缪刺治疗急性踝关节扭伤的临床研究

发布时间：2018-03-01 15:16

本文关键词： 缪刺临床研究急性踝关节扭伤　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：采用随机对照的临床试验研究方法,探讨缪刺法治疗急性踝关节扭伤的临床疗效,评价其安全性及有效性,为今后的临床推广提供科学依据。方法：将门诊收集的90例患者随机分配至试验组A、对照组B及对照组C,试验组A采用缪刺的方法,通过选取患足对侧的腕关节,在腕关节上采取按压的方法找出阿是穴,并在阿是穴上施针,嘱患者活动踝关节,留针20min。对照组B采用普通针刺的方法,依据石学敏主编的“十一五”规划教材中治疗踝关节扭伤的处方,选取申脉、昆仑、解溪、太冲、丘墟等穴。对照组C选用现代医学中本病的治疗规范,即RICE处理原则,包括制动、冰敷、加压包扎、抬高患肢等四个方面。三组疗程均为1周,试验组A与试验组B每日施针,针灸每天1次,研究以疼痛、肿胀、关节活动度及Kofoed评分为主要观测指标,分别在治疗前、第1次治疗后、第7次治疗后进行观测指标评分,最后整理数据,进行统计学分析,做出科学的系统的评价。结果：VAS评分方面,三组的VAS评分在第1次治疗后、第7次治疗后与治疗前比较,组内差异均具有统计学意义(P＜0.05)；三组组间在第1次治疗后评分比较,缪刺组评分均值高于常规针刺组及RICE组,差异具有统计学意义(P＜0.05),第7次治疗后组间评分比较,缪刺组评分均值高于常规针刺组及RICE 组。关节活动度ROM评分方面,三组组内关节活动度第1次治疗后评分、第7次治疗后评分与治疗前评分比较,三组均具有统计学意义(P＜0.05)；三组组间在第1次治疗评分后比较,缪刺组评分均值高于常规针刺组及RICE组,差异具有统计学意义(P＜0.05),但在第7次治疗后组间评分比较,差异没有统计学意义(P＞0.05)。肿胀度评分方面,三组组内关节肿胀度第1次治疗后评分、第7次治疗后评分与治疗前评分比较,三组组内均具有统计学意义(P＜0.05)；三组组间关节肿胀度在第1次治疗后评分,组间差异均没有统计学意义(P＞0.05),第7次治疗后评分,RICE组与缪刺组及普通针刺组比较差异具有统计学意义(P＜0.05)。临床疗效方面,三组组间治疗后kofoed评分组间比较不具有统计学意(P＞0.05),这说明缪刺法与普通针刺、RICE原则比较在治疗急性踝关节扭伤的总疗效方面具有相同优势。结论：三种方法治疗急性踝关节扭伤均有效,均能很好地缓解疼痛、减轻肿胀、改善踝关节的功能状态。在缓解疼痛方面,缪刺、普通针刺及RICE原则均能改善急性踝关节扭伤的疼痛,但是缪刺法在即时止痛方面,效果明显。在改善关节活动度方面,缪刺、普通针刺与RICE原则均能改善踝关节活动度,但缪刺对改善关节活动度的即时效果明显。在改善关节的肿胀度方面,缪刺、普通针刺与RICE原则均能降低踝关节肿胀度,RICE原则治疗疗效要优于针刺缪刺及普通针刺。从kofoed评分的总优良率来看,试验组优良率与两对照组无明显差异,但缪刺法操作更为简单,患者依从性较好,是临床上治疗急性踝关节扭伤的一种简便有效的方法,值得在临床上推广。
[Abstract]:Objective: To study clinical trials using randomized controlled methods, to explore the clinical curative effect of needling method for treatment of acute ankle sprain, evaluate its safety and effectiveness, and provide scientific basis for clinical application in the future. Methods: collected 90 cases of clinic patients were randomly assigned to the test group A, control group B and control group C and the test group A by using the method of needling, by selecting the foot on the side of the wrist, the wrist to press the method to find the needle at Ashi Ashi, and, ask the patient motion of ankle joint for 20min. control group B using the ordinary acupuncture, according to Shi Xuemin editor of the "11th Five-Year" planning materials in the treatment of ankle sprain prescription, selection of Shen Mai, Kunlun, JieXi, Taichong, Qiuxu point. The control group used C therapy for the disease of modern medicine, RICE treatment, including brake, ice, compression bandaging, elevate the limb Four. Three groups were treated for 1 weeks, the test group A and test group B daily acupuncture, acupuncture 1 times a day, with pain, swelling, joint activity and Kofoed score as the main observation indexes, respectively before treatment, after first treatments, seventh observation index score after treatment finally, the data, statistical analysis, evaluation of scientific system. Results: the VAS score, VAS score of three groups in first after treatment, compared with seventh times before and after treatment, group differences were statistically significant (P < 0.05); the three groups in first after treatment scores of needling group mean score was higher than that of conventional acupuncture group and RICE group, the difference was statistically significant (P < 0.05), after the seventh treatment groups were compared, the mean score is higher than that of the conventional needling group, acupuncture group and RICE group. The joint activity score of ROM, the three groups in the joint activity first After treatment score, scoring seventh times after treatment compared with before treatment, three groups were statistically significant (P < 0.05); the difference between three groups in the first treatment score, needling group mean score was higher than that of conventional acupuncture group and RICE group, the difference was statistically significant (P < 0.05), but in the seventh treatment groups were compared, the difference was not statistically significant (P > 0.05). The swelling score, joint swelling degree in the three groups after the first treatment score, scoring seventh times after treatment compared with before treatment, the three groups had statistical significance (P < 0.05); between the three groups in the first joint swelling scores after the treatment, the differences between groups were not statistically significant (P > 0.05), after the seventh treatment score, RICE group and contralateral needling group and common acupuncture group with significant difference (P < 0.05). The clinical curative effect aspect, three groups after the kofoed score Comparison between groups was not statistically significance (P > 0.05), indicating that miuci and ordinary acupuncture, RICE principle has the same advantages in total curative effect in the treatment of acute ankle sprain. Conclusion: the three methods in the treatment of acute ankle sprain were effective, can well relieve the pain, reduce swelling. To improve the function of the ankle joint. Needling in pain relief, and the principle of RICE, the ordinary acupuncture can improve the acute sprain of ankle pain, but miuci in immediate pain relief, the effect is obvious. Needling in improving joint activity, and the RICE principle, the ordinary acupuncture can improve the activity of ankle joint however, the immediate effect of needling joint activity. Needling in swelling, improve joint, common acupuncture and RICE principle can reduce the ankle swelling, the efficacy of RICE treatment is superior to the principle of acupuncture needling and ordinary acupuncture from KOF. According to the total excellent and good rate of OED score, the excellent and good rate of the experimental group is not significantly different from that of the two control group, but the operation of the needling method is simpler and the patient's compliance is better. It is a simple and effective method for the treatment of acute ankle sprain in clinical practice, and is worthy of clinical promotion.

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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