[1]周杰,熊小明,何本祥,等.纳米微针透皮技术联合郑氏新伤软膏贴敷治疗急性踝关节扭伤的临床研究[J].中医正骨,2021,33(02):20-25.
 ZHOU Jie,XIONG Xiaoming,HE Benxiang,et al.A clinical study of nano-microneedles-assisted transdermal technology combined with external application of Zheng’s Xinshang(郑氏新伤)ointments for treatment of acute ankle sprain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(02):20-25.
点击复制

纳米微针透皮技术联合郑氏新伤软膏贴敷治疗急性踝关节扭伤的临床研究()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年02期
页码:
20-25
栏目:
临床研究
出版日期:
2021-02-20

文章信息/Info

Title:
A clinical study of nano-microneedles-assisted transdermal technology combined with external application of Zheng’s Xinshang(郑氏新伤)ointments for treatment of acute ankle sprain
作者:
周杰1熊小明1何本祥2孙育良1
(1.四川省骨科医院,四川 成都 610041; 2.成都体育学院,四川 成都 610041)
Author(s):
ZHOU Jie1XIONG Xiaoming1HE Benxiang2SUN Yuliang1
1.Sichuan Provincial Orthopedics Hospital,Chengdu 610041,Sichuan,China2.Chengdu Sport University,Chengdu 610041,Sichuan,China
关键词:
踝关节 扭伤和劳损 投药皮肤 纳米透皮技术 郑氏新伤软膏 临床试验
Keywords:
ankle joint sprains and strains administrationcutaneous nanocrystalline transdermal technology ZhengShi XinShang ointments clinical trial
摘要:
目的:探讨纳米微针透皮技术联合郑氏新伤软膏贴敷治疗急性踝关节扭伤的临床疗效和安全性。方法:将80例急性踝关节扭伤患者随机分为2组,每组40例。软膏贴敷组采用郑氏新伤软膏贴敷治疗,每晚贴敷8~10 h,共2周; 联合治疗组在贴敷郑氏新伤软膏前先采用纳米微针透皮技术治疗,每晚1次,每次3 min,共2周。分别于治疗前、治疗结束后记录并比较2组患者足踝部周径、踝部疼痛视觉模拟量表(visual analogue scale,VAS)评分及Kofoed踝关节评分,并观察并发症发生情况。结果:①足踝部周径。治疗前2组患者足踝部周径比较,差异无统计学意义[(35.08±2.39)cm,(34.93±2.44)cm,t=0.278,P=0.782]; 治疗结束后,联合治疗组患者足踝部周径小于软膏贴敷组[(28.63±1.40)cm,(30.18±1.60)cm,t=-4.626,P=0.000],2组患者足踝部周径均小于治疗前(t=17.338,P=0.000; t=14.162,P=0.000)。②踝部疼痛VAS评分。治疗前2组患者踝部疼痛VAS评分比较,差异无统计学意义[(7.08±1.14)分,(7.05.±1.13)分,t=-0.308,P=0.758]; 治疗结束后,联合治疗组患者踝部疼痛VAS评分低于软膏贴敷组[(2.03±0.73)分,(3.10±1.17)分,t=-4.467,P=0.000],2组患者踝部疼痛VAS评分均低于治疗前(t=-5.591,P=0.000; t=-5.690,P=0.000)。③Kofoed踝关节评分。治疗前2组患者Kofoed踝关节评分比较,差异无统计学意义[(50.18±5.49)分,(50.23±5.26)分,t=-0.042,P=0.967]; 治疗结束后,联合治疗组患者Kofoed踝关节评分高于软膏贴敷组[(89.95±1.74)分,(82.18±1.88)分,t=19.205,P=0.000],2组患者Kofoed踝关节评分均高于治疗前(t=-40.124,P=0.000; t=-37.709,P=0.000)。④综合疗效。治疗结束后,联合治疗组优15例、良18例、及格6例、差1例,软膏贴敷组优9例、良16例、及格11例、差4例; 联合治疗组的综合疗效优于软膏贴敷组(Z=-2.100,P=0.036)。⑤并发症发生情况。2组患者均未出现药物过敏反应; 联合治疗组2例遗留踝关节轻微疼痛,软膏贴敷组7例遗留踝关节轻微疼痛,因不影响日常生活,均未给予特殊处理。2组并发症发生率比较,差异无统计学意义(χ2=2.003,P=0.157)。结论:纳米微针透皮技术联合郑氏新伤软膏贴敷治疗急性踝关节扭伤,能缓解疼痛、减轻肿胀和改善关节功能,其疗效优于单纯郑氏新伤软膏贴敷治疗,但两者安全性相当。
Abstract:
To explore the clinical curative effects and safety of nano-microneedles-assisted transdermal technology combined with external application of Zheng’s Xinshang(郑氏新伤)ointments for treatment of acute ankle sprain(AAS).Methods:Eighty AAS patients were randomly divided into monotherapy group and combination therapy group,40 cases in each group.All patients were treated with external application of Zheng’s Xinshang(郑氏新伤)ointments,8-10 hours every night for consecutive 2 weeks; and the nano-microneedles-assisted transdermal technology was used