推拿结合牵伸技术治疗慢性跖筋膜炎合并功能性腓肠肌挛缩的疗效观察  

Therapeutic Effect of Massage Combined with Stretch Technique on Chronic Plantar Fasciitis Complicated with Functional Gastrocnemitis Contracture

作　　者：周凌[1,2] 胡毓诗[1,2] 付志彬[1] 田野 刘志杨 周勋[1] ZHOU Ling;HU Yushi;FU Zhibin;TIAN Ye;LIU Zhiyang;ZHOU Xun(Affiliated Sport Hospital of CDSU,Chengdu,Sichuan 610041;Chengdu Sports University,Chengdu,Sichuan 610041)

机构地区：[1]成都体育学院附属体育医院,四川成都610041 [2]成都体育学院,四川成都610041

出　　处：《中医康复》2025年第2期51-55,共5页Traditional Chinese Medicine Rehabilitation

基　　金：国家自然科学基金项目(82074576);四川省中医药管理局科学技术研究专项课题(2023MS284)。

摘　　要：目的:观察推拿结合牵伸技术治疗慢性跖筋膜炎合并功能性腓肠肌挛缩的临床疗效。方法:采用随机化区组方法将70例慢性跖筋膜炎合并功能性腓肠肌挛缩患者分为对照组和治疗组各35例。对照组采用冲击波治疗,共治疗3次,间隔时间7天。治疗组则在此基础上联合推拿结合小腿三头肌、跖筋膜牵伸训练,其中牵伸训练每天3次,分早、中、晚3个时间段进行,跖筋膜牵伸及小腿三头肌牵伸每次各进行2遍,每遍连续牵拉10次,组间可适当休息,共牵拉4周;推拿治疗每日治疗1次,每周治疗5天,待足底疼痛症状缓解后每隔2天治疗1次,连续治疗4周,4周后每隔2天进行跖筋膜及小腿三头肌牵伸训练。对两组患者实施随访,对治疗前、治疗后4周、治疗后12周分别采用VAS评分评价疼痛程度,AOFAS-AHS评分对患足功能及测量踝关节背伸角度进行综合评价。结果:治疗后4周、治疗后12周,治疗组VAS评分、AOFAS-AHS评分、踝关节背伸角度改善程度均显著优于对照组(P<0.05)。结论:推拿结合牵伸技术治疗慢性跖筋膜炎合并功能性腓肠肌挛缩具有良好临床疗效,且效果优于单纯冲击波治疗,简便易操作,值得推广。Objective:To observe the clinical effect of massage combined with stretch technique on chronic plantar fasciitis complicated with functional gastrocnemitis contracture.Methods:Seventy patients with chronic plantar fasciitis with functional gastrocnemius contracture were divided into control group(n=35)and treatment group(n=35)by randomized blocks method.The control group was treated with shockwave therapy for 3 times with an interval of 7 days;the stretching exercises were performed three times a day,in three time periods:early morning,noon,and evening.The plantar fascia and calf muscle stretching were each performed twice,with 10 consecutive stretches in each round.The groups could take a break as needed,and the stretching was continued for 4 weeks.Massage therapy was administered once a day,five days a week,and continued until foot pain symptoms subsided,then every other day for 4 weeks,and then every other day for 2 weeks after that.After 4 weeks,plantar fascia and triceps calf stretching exercises were performed every 2 days.VAS score,AOFAS-AHS score,the ankle dorsiflexion angles were used to evaluate the outcome of treatment before treatment,4 weeks after treatment and 12 weeks after treatment.Results:After 4 weeks and 12 weeks of treatment,the VAS score,AOFAS-AHS score,and ankle dorsiflexion angles improvement in the treatment group were significantly better than those in the control group(P<0.05).Conclusion:Massage combined with extension technique in the treatment of chronic plantar fasciitis combined with functional gastrocnemius contracture has good clinical effect,and the effect is better than that of shock wave therapy alone.

关 键 词：慢性跖筋膜炎 功能性腓肠肌挛缩 推拿 牵伸技术 疼痛 足功能 踝关节背伸 

分 类 号：R274.9[医药卫生—中西医结合]