三联疗法治疗慢性踝关节不稳的临床疗效研究
发布时间：2018-07-23 18:43
【摘要】：目的:通过对经功能锻炼、理筋手法和中药熏洗三联疗法治疗前后的慢性踝关节不稳患者踝关节等速肌力、本体感觉测试结果及踝关节AOFAS评分结果进行比较,分析其疗效,并与经功能锻炼结合超短波治疗的慢性踝关节不稳患者的测试及疗效分析结果进行对比,探讨三联疗法治疗慢性踝关节不稳的临床价值。方法:根据纳入标准和排除标准选取35例单侧慢性踝关节不稳患者,随机分为对照组和治疗组,两组患者在年龄、性别、病程、体重等方面经统计学分析,无显著性差异(P㧐0.05)。对照组采用踝关节功能锻炼结合超短波进行治疗,治疗组采用功能锻炼、理筋手法及中药熏洗三联法进行治疗。于治疗前及治疗后4周,采用Biodex system-3多关节等速测试系统(Biodex corporation.Newyork.USA),分别对两组患者进行等速肌力及本体感觉测试,按AOFAS评分系统进行对两组患者评分,并按国家中医药管理局《中医病证诊断疗效标准》进行疗效评定,做好结果记录。对记录结果采用SPSS17.0软件进行统计学处理,比较分析两种治疗方法治疗慢性踝关节不稳的治疗效果。结果:①治疗前,两组患者等速肌力测试及本体感觉测试显示慢性踝关节不稳患者患侧踝关节内外翻肌群相对峰值力矩(RPT)及内外翻肌群峰值力矩比(E/I)明显低于健侧(P0.05),患侧踝关主动关节位置觉(JPSA)、被动关节位置觉(JPSP)及踝关节运动觉(KT)值明显高于健侧(P0.05),慢性踝关节不稳患者存在踝关节肌力及本体感觉的缺失。②经治疗四周后,两组慢性踝关节不稳患者踝关节RPT值、E/I值明显高于治疗前,差异具有统计学意义(P0.05);踝关节AOFAS评分亦明显高于治疗前,差异具有统计学意义(P0.05);本体感觉测试踝关节JPSA、JPSP值及踝关节KT值明显低于治疗前,差异具有统计学意义(P0.05)。疗效评定示总有效率,对照组84.2%,治疗组93.8%;治愈率,对照组52.5%,治疗组56.3%,说明踝关节功能锻炼结合超短波治疗与三联疗法均能提升慢性踝关节不稳患者踝关节肌力、本体感觉,改善踝关节功能。而两组间比较,显示治疗组各项观察指标均优于对照组(P0.05),治疗组治疗效果优于对照组。结论:三联疗法与功能锻炼结合超短波治疗均能有效恢复慢性踝关节不稳患者踝关节周围肌群肌力及本体感觉,改善踝关节不稳症状,但三联疗法治疗效果更为确切,对踝关节功能恢复效果更好,值得临床推广。
[Abstract]:Objective: to compare the results of isokinetic muscle strength, proprioceptive test and AOFAS score of ankle joint in patients with chronic ankle instability before and after treatment with functional exercise, manipulation and fumigation with traditional Chinese medicine. The clinical value of triple therapy in the treatment of chronic ankle instability was discussed by comparing with the results of test and curative effect analysis in patients with chronic ankle instability treated by functional exercise and ultrashort wave therapy. Methods: 35 patients with unilateral chronic ankle instability were randomly divided into control group and treatment group according to the inclusion criteria and exclusion criteria. There was no significant difference in age, sex, course of disease and body weight between the two groups (P0.05). The control group was treated with functional exercise of ankle and ultrashort wave, while the treatment group was treated with functional exercise, muscle manipulation and traditional Chinese medicine fumigation and washing. Isokinetic muscle strength and proprioceptive sensation were measured with Biodex system-3 multiple joint isokinetic test system (Biodex corporation.Newyork.USA) before and 4 weeks after treatment. The patients in both groups were scored according to AOFAS scoring system. And according to the State Administration of traditional Chinese Medicine, the criteria for the diagnosis of TCM disease and syndrome efficacy evaluation, make a good record of the results. The results were statistically analyzed by SPSS17.0 software, and the results of treatment of chronic ankle instability were compared and analyzed. Results before treatment, The isokinetic muscle strength test and proprioceptive test showed that the relative peak torque (RPT) and the ratio of peak torque (E / I) of the internal and external varus muscle group in the patients with chronic ankle instability were significantly lower than those in the healthy side (P0.05), and the ankle closure was active in the affected side (P0.05). The values of (JPSP) and (KT) of passive position sense of joint (JPSA), and motion sense of ankle joint were significantly higher than those of healthy side (P0.05). The loss of ankle muscle strength and proprioceptive sensation was found in patients with chronic ankle instability after four weeks of treatment. The RPT value and E / P I value of ankle joint in the two groups were significantly higher than those before treatment (P0.05), and the AOFAS score of ankle joint was also significantly higher than that before treatment. The difference was statistically significant (P0.05); the value of JPSAA JPSP and KT of ankle joint in proprioceptive test was significantly lower than that before treatment (P0.05). The total effective rate was evaluated in the control group (84.2%), the treatment group (93.88%), the cure rate, the control group (52.5%) and the treatment group (56.3%). The results showed that the ankle joint function exercise combined with ultrashort wave therapy and triple therapy could improve the ankle muscle strength and proprioceptive sensation of the patients with chronic ankle instability. Improve ankle function. The comparison between the two groups showed that the treatment group was superior to the control group (P0.05), the treatment group was better than the control group. Conclusion: the triple therapy combined with functional exercise combined with ultrashort wave therapy can effectively restore the muscle strength and proprioception of the patients with chronic ankle instability, and improve the symptoms of ankle instability, but the triple therapy is more effective. The effect of ankle function recovery is better, and it is worth popularizing in clinic.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