before external application of Zheng’s Xinshang ointments in combination therapy group,once every night for 3 minutes at a time.The ankle circumferences,ankle pain visual analogue scale(VAS)scores and Kofoed ankle scores were recorded and compared between the 2 groups before the treatment and after the end of the treatment respectively,and the complications were observed.Results:There was no statistical difference in ankle circumferences between the 2 groups before the treatment(35.08±2.39 vs 34.93±2.44 cm,t=0.278,P=0.782).The ankle circumferences were smaller in combination therapy group compared to monotherapy group after the end of the treatment(28.63±1.40 vs 30.18±1.60 cm,t=-4.626,P=0.000).The ankle circumferences were smaller after the end of the treatment compared to pre-treatment(t=17.338,P=0.000; t=14.162,P=0.000).There was no statistical difference in ankle pain VAS scores between the 2 groups before the treatment(7.08±1.14 vs 7.05.±1.13 points,t=-0.308,P=0.758).The ankle pain VAS scores were lower in combination therapy group compared to monotherapy group after the end of the treatment(2.03±0.73 vs 3.10±1.17 points,t=-4.467,P=0.000).The ankle pain VAS scores were lower after the end of the treatment compared to pre-treatment(t=-5.591,P=0.000; t=-5.690,P=0.000).There was no statistical difference in Kofoed ankle scores between the 2 groups before the treatment(50.18±5.49 vs 50.23±5.26 points,t=-0.042,P=0.967).The Kofoed ankle scores were higher in combination therapy group compared to monotherapy group after the end of the treatment(89.95±1.74 vs 82.18±1.88 points,t=19.205,P=0.000).The Kofoed ankle scores were higher after the end of the treatment compared to pre-treatment(t=-40.124,P=0.000; t=-37.709,P=0.000).After the end of the treatment,15 patients obtained an excellent result,18 good,6 fair and 1 poor in combination therapy group; while 9 patients obtained an excellent result,16 good,11 fair and 4 poor in monotherapy group.The combination therapy group surpassed the monotherapy group in the total clinical curative effects(Z=-2.100,P=0.036).No drug hypersensitivity reactions were found in the 2 groups.The residual mild ankle pain was found in 2 patients in combination therapy group and 7 patients in monotherapy group,and no special treatment were performed for noneffects on daily living.There was no statistical difference in complication incidences between the 2 groups(χ2=2.003,P=0.157).Conclusion:The combination therapy of nano-microneedles-assisted transdermal technology and external application of Zheng’s Xinshang(郑氏新伤)ointments can relieve the ankle pain,reduce the ankle swelling and improve the ankle function in treatment of AAS,and it surpasses the monotherapy of external application of Zheng’s Xinshang(郑氏新伤)ointments in the clinical curative effects,while they are similar to each other in safety.

