平衡针灸联合地黄强筋汤对足跟痛患者疼痛症状及美国足踝外科协会踝-后足量表评分的影响  

Effects of balanced acupuncture combined with Dihuang Qiangjin Decoction on pain symptoms and AOFAS-AH scores in patients with heel pain

作　　者：段静 豆志 DUAN Jing;DOU Zhi(Department of Acupuncture,Shenzhen Pingle Orthopedic Hospital(Shenzhen Pingshan Traditional Chinese Medicine Hospital),Shenzhen,Guangdong 518118;Department of Medical Imaging,Shenzhen Pingle Orthopedic Hospital(Shenzhen Pingshan Traditional Chinese Medicine Hospital),Shenzhen,Guangdong 518118)

机构地区：[1]深圳平乐骨伤科医院(深圳市坪山区中医院)针灸科,广东深圳518118 [2]深圳平乐骨伤科医院(深圳市坪山区中医院)医学影像科,广东深圳518118

出　　处：《河北中医》2025年第3期472-476,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：深圳市坪山区卫生系统科研项目(编号:202001)。

摘　　要：目的观察平衡针灸联合地黄强筋汤对足跟痛肝肾亏虚型患者疼痛症状及美国足踝外科协会踝-后足量表(AOFAS-AH)评分的影响。方法选取2021年5月至2022年7月深圳平乐骨伤科医院(深圳市坪山区中医院)针灸科足跟痛肝肾亏虚型患者94例为研究对象,按照随机数字表法分为2组,对照组47例予足跟部封闭治疗+双氯芬酸钠肠溶片口服治疗,治疗组47例予平衡针灸+地黄强筋汤口服治疗。比较2组疗效。比较2组治疗前后疼痛视觉模拟评分(VAS)、AOFAS-AH评分及后足内侧和外侧接触面积、冲量及平均压力。随访6个月统计2组复发率。结果治疗组总有效率93.62%(44/47),对照组总有效率78.72%(37/47),治疗组总有效率明显高于对照组(P<0.05)。治疗后,2组足跟部疼痛VAS均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后,2组AOFAS-AH各维度评分及总分均较本组治疗前升高(P<0.05),且治疗组疼痛、功能维度评分及总分高于对照组(P<0.05)。治疗后,2组后足内侧、外侧接触面积、平均压力均较本组治疗前升高(P<0.05),且治疗组均高于对照组(P<0.05)。随访6个月,治疗组复发率为11.76%(2/17),对照组为30.00%(3/10),2组复发率比较差异无统计学意义(P>0.05)。结论平衡针灸联合地黄强筋汤治疗肝肾亏虚型足跟痛疗效确切,可有效减轻足跟疼痛,促进足跟功能恢复,改善足底生物力学。Objective To explore the effect of balanced acupuncture combined with Dihuang Qiangjin Decoction on pain symptoms and American Orthopedic Foot and Ankle Society Ankle-Hindfoot(AOFAS-AH)scores in patients with heel pain.Methods A total of 94 patients with heel pain admitted to the Department of Acupuncture,Shenzhen Pingle Orthopedic Hospital(Shenzhen Pingshan Traditional Chinese Medicine Hospital)between May 2021 and July 2022 were enrolled.They were randomized 1∶1 to receive closed treatment for heel+oral diclofenac sodium enteric-coated tablets(the control group)or balanced acupuncture+oral Dihuang Qiangjin Decoction(the treatment group).The aim was to compare curative effect,visual analogue scale(VAS)for pain,AOFAS-AH scores,plantar biomechanics indexes(posterior medial/lateral contact areas,impulse,mean pressure).A 6-month follow-up was performed to assess recurrence rate.Results The overall effective rate in the treatment group was significantly higher than that in the control group(93.62%[44/47]vs 78.72%[37/47],P<0.05).After treatment,VAS scores in the both groups were significantly decreased(P<0.05),which decreased notably in the treatment group compared with the control group(P<0.05).The dimension score and total score of AOFAS-AH in the both groups were significantly increased(P<0.05),AOFAS-AH(pain and function)score and total score were significantly higher in the treatment group than in the control group(P<0.05).The posterior medial/lateral contact areas and mean pressure in the both groups were significantly increased(P<0.05),which were significantly higher in the treatment group than in the control group(P<0.05).After 6 months of follow-up,the recurrence rate in the treatment group was comparable to the control group(11.76%[2/17]vs 30.00%[3/10],P>0.05).Conclusion The balanced acupuncture combined with Dihuang Qiangjin Decoction has a definite therapeutic effect,which can effectively relieve heel pain,promote heel function recovery,and improve plantar biomechanics in patients with heel pain of liver

关 键 词：足跟痛 针灸疗法 平衡针灸 植物药疗法 

分 类 号：R274.9[医药卫生—中西医结合] R246.21[医药卫生—中医骨伤科学]