本文编号：2140308
[Abstract]:Objective: to compare the results of isokinetic muscle strength, proprioceptive test and AOFAS score of ankle joint in patients with chronic ankle instability before and after treatment with functional exercise, manipulation and fumigation with traditional Chinese medicine. The clinical value of triple therapy in the treatment of chronic ankle instability was discussed by comparing with the results of test and curative effect analysis in patients with chronic ankle instability treated by functional exercise and ultrashort wave therapy. Methods: 35 patients with unilateral chronic ankle instability were randomly divided into control group and treatment group according to the inclusion criteria and exclusion criteria. There was no significant difference in age, sex, course of disease and body weight between the two groups (P0.05). The control group was treated with functional exercise of ankle and ultrashort wave, while the treatment group was treated with functional exercise, muscle manipulation and traditional Chinese medicine fumigation and washing. Isokinetic muscle strength and proprioceptive sensation were measured with Biodex system-3 multiple joint isokinetic test system (Biodex corporation.Newyork.USA) before and 4 weeks after treatment. The patients in both groups were scored according to AOFAS scoring system. And according to the State Administration of traditional Chinese Medicine, the criteria for the diagnosis of TCM disease and syndrome efficacy evaluation, make a good record of the results. The results were statistically analyzed by SPSS17.0 software, and the results of treatment of chronic ankle instability were compared and analyzed. Results before treatment, The isokinetic muscle strength test and proprioceptive test showed that the relative peak torque (RPT) and the ratio of peak torque (E / I) of the internal and external varus muscle group in the patients with chronic ankle instability were significantly lower than those in the healthy side (P0.05), and the ankle closure was active in the affected side (P0.05). The values of (JPSP) and (KT) of passive position sense of joint (JPSA), and motion sense of ankle joint were significantly higher than those of healthy side (P0.05). The loss of ankle muscle strength and proprioceptive sensation was found in patients with chronic ankle instability after four weeks of treatment. The RPT value and E / P I value of ankle joint in the two groups were significantly higher than those before treatment (P0.05), and the AOFAS score of ankle joint was also significantly higher than that before treatment. The difference was statistically significant (P0.05); the value of JPSAA JPSP and KT of ankle joint in proprioceptive test was significantly lower than that before treatment (P0.05). The total effective rate was evaluated in the control group (84.2%), the treatment group (93.88%), the cure rate, the control group (52.5%) and the treatment group (56.3%). The results showed that the ankle joint function exercise combined with ultrashort wave therapy and triple therapy could improve the ankle muscle strength and proprioceptive sensation of the patients with chronic ankle instability. Improve ankle function. The comparison between the two groups showed that the treatment group was superior to the control group (P0.05), the treatment group was better than the control group. Conclusion: the triple therapy combined with functional exercise combined with ultrashort wave therapy can effectively restore the muscle strength and proprioception of the patients with chronic ankle instability, and improve the symptoms of ankle instability, but the triple therapy is more effective. The effect of ankle function recovery is better, and it is worth popularizing in clinic.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
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