参考文献/References:

[1] HUBBARD-TURNER T,WIKSTROM E A,GUDERIAN S,et al.An acute lateral ankle sprain significantly decreases physical activity across the lifespan[J].J Sports Sci Med,2015,14(3):556-561.
[2] LIU X F,FANG Y,CAO Z H,et al.Repair of acute injuries of the lateral ligament complex of the ankle by suture anchors[J].Int J Clin Exp Med,2015,8(11):21796-21801.
[3] 向澍,顾健华.青鹏软膏膏摩法治疗陈旧性踝关节扭伤的临床研究[J].中医正骨,2017,29(8):33-35.
[4] 马昕,陈世益.运动员急性踝关节外侧副韧带损伤[J].中国运动医学杂志,1999,18(1):62-64.
[5] 王和鸣,黄桂成.中医骨伤科学[M].北京:中国中医药出版社,2012:314.
[6] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:198-199.
[7] 周霖,孙凯,陈彦,等.伤柏膏治疗急性踝关节外侧副韧带损伤患者疼痛的临床效果[J].南方医科大学学报,2017,37(3):398-401.
[8] KOFOED H,S?RENSEN T S.Ankle arthroplasty for rheumatoid arthritis and osteoarthritis:prospective long-term study of cemented replacements[J].J Bone Joint Surg Br,1998,80(2):328-332.
[9] 龚志兵,庄至坤,张焕堂,等.骨散外敷治疗急性踝关节扭伤气滞血瘀证的临床研究[J].中医正骨,2018,30(12):13-17.
[10] 李元贞,郑永浩,胡翔.消定膏外敷联合RICE基础疗法治疗急性踝关节扭伤37例临床观察[J].甘肃中医药大学学报,2018,35(2):58-62.
[11] 张泰.芳香性中药成分透皮吸收促进作用的研究进展[J].中华中医药杂志,2019,34(6):2589-2592.
[12] 白毅,杜丽娜,冯雪,等.天然药物经皮给药系统研究进展[J].中国药学杂志,2014,49(16):1377-1381.
[13] MüNCH S,WOHLRAB J,NEUBERT R H H.Dermal and transdermal delivery of pharmaceutically relevant macromolecules[J].Eur J Pharm Biopharm,2017,119:235-342.
[14] 薛冰心,吴纯洁.影响药物经皮吸收的客观因素[J].中国现代医学杂志,2010,20(16):2479-2483.
[15] 张朵朵,吴艳丽,鞠大宏,等.微针在经皮给药领域中的应用研究进展[J].中华中医药杂志,2014,29(8):2559-2562.
[16] RZHEVSKIY A S,SINGH T R R,DONNELLY R F,et al.Microneedles as the technique of drug delivery enhancement in diverse organs and tissues[J].J Control Release,2018,270:184-202.
[17] CHEN J,QIU Y,ZHANG S,et al.Dissolving microneedle-based intradermal delivery of interferon-α-2b[J].Drug Dev Ind Pharm,2016,42(6):890-896.
[18] REJINOLD N S,SHIN J H,SEOK H Y,et al.Biomedical applications ofmicroneedles in the rapeutics: recent advancements and implications in drug delivery[J].Expert Opin Drug Deliv,2016,13(1):109-131.
[19] NALWA H S.A special issue on reviews in nanomedicine,drug delivery and vaccine development[J].J Biomed Nanotechnol,2014,10(9):1635-1640.
[20] 林明慧.糠酸莫米松乳膏联合纳晶纳米微针导入对白癜风患者复色情况的影响[J].实用医技杂志.2020,27(8):1064-1065.
[21] 李彩霞,李伟,李聪颖,等.纳米微针对皮肤表面麻醉药膏的透皮吸收的影响[J].中国医疗美容,2020,10(11):66-68.
[22] HENRY S,MCALLISTER D V,ALLEN M G,et al.Microfabricated microneedles:a novel approach to transdermal drug delivery[J].J Pharm Sci,1998,87(8):922-925.
[23] DENG Y,CHEN J,ZHAO Y,et al.Transdermal delivery of siRNA through microneedle array[J].Sci Rep,2016,6:21-22.
[24] CAFFAREL-SALVADOR E,DONNELLY R F.Transdermal drug delivery mediated by microneedle arrays:innovations and barriers to success[J].Curr Pharm Des,2016,22(9):1105-1117.
[25] 尹璐,王恩波,富彦财,等.纳晶微针的促渗透作用及安全性实验研究[J].临床军医杂志,2015,43(4):339-341.
[26] CAULMAN S A,ANSTEY A,CATELEY C,et al.Microneedle mediatesd delivery of nanoparticles into human skin[J].Int J Pharm,2009,366(1/2):190-200.
[27] 陶艳玲,苗颖颖,吴婷妍,等.纳米微针对人皮肤屏障功能及红斑的影响[J].中国中西医结合皮肤性病学杂志,2017,16(1):11-15.
[28] 张亮.新型纳米微针与传统微针对双氯芬酸钠凝胶体外透皮实验的效果对比研究[D].成都:成都体育学院,2019.
[29] B?ME K,LIKAR R.Efficacy and tolerability of a new opioid analgesic formulation, buprenorphine transdermal therapeutic system(TDS),in the treatment of patients with chronic pain.A randomised,double-blind,placebocontrolled study[J].Pain Clin,2003,15(2):193-202.
[30] 张瑞雪,张庆瑞,戴逸楠,等.纳米晶片促进药物经皮渗透作用的研究[J].临床皮肤科杂志,2017,46(4):247-250.

