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  

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 

机构地区：[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

出　　处：《中医正骨》2013年第10期31-34,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

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�Objective：To investigate the role of Chinese herbal steaming and washing therapy combined with ankle joint function exercises in the postoperative rehabilitation ofpilon 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

关 键 词：胫骨骨折 PILON骨折 薰洗 运动疗法 中医康复 

分 类 号：R274[医药卫生—中医骨伤科学]