中医适宜技术镇痛法联合渐进性肌肉训练在跟骨骨折患者围术期中的促康复效果研究  

Effect of analgesia scheme based on traditional Chinese medicine appropriate technology combined with progressive muscle relaxation on the recovery of perioperative patients with calcaneal fracture

作　　者：赵娜 刘德峰 郑继会[2,3] 苑娜 ZHAO Na;LIU Defeng;ZHENG Jihui;YUAN Na(Department of Joint Trauma,Cangzhou Hospital of Integrated TCM-WM Hebei,Cangzhou,Hebei 061001;Hebei Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Osteoarthritis Research(Preparatory),Cangzhou,Hebei 061001;Third Department of Spine,Orthopedic Branch,Cangzhou Hospital of Integrated TCM-WM Hebei,Cangzhou,Hebei 061001;Department of Audit,Cangzhou Hospital of Integrated TCM-WM Hebei,Cangzhou,Hebei 061001)

机构地区：[1]河北省沧州中西医结合医院关节创伤科,河北沧州061001 [2]河北省中西医结合骨关节病研究重点实验室(筹),河北沧州061001 [3]河北省沧州中西医结合医院骨科院区脊柱三科,河北沧州061001 [4]河北省沧州中西医结合医院审计科,河北沧州061001

出　　处：《河北中医》2024年第10期1628-1633,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2018497)。

摘　　要：目的观察中医适宜技术镇痛方案与渐进性肌肉训练(PMR)方案联合促进跟骨骨折患者围术期康复及改善预后的临床效果。方法本次共计纳入80例跟骨骨折手术治疗患者为研究对象,样本采集时间为2018年12月至2020年12月。所有患者以数字表法随机分2组,包括对照组(40例)与观察组(40例)。对照组患者给予常规管理,观察组增加中医适宜技术镇痛法联合PMR方案。对比不同方案下2组跟骨骨折术后患者疼痛及功能康复情况差异。结果2组跟骨骨折患者术后1 d时的疼痛评为未见明显组间差异(P>0.05),术后7、14 d时观察组患者的疼痛评分相比对照组患者明显更低(P<0.05);2组跟骨骨折患者术前时焦虑、抑郁与舒适度评分均未见明显组间差异(P>0.05),术后14 d时2组患者的焦虑及抑郁评分相比术前均明显降低(P<0.05),舒适度评分则明显增高(P<0.05),且观察组焦虑及抑郁评分相比对照组患者更低(P<0.05),舒适度评分相比对照组患者更高(P<0.05);观察组跟骨折患者术后康复锻炼的依从率相比对照组明显增高(P<0.05),足踝功能评分也明显高于对照组(P<0.05);2组跟骨骨折患者术前时降钙素原(PCT)、白细胞介素6(IL-6)、C反应蛋白(CRP)表达水平均未见明显组间差异(P<0.05),术后7 d时2组患者的PCT、IL-6、CRP表达水平均明显较术前降低(P<0.05),且观察组PCT、IL-6、CRP表达水平相比对照组患者更低(P<0.05)。结论中医适宜技术镇痛法联合PMR能够减轻跟骨骨折术后患者疼痛症状,负性情绪及炎症反应程度,并提高康复锻炼依从性与足踝部功能恢复状况。Objective To study the effect of analgesia scheme based on traditional Chinese medicine(TCM)appropriate technology combined with progressive muscle relaxation(PMR)on the recovery and prognosis of perioperative patients with calcaneal fracture.Methods Eighty perioperative patients with calcaneal fracture visited our hospital from December 2018 to December 2020 were recruited.They were randomly assigned into control group(n=40)and study group(n=40).All patients were treated with conventional western medicine(CWM)care,those in the study group were additionally analgesia scheme based on TCM appropriate technology+PMR.The aim was to compare visual analogue scale(VAS)for pain score and functional rehabilitation under different schemes.Results None of the 1-day VAS scores differed significantly between groups(P>0.05).The 7-day and 14-day VAS scores were significantly lower in the observation group than in the control group(P<0.05).The preoperative anxiety/depression and comfort scores were comparable between groups(P>0.05),at days 14,significantly decreased of anxiety/depression score and increased comfort scores were found in the both groups(P<0.05),which were significantly pronounced in observation group(P<0.05).The compliance rate of postoperative rehabilitation exercise and the ankle function score were significantly higher in the observation group than in the control group(P<0.05).The difference was not statistically significant in the levels of procalcitonin(PCT),interleukin 6(IL-6),and C-reactive protein(CRP)between groups(P>0.05),the 7-day PCT,IL-6,CRP in the both groups were significantly decreased(P<0.05),which decreased notably in the observation group compared to the control group(P<0.05).Conclusion The combination can reduce postoperative pain symptoms of patients with calcaneal fracture,negative emotions and inflammatory response,and improve the compliance of postoperative rehabilitation exercises and the recovery of ankle function.

关 键 词：骨折 跟骨 中医康复 运动疗法 

分 类 号：R274.1[医药卫生—中医骨伤科学]