机构地区:[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410011
出 处:《康复学报》2025年第1期69-74,82,共7页Rehabilitation Medicine
基 金:湖南省自然科学基金项目(2024JJ6360);湖南省中医药科研基金(B2024050);湖南中医药大学校院联合基金(2023XYLH009)。
摘 要:目的 观察针灸推拿联合治疗对踝关节骨折患者术后关节机能康复的影响。方法 选取2021年6月—2023年6月在湖南中医药大学第一附属医院四肢关节科收治的踝关节骨折患者98例。根据信封法将其分为2组,其中对照组48例,观察组50例。对照组术后次日给予康复功能训练;观察组术后在康复功能训练基础上于术后第2~7天联合针灸推拿治疗。分别在术后第1天、第1周和第4周评估2组踝部视觉模拟(VAS)评分的差异;测量2组踝部肿胀值、足趾甲襞微循环指标的水平。于术后第1天、术后第4周、术后第24周后比较2组踝关节活动度、美国矫形足踝协会踝与后足(AOFAS)评分、日常生活活动能力(ADL)评分差异。结果 与术后第1天比较,2组术后第1周和第4周的踝部疼痛评分和肿胀值均下降(P<0.05);与对照组比较,观察组术后第1天踝部疼痛评分和肿胀值差异无统计学意义(P>0.05),术后第1周和第4周踝部疼痛评分和肿胀值均下降(P<0.05)。与术后第1天比较,2组在术后第1周和第4周的管襻数目增多、管襻顶直径变大、输入枝长度增长(P<0.05)。与对照组比较,观察组术后第1天的足趾甲襞微循环相关指标差异无统计学意义(P>0.05),术后第1周和第4周的血管襻数目增多、管襻顶直径变大、输入枝长度增长(P<0.05)。与术后第1天比较,2组术后第4周和第24周的背伸、跖屈、旋前、旋后活动度变大(P<0.05)。与对照组比较,观察组术后第1天踝关节活动度差异无统计学意义(P>0.05),术后第4周和第24周背伸、跖屈、旋前、旋后活动度均明显变大(P<0.05)。与术后第1天比较,2组术后第4周和第24周AOFAS和ADL评分均有所提高(P<0.05)。与对照组比较,观察组术后第1天AOFAS评分和ADL评分差异均无统计学意义(P>0.05),术后第4周和第24周AOFAS和ADL评分均升高(P<0.05)。治疗期间,未发生皮下淤血、感染等不良事件。结论 针灸推拿联合治Objective To observe the effect of acupuncture and tuina combination therapy on postoperative joint function rehabilitation in patients with ankle fractures.Methods A total of 98 patients with ankle fractures admitted to the Department of Limb and Joint of the First Hospital of Hunan University of Chinese Medicine from June 2021 to June 2023 were selected.They were divided into two groups according to the envelope method,including 48 cases in the control group and 50 cases in the observation group.The control group was given rehabilitation function training from the day after surgery;the observation group was given combined acupuncture and massage treatment in addition to rehabilitation function training from the second to the seventh day after surgery.The differences in ankle Visual Analogue Scale(VAS)scores between two groups were evaluated on the first day after surgery,the first week after surgery,and the fourth week after surgery.The ankle swelling values and toe nailfold microcirculation indicators of the two groups were measured on the first day after surgery,the fourth week after surgery,and the twenty-fourth weeks after surgery.The differences in ankle joint range of motion,American Orthopaedic Foot&Ankle Society(AOFAS)scores,and activities of daily living(ADL)scores between two groups were compared on the first day after surgery,the fourth week after surgery,and the twenty-fourth weeks after surgery.Results Compared with the first day after surgery,the ankle pain scores and swelling values of both groups decreased at the first and fourth weeks after surgery(P<0.05).There was no statistically significant difference in the ankle pain score and swelling value between two groups on the first day after surgery(P>0.05),but the ankle pain scores and swelling values of the observation group decreased at the first week and fourth week after surgery compared with the control group(P<0.05).Compared with the first day after surgery,the number of vascular arches,the diameter of the arch top and the length of the inp
关 键 词:踝关节骨折 踝关节功能 针灸 推拿 康复功能训练 日常生活活动能力
分 类 号:R246.9[医药卫生—针灸推拿学]
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