摇拔戳手法治疗急性踝关节外侧韧带损伤的临床研究  

Clinical Research of Shaking Drawing Folding Manipulation Treatment of Acute Injury of Lateral Ligament of Ankle

作　　者：温鑫柱[1] 黄江海 方志远[1] 孙树椿[2] 闫安[2] WEN Xinzhu;HUANG Jianghai;FANG Zhiyuan;SUN Shuchun;YAN An(Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China;Wangjing Hospital of Chinese Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]中国中医科学院望京医院

出　　处：《中国中医骨伤科杂志》2023年第5期49-53,59,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：北京中医药大学东方医院“1166”中青年专家人才培养工程项目(040204001002010)。

摘　　要：目的:对比摇拔戳手法治疗急性踝关节外侧韧带损伤的疗效。方法:选取急性踝关节外侧韧带损伤患者66例,治疗组和对照组各33例;终末纳入结果统计患者共62例,其中治疗组32例,对照组30例。62例患者中男20例,女42例。治疗组男9例,女23例;对照组男11例,女19例。所有患者均为单侧踝关节外侧韧带损伤,左侧34例,右侧28例。Ⅰ级韧带损伤34例,Ⅱ级韧带损伤28例。治疗组采用清宫正骨摇拔戳手法治疗,对照组按RICE(休息、冰敷、加压、抬高患肢)原则治疗,对比观察一个疗程结束时及伤后6个月末次随访时两组患者的治疗前后的疼痛视觉模拟量表(VAS)评分及美国足踝外科协会(AOFAS)踝-后足功能评分差异,以及肌骨超声影像检查距腓前韧带愈合情况及连续性。结果:两组患者治疗前后其疼痛评分均有所降低,在一个疗程结束时,治疗组VAS评分为2.37±1.58,对照组为4.01±2.34,差异有统计学意义(P<0.01);AOFAS踝-后足功能评分均有不同程度升高,在疗程结束时治疗组较对照组改善明显,治疗组评分为92.15±15.34,对照组评分为80.43±22.67,两组结果差异有统计学意义(P<0.05)。肌骨超声影像检查结果示:两组患者在疗程结束时其韧带连续性均存在,治疗组愈合率为81.25%,对照组为76.67%,总体愈合率为79.03%,组间比较差异无统计学意义(P>0.05)。结论:摇拔戳手法治疗急性踝关节外侧韧带损伤,在缓解疼痛、改善踝关节功能方面具有显著的临床疗效。Objective:To compare the efficacy of shaking and pulling technique on the treatment of acute lateral ankle ligament injury.Methods:66 patients with acute lateral ligament injury of ankle were selected, including 33 cases on the treatment group and 33 cases in the control group.62 patients were included in the final statistics, including 32 cases in the treatment group and 30 cases in the control group.Among the 62 patients, there were 20 males and 42 females.There were 9 males and 23 females in the treatment group and 11 males and 19 females in the control group.All patients had unilateral lateral ankle ligament injury, 34 cases left and 28 cases right.There were 34 cases of grade Ⅰ ligament injury and 28 cases of grade Ⅱ ligament injury.The treatment group was treated by the manipulation of Qinggong orthoostomy, control group was treated by RICE(rest, ice, compression, elevation) principle of treatment, the difference of pain visual analogue scale(VAS) score before and after treatment and the result of American orthopedic foot and ankle society(AOFAS) ankle-posterior foot function scoring system at the end of one course of treatment and the end of 6 months after injury were compared and observed.The results of anterior talofibular ligament healing were examined by intramuscular ultrasound.Results:The pain scores of the two groups decreased before and after treatment.At the end of one course of treatment, the VAS scores of the treatment group were 2.37±1.58,the control group was 4.01±2.34,the difference was statistically significant(P<0.01),and the foot function scoring system of the AOFAS ankle and one posterior foot was increased in varying degrees.The treatment group was better than the control group, the treatment group AOFAS score was 92.15±15.34,and control group was 80.43±22.67.The difference between the two groups was statistically significant(AOFAS was 92.15±0.05).Results of muscle and bone ultrasound imaging: treatment group was 81.25%,76.67% in control group, overall healing rate of 79.03%,and

关 键 词：摇拔戳手法 踝关节扭伤 距腓前韧带 跟腓韧带 距腓后韧带 

分 类 号：R686.5[医药卫生—骨科学]