多方法联合治疗老年创伤性踝关节炎的近期疗效  

Short-term efficacy of multiple combined methods in the treatment of senile traumatic ankle arthritis

作　　者：郭帅帅 张同海[1] 孙天适 Guo Shuaishuai;Zhang Tonghai;Sun Tianshi(Department of Painology,Affiliated Hospital of Jilin Medical University,Jilin City,Jilin Province 132021,China)

机构地区：[1]吉林医药学院附属医院疼痛科,吉林省吉林市132021

出　　处：《中华疼痛学杂志》2023年第5期770-775,共6页Chinese Journal Of Painology

摘　　要：目的探讨针灸、痛点注射以及冲击波联合治疗老年创伤性踝关节炎的近期疗效。方法收集2019年8月至2021年9月吉林医药学院附属医院疼痛科收治老年创伤性踝关节炎患者120例, 按照随机数字表法分为针灸治疗组、痛点注射组、冲击波组和联合组4组, 每组30例。4组患者分别进行为期3周的针灸治疗、痛点注射治疗、冲击波治疗以及三组联合治疗。比较治疗前、治疗后1及3个月时的视觉模拟评分(VAS)、踝关节活动度(ROM)、疗效及患者满意度。结果与治疗前比较, 4组患者的疼痛与关节活动度均有改善, 差异有统计学意义(P<0.05)。治疗后1、3个月时, 联合组VAS(3.5±1.0和2.3±0.6)分, 低于针灸治疗组的(4.2±0.8和2.9±0.9)分、痛点注射组的(4.2±0.8和2.9±0.8)分及冲击波组的(4.1±0.8和2.9±0.9)分, 差异均有统计学意义(P均<0.05)。治疗后1、3个月时ROM角度, 联合组为(36.6±0.6和38.5±0.5)°角分别高于针灸治疗组的(35.5±0.5和37.1±0.8)°角、痛点注射组(35.6±0.5和37.3±0.9)°角、冲击波组(35.5±0.5和37.1±0.7)°角, 差异均有统计学意义(P均<0.05)。4组的总有效率分别为56.7%(17/30例)、56.7%(17/30例)、63.3%(19/30例)、83.4%(22/30例), 差异有统计学意义(χ^(2)=13.63, P=0.034), 满意度分别为80.0%(24/30例)、83.3%(25/30例)、86.6%(26/30例)、96.6%(29/30例), 差异有统计学意义(χ^(2)=14.45, P=0.025)。结论针灸、痛点注射与冲击波联合治疗创伤性踝关节炎近期疗效和满意度均优于每一项单独治疗。Objective To investigate the short-term efficacy of multiple method with acupuncture,painful point injections,and shock waves in the treatment of traumatic ankle osteoarthritis in the elderly.Methods One hundred and twenty elderly patients with traumatic ankle osteoarthritis were recruited from August 2019 to September 2021 in the Department of Painology,Affiliated Hospital of Jilin Medical University.The patients were divided into four groups according to random number table method:acupuncture treatment group,pain point injection group,shock wave group and combined group;and received acupuncture,pain point injection,shock wave treatment,or combination of the three groups for 3 weeks in the four groups respectively.Visual analogue score(VAS),range of motion(ROM),treatment outcome and satisfaction were compared among the four groups before,and 1 month and 3 months after the treatment.Results After the treatment at 1 month and 3 months,the VAS were lower in combined group(3.5±1.0 and 2.3±0.6)than that in the acupuncture treatment group(4.2±0.8 and 2.9±0.9),in the pain point injection group(4.2±0.8 and 2.9±0.8),and in the shock wave group(4.1±0.8 and 2.9±0.9)(P<0.05).The ROM at 1 month and 3 months after the treatment were(36.6±0.6 and 38.5±0.5)°,which was higher than that in the acupuncture treatment group(35.5±0.5 and 37.1±0.8)°,in the pain point injection group(35.6±0.5 and 37.3±0.9)°,and in the shock wave group(35.5±0.5 and 37.1±0.7)°(all P<0.05).The effect rates were 56.7%(17/30 cases),56.7%(17/30 cases),63.3%(19/30 cases),and 83.4%(22/30)in the acupuncture treatment group,pain point injection group,shock wave group and combined group respectively(χ^(2)=13.63,P=0.034).The satisfaction rates were 80.0%(24/30 cases),83.3%(25/30 cases),86.6%(26/30 cases),and 96.6%(29/30 cases)in the acupuncture treatment group,pain point injection group,shock wave group and combined group respectively(χ^(2)=14.45,P=0.025).Conclusion The short-term efficacy and satisfaction of the multiple method with acupunct

关 键 词：针灸疗法 老年人 创伤性踝关节炎 痛点注射 冲击波 

分 类 号：R684.3[医药卫生—骨科学]