阿仑膦酸钠维D3联合中医手法治疗慢性踝关节损伤继发局部骨质疏松的临床疗效观察  

Clinical Efficacy of Alendronate Sodium Vitamin D3 Combined with Traditional Chinese Medicine Manipulation in Treatment of Localized Osteoporosis Secondary to Chronic Ankle Injury

作　　者：许子平 张琦[1] 张海鑫 杨茂伟[2] XU Ziping;ZHANG Qi;ZHANG Haixin;YANG Maowei(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;The First Hospital of China Medical University,Shenyang 110001,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]中国医科大学附属第一医院,辽宁沈阳110001

出　　处：《实用中医内科杂志》2024年第12期103-107,共5页Journal of Practical Traditional Chinese Internal Medicine

基　　金：辽宁省科技厅应用基础研究基金和沈阳市科学公共卫生研发项目(22-321-32-12);骨质疏松和骨矿盐疾病中青年医生优才培养计划暨白求恩·石药骨质疏松科研基金项目(GX2021B06)。

摘　　要：目的观察阿仑膦酸钠维D_(3)联合中医手法治疗慢性踝关节损伤术后患者骨密度变化的临床疗效。方法选择75例踝关节损伤后保守治疗3个月仍疼痛的患者,所有患者行改良Brostr9m-Gould术修复踝关节外侧韧带后随机分为对照组、手法治疗组和联合治疗组。对照组患者予补充钙剂和常规康复锻炼,手法治疗组在对照组的基础上加以中医手法治疗,联合治疗组在手法治疗组的基础上加用阿仑膦酸钠维D_(3)口服。在治疗前、治疗后1、3、6个月进行下肢肌肉功能测定;治疗前、治疗后3、6个月收集踝关节局部骨密度值和AOFAS踝-后足评分;治疗后6个月进行中医临床疗效评价。结果经统计学处理,3组总有效率间差异无统计学意义(P>0.05),但手法治疗组与联合治疗组的显效率均明显高于对照组(P<0.05);治疗3、6个月后手法治疗组、联合治疗组患者的AOFAS评分、踝关节局部骨密度和下肢肌肉功能改善均明显优于对照组(P<0.05),同时联合治疗组优于手法治疗组(P<0.05)。结论阿仑膦酸钠维D_(3)联合中医手法治疗能够改善慢性踝关节损伤术后患者局部疼痛的临床症状,明显改善局部骨密度,促进下肢肌肉功能恢复,临床疗效确切,值得推广应用。Objective To observe the clinical efficacy of alendronate vitamin D_(3)combined with traditional Chinese medicine(TCM)manipulation treating bone mineral density changes in postoperative patients with chronic ankle injuries.Method Sixty patients who were still in pain after 3 months of conservative treatment for ankle injuries were selected,and all of them were ran⁃domly divided into a control group and a treatment group after repairing the lateral ligament of the ankle with modified Broström Gould technique,and the treatment group was divided into manipulation treatment group and combined treatment group.In the control group,the patients were given calcium supplements and regular rehabilitation exercises.In the manipulation treatment group,TCM manipulation was added on the basis of the control group,and in the combined therapy group,alendronate sodium and vitamin D_(3)were added orally on the basis of the manipulation treatment group.Lower limb muscle strength evaluation was col⁃lected before treatment and 1,3 and 6 months after treatment,and local bone mineral density of the ankle joint,and American Or⁃thopedic Foot and Ankle Society(AOFAS)ankle-hindfoot score were collected before treatment,3 and 6 months after treatment.The clinical efficacy of TCM was evaluated after 6 months of treatment.Results After statistical treatment,the differences in total effective rates between the manipulation treatment group and the control group,and between the combined therapy group and the control group were statistically significant(P<0.05),and the AOFAS scores,local bone mineral density of the ankle joints and the improvement of muscle capacity of the lower extremities of the patients in the manipulation treatment group and the combined therapy group were significantly better than those of the control group after 3 and 6 months of treatment(P<0.05),and at the same time,the patients in the combined therapy group had better pain relief and AOFAS scores than those of the control group.At the same time,the pain relief and

关 键 词：踝关节慢性损伤 骨密度 阿仑膦酸钠维D3 中医手法 

分 类 号：R580[医药卫生—内分泌] R684[医药卫生—内科学]