缪刺法在急性闭合性跟腱断裂术后康复中的应用  

The application of contralateral acupuncture for rehabilitation after acute closed achilles tendon rupture

作　　者：张大威[1] 叶祥明[1] 章晓峰[1] 章闻捷 

机构地区：[1]浙江省人民医院康复医学科,杭州310014

出　　处：《中国针灸》2017年第3期237-241,共5页Chinese Acupuncture & Moxibustion

基　　金：浙江省中医药科学研究基金项目:2016ZA022

摘　　要：目的:观察缪刺法结合常规康复训练与单纯常规康复训练对急性闭合性跟腱断裂术后患者患侧踝跖屈肌群功能及临床疗效的差异。方法:将74例急性闭合性跟腱断裂术后患者随机分为观察组和对照组,每组37例。两组患者在术后均行12周常规康复训练。观察组患者于前6周每日常规康复训练前接受缪刺治疗,取健侧足三里、阳陵泉和承山、太溪穴行电针治疗。两组均每日治疗1次,5次为一疗程,疗程间休息2d。治疗6周、8周、12周后采用Biodex System 4多关节等速肌力测试系统测试并比较两组患者患侧踝跖屈肌群跖屈峰力矩(plantar flexion peak torque,PFPT)、峰力矩与体质量比(peak torque/body weight,PT/BW)、总功(total work,TW)。于治疗6周、12周后进行疗效评价,并在治疗结束后12周进行随访。结果:治疗8周、12周后,相同时间点两组患者PFPT、PT/BW、TW值比较,观察组明显优于对照组(均P<0.05)。两组治疗8周后,PFPT、PT/BW、TW值与治疗6周后相比均提高(均P<0.05);两组治疗12周后,PFPT、PT/BW、TW值与治疗8周后、6周后相比均提高(均P<0.05)。治疗12周后和治疗结束后12周随访,观察组疗效优良率明显优于对照组,差异均有统计学意义[89.2%(33/37)vs70.3%(26/37),94.6%(35/37)vs 75.7%(28/37),均P<0.05]。结论:在急性闭合性跟腱断裂术后康复中,缪刺法配合常规康复训练比单纯常规康复训练能更好地提高踝关节跖屈肌群功能和临床疗效。Objective To observe the differences of affected-side ankle plantar flexors function and clinical efficacy between contralateral acupuncture combined with rehabilitation training and rehabilitation training alone for patients with acute closed achilles tendon rupture.Methods Seventy-four patients with acute closed achilles tendon rupture were randomly assigned to an observation group and a control group,37 cases in each group.Patients in the both groups were treated with routine rehabilitation training after the operation for 12weeks;besides,patients in the observation group were treated with contralateral acupuncture at Zusanli（ST 36）,Yanglingquan（GB 34）,Chengshan（BL 57）,Taixi（KI 3）before rehabilitation training in the first 6weeks.The treatment were given once a day,5times as 1course with 2dat the interval.The Biodex System 4multi-joint dynamometers system was applied to test and compare affected-side plantar flexion peak torque（PFPT）,peak torque/body weight（PT/BW）and total work（TW）after 6weeks,8weeks and 12 weeks.The efficacy evaluation was conducted after6 weeks and 12 weeks,and the follow-up visit was conducted 12 weeks after end of treatment.Results The PFPT,PT/BW,TW in the observation group were significantly superior to those in the control group after 8weeks and 12 weeks of treatment（all P〈0.05）;compared with those after 6weeks,the PFPT,PT/BW,TW were significantly increased after 8weeks of treatment（all P〈0.05）;compared with those after 6weeks and 8weeks,the PFPT,PT/BW,TW were significantly increased after 12 weeks of treatment（all P〈0.05）.After 12 weeks of treatment and at follow-up visit,the clinical excellent and effective rates in the observation group were higher than those in the control group[89.2%（33/37）vs 70.3%（26/37）,94.6%（35/37）vs 75.7%（28/37）,both P〈0.05].Conclusion During the postoperative rehabilitation of acute closed achilles tendon rupture,the contralateral acupuncture combined with rehabilitation training could improve ankl

关 键 词：急性闭合性跟腱断裂 术后 缪刺法 常规康复训练 等速肌力测试 随机对照试验 

分 类 号：R246.2[医药卫生—针灸推拿学]