冰硝散外敷联合康复指导在踝关节周围骨折术后康复中的应用及对踝足功能的影响  

Application of external Bingxiao Powder in postoperative rehabilitation of peri-ankle fractures and its influences on ankle and foot function

作　　者：王国斌 张杰 WANG Guobin;ZHANG Jie(Department of Rehabilitation,Wangjing Hospital of CACMS,Beijing 100102;Department of Traditional Chinese Medicine,Shunyi District Maternal and Child Health Hospital,Beijing 101300)

机构地区：[1]中国中医科学院望京医院康复治疗部,北京100102 [2]北京市顺义区妇幼保健院中医科,北京101300

出　　处：《河北中医》2022年第11期1821-1824,1829,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的 观察冰硝散外敷联合康复指导在踝关节周围骨折术后康复中的应用及对踝足功能的影响。方法 将80例踝关节周围骨折术后患者按照随机数字表法分为2组,对照组40例予康复指导干预,治疗组40例在对照组治疗基础上予冰硝散外敷。2组均治疗10周。比较2组术后2、6、12周疼痛视觉模拟评分(VAS)、关节肿胀评分,术前及术后6个月中医证候评分、踝关节活动度及美国矫形足踝协会(AOFAS)踝-后足评分,并统计2组疗效及术后并发症发生率。结果 治疗组总有效率95.00%(38/40),对照组总有效率77.50%(31/40),治疗组临床疗效优于对照组(P<0.05)。2组术后6、12周疼痛VAS及关节肿胀评分均较本组术后2周降低(P<0.05),2组术后12周均较本组术后6周降低(P<0.05),且治疗组术后6、12周均低于对照组同期(P<0.05)。2组术后6个月中医证候各项评分均较本组术前降低(P<0.05),且治疗组术后6个月均低于对照组(P<0.05)。2组术后6个月踝关节跖屈角度、背屈角度及AOFAS评分均较本组术前增加(P<0.05),且治疗组术后6个月均高于对照组(P<0.05)。治疗组术后并发症总发生率低于对照组(P<0.05)。结论 冰硝散外敷联合康复指导能减轻踝关节周围骨折患者术后疼痛及肿胀,促进踝足功能恢复,疗效较好,安全性佳,在踝关节周围骨折术后康复中具有较高的临床应用价值。Objective To observe the application of external Bingxiao Powder combined with rehabilitation guidance in patients with peri-ankle fractures and its influences on ankle and foot function. Methods Totally 80 patients with peri-ankle fractures were randomly assigned to receive either rehabilitation guidance(the control group, n=40) or external Bingxiao Powder + rehabilitation guidance(the treatment group, n=40) for 10 weeks. The visual analogue scale(VAS) and joint swelling index of postoperative weeks 2, 6, 12 were compared. Traditional Chinese medicine(TCM) syndrome score, ankle mobility, and American Orthopedic Foot and Ankle Society(AOFAS) ankle-hindfoot score of preoperative period and postoperative month 6 were recorded;the curative effect and postoperative morbidity were assessed. Results The overall effective rate was higher in the treatment group compared with the control group(95.00% [38/40] vs 77.50% [31/40], [P<0.05], respectively). VAS and joint swelling index of postoperative weeks 6, 12 in the both groups were lower than those of postoperative week 2(P<0.05), which were lower in postoperative week 12 vs week 6(P<0.05). VAS and joint swelling index of postoperative weeks 6, 12 in the treatment group were decreased as compared with the control group(P<0.05). TCM symptom scores of postoperative month 6 in the both groups were decreased(P<0.05), the treatment group was more prevalent compared with the control group(P<0.05). The ankle mobility(plantarflexion, dorsiflexion), AOFAS scores of postoperative month 6 in the both groups were increased(P<0.05), the treatment group was more common relative to the control group(P<0.05). The postoperative morbidity was lower in the treatment group than in the control group(P<0.05). Conclusion For patients with peri-ankle fractures, external Bingxiao Powder combined with rehabilitation guidance has good curative effect, can reduce postoperative pain and swelling, and promote the recovery of ankle and foot functions, and with good safety and high clinical application

关 键 词：踝骨折 外科手术 敷贴疗法 康复 

分 类 号：R683.425.09[医药卫生—骨科学]