电针联合等速训练对THA术后髋关节生物力学的影响  

Study on the effect of electroacupuncture combined with isokinetic training on the biomechanics of hip joint in patients after THA surgery

作　　者：孙阳[1] 杨帅[2] 贾晋瑄 杜震[3] 周凌峰 魏贤振[4] Sun yang;Yang shuai;Jia Jinxuan;Du Zhen;Zhou Lingfeng;Wei Xianzhen(Department of Rehabilitation Medicine,Shanghai Municipal Hospital of Traditinmal Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Department of Rehabilitation Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Medical Service,Shanghai Municipal Hospital of Traditinmal Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Orthopedics and Traumatology Department,Shanghai Municipal Hospital of Traditinmal Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院康复医学科,200071 [2]上海交通大学医学院附属瑞金医院康复医学科,200025 [3]上海中医药大学附属市中医医院医务处,200071 [4]上海中医药大学附属市中医医院骨伤科,200071

出　　处：《中华老年骨科与康复电子杂志》2024年第2期103-110,共8页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：上海市卫生健康委员会科研课题(20204Y0262);上海市进一步加快中医药传承创新发展三年行动计划(2021年-2023年)(ZY(2021-2023)-0201-04)。

摘　　要：目的探究电针联合等速肌力训练对全髋关节置换术后患者髋关节生物力学的影响。方法选取全髋关节置换术后患者72例,采用完全随机化方法分为观察组和对照组各36例(观察组脱失1例)。观察组采用电针联合等速肌力训练疗法,对照组采用传统康复训练疗法。于术后3个月时对所有患者进行等速肌力测定并记录各项数据。结果共72例患者获得随访,随访时间3个月。其中男性22例,女性49例,平均年龄(75.17±10.49)岁。术后3个月时,观察组患者健侧伸肌群PT[(79.11±7.11)N·m,t=2.589,P=0.012],患侧屈肌群PT[(73.23±9.40)N·m,t=2.158,P=0.034]、PTA[(73.00±18.58)°,t=3.020,P=0.004]、TW[(113.80±39.75)J,t=2.395,P=0.019],伸肌群PT[(67.09±8.69)N·m,t=3.035,P=0.003]、PT/BW[(108.27±23.50)%N·m/Kg,t=2.252,P=0.028],健侧内收肌群AP[(14.09±3.72)W,t=0.239,P=0.020]、患侧外展肌群PT[(61.43±15.02)N·m,t=4.158,P=0.000]、PT/BW[(98.25±26.25)%N·m/Kg,t=3.721,P=0.000]、PTA[(29.11±11.06)°,t=2.011,P=0.048]、TW[(121.29±33.21)J,t=6.204,P=0.000],内收肌群PT[(48.54±15.92)N·m,2.768,P=0.007]、PT/BW[(78.70±28.93)%N·m/Kg,t=2.531,P=0.014]、TW[(50.43±15.16)J,t=7.186,P=0.000],以上指标均具有统计学差异(P<0.05);患侧与健侧指标比较,除观察组屈肌群TW[(113.80±39.75)J,t=5.258,P=0.264]、外展肌群TW[(121.29±33.21)J,t=2.467,P=1.552]、内收肌群TW[(50.43±15.16)J,t=7.176,P=0.089],对照组伸肌群PTA[(85.42±16.00)°,t=3.099,P=5.599]、伸肌群TW[(122.33±35.41)J,t=2.965,P=0.157]外,其他指标差异均有统计学意义(P<0.05)。结论通过分析髋关节生物力学特征证实,电针联合IST有助于改善THA术后患者髋周各肌群肌力,增强髋关节稳定性,值得临床广泛推广使用。Objective To investigate the effect of electroacupuncture combined with isokinetic muscle strength training on the biomechanics of the hip joint in patients after total hip arthroplasty.Methods 72 patients who underwent total hip arthroplasty were selected and randomly divided into an observation group and a control group,with 36 cases in each group(1 case of dislocation in the observation group).The observation group received electroacupuncture combined with isokinetic muscle strength training therapy,while the control group received traditional rehabilitation training therapy.Results A total of 72 patients were followed up for a period of three months.Among them,there are 22 males and 49 females,with an average age of(75.17±10.49)years old.At 3 months post surgery,in the observation group,the healthy side extensor muscle group PT[(79.11±7.11)N·m,t=2.589,P=0.012],the affected side flexor muscle group PT[(73.23±9.40)N·m,t=2.158,P=0.034],PTA[(73.00±18.58)°,t=3.020,P=0.004],TW[(113.80±39.75)J,t=2.395,P=0.019],extensor muscle group PT[(67.09±8.69)N·m,t=3.035,P=0.003],PT/BW[(108.27±23.50)%N·m/Kg,t=2.252,P=0.028],and healthy side medial extension muscle group PT[(67.09±8.69)N·m,t=3.035,P=0.003]were observed.AP[(14.09±3.72)W,t=0.239,P=0.020],PT[(61.43±15.02)N·m,t=4.158,P=0.000],PT/BW[(98.25±26.25)%N·m/Kg,t=3.721,P=0.000],PTA[(29.11±11.06)°,t=2.011,P=0.048],TW[(121.29±33.21)J,t=6.204,P=0.000],PT[(48.54±15.92)N·m,t=2.768,P=0.007],PT/BW[(78.70±28.93)%N·m/Kg,t=2.531,P=0.014],TW[(50.43±15.16)J,t=7.186,P=0.000],all of the above indicators have statistical differences(P<0.05);Compared with the healthy side,except for the observation group's flexor muscle group TW[(113.80±39.75)J,t=5.258,P=0.264],abductor muscle group TW[(121.29±33.21),t=2.467,P=1.552],adductor muscle group TW[(50.43±15.16)J,t=7.176,P=0.089],the control group's extensor muscle group PTA[(85.42±16.00)°,t=3.099,P=5.599],and extensor muscle group TW[(122.33±35.41)J,t=2.965,P=0.157],all other indicators showed statistically signifi

关 键 词：电针 等速肌力训练 全髋关节置换术 生物力学 

分 类 号：R687.3[医药卫生—骨科学]