in a prolonged increase in interleukin-6 and tumor necrosis factor-α levels in rat skeletal muscle[J].J Muscle Res Cell Motil,2019,40(3-4):379-387.
[14] HARALDSSON B T,LANGBERG H,AAGAARD P,et al.Corticosteroids reduce the tensile strength of isolated collagen fascicles[J].Am J Sports Med,2006,34(12):1992-1997.
[15] HART L.Corticosteroid and other injections in the management of tendinopathies:a review[J].Clin J Sport Med,2011,21(6):540-541.
[16] FRIZZIERO A,TRAINITO S,OLIVA F,et al.The role of eccentric exercise in sport injuries rehabilitation[J].Br Med Bull,2014,110(1):47-75.
[17] OHBERG L,ALFREDSON H.Effects on neovascularisation behind the good results with eccentric training in chronic mid-portion achilles tendinosis?[J].Knee Surg Sports Traumatol Arthrosc,2004,12(5):465-470.
[18] FAHLSTRÖM M,JONSSON P,LORENTZON R,et al.Chronic achilles tendon pain treated with eccentric calf-muscle training[J].Knee Surg Sports Traumatol Arthrosc,2003,11(5):327-333.
[19] MASOOD T,KALLIOKOSKI K,MAGNUSSON S P,et al.Effects of 12-wk eccentric calf muscle training on muscle-tendon glucose uptake and semg in patients with chronic achilles tendon pain[J].J Appl Physiol(1985),2014,117(2):105-111.
[20] KAUX J F,DRION P,LIBERTIAUX V,et al.Eccentric training improves tendon biomechanical properties:a rat model[J].J Orthop Res,2013,31(1):119-124.
[21] KAUX J F,LIBERTIAUX V,LEPRINCE P,et al.Eccentric training for tendon healing after acute lesion:a rat model[J].Am J Sports Med,2017,45(6):1440-1446.

相似文献/References:

[1]魏家森,陈哲,王军.跟腱断裂的治疗进展[J].中医正骨,2015,27(07):44.
[2]丁玉华.跟腱断裂缝合术的围手术期护理[J].中医正骨,2015,27(07):77.
[3]朱彦昭,申成春,蒋丽娜,等.改良Krackow技术治疗跟腱缺血区断裂[J].中医正骨,2015,27(05):52.
[4]沈军,武理国,马一平,等.经皮微创缝合术联合中药薰洗和功能锻炼治疗新鲜闭合性跟腱断裂[J].中医正骨,2016,28(04):47.
[5]刘骏逸,段卫峰,杜志军.改良经皮缝合法治疗急性跟腱断裂[J].中医正骨,2017,29(10):76.
[6]孟丽娟,吴永磊,庞寅田,等.改良Ma-Griffith术联合下肢损伤薰洗方薰洗治疗闭合性跟腱断裂[J].中医正骨,2017,29(11):63.
[7]廖立青,武凯,李义凯.封闭疗法治疗跟腱炎存在的问题[J].中医正骨,2019,31(02):49.
[8]林武杰,庄汝杰.止点性跟腱炎的研究进展[J].中医正骨,2020,32(01):60.
[9]明晓锋,王振,冯彦江,等.改良有限切开修复技术治疗急性闭合性跟腱断裂[J].中医正骨,2021,33(01):67.
[10]程卫东,李朝晖,明晓锋,等.经皮跟腱剥脱术治疗非止点性跟腱炎[J].中医正骨,2021,33(05):68.
 CHENG Weidong,LI Zhaohui,MING Xiaofeng,et al.Percutaneous achilles tendon stripping for treatment of non-insertional achilles tendinitis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(08):68.

备注/Memo

备注/Memo:
基金项目:浙江省“十三五”中医药重点专科建设项目(浙卫办中医[2019]1号); 浙江省高等学校中青年学科带头人培养计划(浙教办高科[2017]68号) 通讯作者:吴连国 E-mail:mdwu8535@126.com
更新日期/Last Update: 2020-08-20