理筋正骨手法联合消瘀接骨散治疗陈旧性踝关节扭伤临床观察  

Clinical Effect of Tendon-Regulation and Bone-Setting Manipulation Combined with Xiaoyu Jiegu Powder in Treatment of Old Ankle Sprain

作　　者：金祥雨 陈朝晖[2] 江雨 沈文庆 洪若琳 JIN Xiang-yu;CHEN Zhao-hui;JIANG Yu;SHEN Wen-qing;HONG Ruo-lin(Graduate School of Anhui University of Chinese Medicine, Anhui Hefei 230012, China;College of Acupuncture and Moxibustion, Anhui University of Chinese Medicine, Anhui Hefei 230012, China)

机构地区：[1]安徽中医药大学研究生院,安徽合肥230012 [2]安徽中医药大学针灸推拿学院,安徽合肥230012

出　　处：《安徽中医药大学学报》2021年第5期14-18,共5页Journal of Anhui University of Chinese Medicine

基　　金：安徽省高校自然科学研究项目(KJ2018A0273)。

摘　　要：目的观察理筋正骨手法联合消瘀接骨散治疗陈旧性踝关节扭伤的疗效。方法采用随机数字表法将60例陈旧性踝关节扭伤患者随机分为治疗组和对照组,每组30例,治疗组患者采用理筋正骨手法联合消瘀接骨散治疗,对照组患者采用中频电联合消瘀接骨散治疗。采用视觉模拟量表(visual analog scale,VAS)对患者治疗前后踝关节疼痛进行评分,采用压痛仪测定患者主诉最为疼痛部位的数值,采用表面肌电(surface electromyography,sEMG)检测仪及其配套电脑软件采集并分析治疗前后中位频率(median frequency,MF)和积分肌电(integrated electromyography,iEMG)的值,采用Baird-Jackson踝关节功能评分评价治疗前后踝关节功能改善程度,并参考《中医病证诊断疗效标准》进行疗效评价。结果治疗组临床疗效显著优于对照组(P<0.05)。与治疗前比较,两组治疗后VAS评分减少,压痛数值、Baird-Jackson踝关节功能各项评分、腓骨长短肌iEMG值和MF值增加,差异均有统计学意义(P<0.05);且各指标减少或增加程度,治疗组与对照组比较,差异均有统计学意义(P<0.05)。结论理筋正骨手法结合消瘀接骨散可有效减轻陈旧性踝扭伤患者的疼痛,改善踝周肌肉募集程度,降低踝周肌群疲劳度,改善踝关节功能,且疗效优于中频电疗法结合消瘀接骨散。Objective To investigate the clinical effect of tendon-regulation and bone-setting manipulation combined with Xiaoyu Jiegu Powder in the treatment of old ankle sprain.Methods A total of 60 patients with old ankle sprain were divided into treatment group and control group using a random number table,with 30 patients in each group.The patients in the treatment group were given tendon-regulation and bone-setting manipulation combined with Xiaoyu Jiegu Powder,and those in the control group were given medium-frequency electrotherapy combined with Xiaoyu Jiegu Powder.Visual Analogue Scale(VAS)was used to determine the score of ankle joint pain before and after treatment,and a tenderness instrument was used to measure the value at the site with the most severe pain based on chief complaint;surface electromyography and its auxiliary software were used to collect and analyze the values of median frequency(MF)and integrated electromyography(iEMG)before and after treatment;Baird-Jackson ankle joint function score was used to evaluate the improvement in ankle joint function after treatment,and Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine was used to assess treatment outcome.Results The treatment group had a significantly better treatment outcome than the control group(P<0.05).After treatment,both groups had significant reductions in VAS score and significant increases in tenderness value and the scores of each item of Baird-Jackson ankle joint function and the iEMG and MF values of the peroneus longus and the peroneus brevis(P<0.05),and the treatment group had significantly greater reductions or increases in the above indices than the control group(P<0.05).Conclusion For patients with old ankle sprain,tendon-regulation and bone-setting manipulation combined with Xiaoyu Jiegu Powder can effectively alleviate pain,improve the recruitment of ankle muscles,reduce the fatigue of ankle muscles,and improve ankle joint function,with a better clinical effect than medium-freque

关 键 词：理筋正骨手法 陈旧性踝扭伤 消瘀接骨散 中频电 

分 类 号：R256.35[医药卫生—中医内科学]