相似文献/References:

[1]江涛,江林,史俊德,等.动气针法在踝关节骨折术后中后期康复中的应用[J].中医正骨,2015,27(11):20.
 JIANG Tao,JIANG Lin,SHI Junde,et al.Application of Dongqi acupuncture(动气针法)to postoperative rehabilitation in the middle-late period in patients with ankle joint fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):20.
[2]方华宴,李兴华,王爱国.手术治疗踝关节骨折手术失败导致的复杂陈旧性踝关节脱位[J].中医正骨,2015,27(11):45.
[3]朱彦昭,申成春,蒋丽娜,等.早期手术修复踝关节骨折合并的三角韧带完全断裂[J].中医正骨,2015,27(08):46.
[4]戴国钢,刘剑伟,黄雷,等.第一跗跖关节滑膜嵌顿10例报告[J].中医正骨,2015,27(07):75.
[5]刘辉,刘波,伍萨,等.踝关节不稳患者踝关节等速肌力和动态平衡能力的临床研究[J].中医正骨,2015,27(02):7.
 LIU Hui,LIU Bo,WU Sa,et al.Clinical study on ankle isokinetic muscle strength and dynamic balance ability of patients with ankle joint instability[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):7.
[6]刘 超.续骨活血汤和接骨紫金丹在三踝骨折治疗中的应用[J].中医正骨,2015,27(06):57.
[7]李光阳,吴祥宗,陶志东,等.改良外侧入路在三踝骨折切开复位内固定术中的应用[J].中医正骨,2015,27(05):48.
[8]陈诚,成永忠,程灏,等.旋后-外旋型三踝骨折的筋骨结构关系研究[J].中医正骨,2016,28(01):6.
 CHEN Cheng,CHENG Yongzhong,CHENG Hao,et al.Study on the structural relationship of supination-extorsion-type trimalleolar fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(02):6.
[9]徐善强,巫宗德,徐强,等.经皮微创内固定术治疗C型Danis-Weber踝关节骨折[J].中医正骨,2016,28(02):49.
[10]翁祝承,陈金洪.切开复位内固定结合韧带修复重建治疗旋前-外旋型踝关节骨折[J].中医正骨,2017,29(02):55.
[11]田正强.消肿止痛散外敷联合绷带固定治疗急性踝关节扭伤[J].中医正骨,2015,27(10):28.
[12]张海林,吴越.中医药综合疗法治疗急性踝关节扭伤150例[J].中医正骨,2015,27(04):44.
[13]邬博来,辛景义.距腓前韧带和跟腓韧带解剖重建治疗习惯性踝关节扭伤[J].中医正骨,2017,29(03):60.
[14]叶宜颖,高景华,王尚全,等.孙树椿教授治疗踝关节扭伤的经验[J].中医正骨,2017,29(03):77.
[15]孙洪林.手法联合中药外敷治疗急性踝关节扭伤[J].中医正骨,2017,29(06):65.
[16]龚志兵,庄至坤,张焕堂,等.骨散外敷治疗急性踝关节扭伤气滞血瘀证的临床研究[J].中医正骨,2018,30(12):13.
 GONG Zhibing,ZHUANG Zhikun,ZHANG Huantang,et al.A clinical study of external application of Gusan(骨散)for treatment of qi-stagnation-blood-stasis-type acute ankle sprain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(02):13.
[17]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.
 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(02):20.

备注/Memo

备注/Memo:
通讯作者:熊小明 E-mail:2841710476@qq.com
更新日期/Last Update: 2021-02-20