摇拔戳手法治疗陈旧性踝关节扭伤的病例对照研究

发布时间：2018-03-26 03:09

本文选题：摇拔戳手法　切入点：肌内效贴　出处：《中国中医科学院》2016年硕士论文

【摘要】：目的：研究摇拔戳手法治疗陈旧性踝关节扭伤的临床疗效,从循证医学的角度评价其有效性及安全性,为今后的临床推广提供客观全面的科学依据。方法：对2015.6-2016.2间来自中国中医科学院望京医院骨科门诊的60例患者,将符合纳入标准的患者按照中央随机的方法分配到试验组(30例)和对照组(30例)。试验组予以摇拔戳手法,手法操作为3次,共治疗1周；对照组予以肌内效贴扎贴,贴扎每日1次,单次贴扎维持约24h左右,疗程1周,疗程间可休息1日。以治疗前、治疗后1天、治疗后7天、治疗后1个月4个时间点作为采集时间节点,用于采集VAS疼痛评分、肿胀程度及Takakura功能评分以进行疗效评价来得到数据,每位患者的治疗周期均为一周。所有收集到的数据以SPSS16.0软件统计：计量资料用卡方检验,以t检验和单因素方差分析；均数±标准差做计量指标、以例数及百分比进行统计描述计数指标。结果：试验组在VAS疼痛方面,通过T3检验的多重比较,从治疗后第1天患者的疼痛开始缓解,在治疗后第1天、7天疼痛症状缓解程度相等,且均小于接受治疗1个月后随访时的症状缓解程度(P0.01)。消除肿胀方面,首次治疗后第1天,患肢的肿胀程度未减轻,第1天以后,肿胀开始减轻,并与之后各相邻时间节点上肿胀减轻程度相近(P0.05)。在Takakura功能评分方面,从治疗第1周后患者Takakura功能评分得到逐渐改善(P0.01)。对照组在VAS疼痛方面,通过T3检验的多重比较,从治疗后第1天患者的疼痛开始缓解,在治疗后第1天、7天疼痛症状缓解程度则相等且均小于接受治疗1个月后随访时的症状缓解程度(P0.01)。消除肿胀方面,首次治疗后第1天,患肢的肿胀程度未减轻,第1天以后,肿胀开始减轻,并与之后各相邻时间节点上肿胀减轻程度相近(P0.05)。在Takakura功能评分方面,从治疗第1周后患者Takakura功能评分得到逐渐改善(P0.01)。试验组与对照组在VAS疼痛评分、肿胀周径对比、踝关节功能Takakura评分方面,比较各组间的访视时点与基线之间差值差值P0.05,没有统计学意义,说明在治疗期间试验组各个时间节点在改善疼痛、肿胀与关节功能的效果上均与对照组相近。在总有效率方面,经Wilcoxon秩和检验,可得两组间Takakura功能评分比较并不具显著的统计学意义(P0.01),说明试验组与对照组在Takakura功能评分的总体疗效评价上是近似的。结论：(1)两种治疗方法对陈旧性踝关节扭伤的治疗均生效,均可达到缓解疼痛、减轻肿胀、改善踝关节的功能的目的；(2)从对照结果来看,试验组的成绩在针对疼痛、肿胀症状上与对照组相近(3)就Takakura功能评分的总有效率而言,试验组愈显率和有效率与对照组相近。
[Abstract]:Objective: to study the clinical effect of shaking and poking in the treatment of old ankle sprain, and to evaluate its efficacy and safety from the point of view of evidence-based medicine. Methods: 60 cases of orthopedic outpatients from Wangjing Hospital, Chinese Academy of traditional Chinese Medicine, 2015.6-2016.2, were studied. The patients who met the inclusion criteria were assigned to the experimental group (30 cases) and the control group (30 cases) according to the central random method. Once a day, once a day, once a day, a single patch for about 24 hours, a course of treatment for 1 week, and a rest period of 1 day. Before treatment, 1 day after treatment, 7 days after treatment, and 1 month after treatment, 4 time points were used as the collection time node. It was used to collect VAS pain score, swelling degree and Takakura function score to evaluate the curative effect. The treatment cycle of each patient was one week. All the collected data were counted by SPSS16.0 software: the measurement data were chi-square test. T test and single factor analysis of variance, mean 卤standard deviation as measurement index, and cases and percentages were used to describe the counting index. Results: in VAS pain, the trial group passed the multiple comparison of T3 test. The pain relief began on the first day after treatment, and the degree of relief of pain symptoms was equal on day 1 to day 7 after treatment, and was lower than that at follow-up for 1 month after treatment (P 0.01). In terms of eliminating swelling, the first day after the first treatment, the degree of relief of symptoms was less than that of the first day of treatment. The swelling degree of the affected limb was not alleviated. After the first day, the swelling began to lighten, and the degree of swelling relief was similar to that on the adjacent time nodes (P 0.05). In terms of Takakura function score, From the first week after treatment, the scores of Takakura function of the patients were gradually improved (P 0.01). In the control group, the pain of VAS was alleviated from the first day after treatment through the multiple comparison of T3 test. The degree of relief of pain symptoms was equal on day 1 and 7 days after treatment and was less than that at follow-up for 1 month after treatment. In terms of eliminating swelling, the degree of swelling of the affected limbs did not decrease on the first day after the first treatment, but after the first day, the extent of the swelling of the affected limb did not decrease after the first day of treatment, but after the first day of treatment, The swelling began to lighten, and the degree of swelling relief was similar to that of the adjacent time points (P 0.05). In terms of Takakura function score, the Takakura function score of the patients gradually improved after the first week of treatment. The test group and the control group received the VAS pain score. In terms of swelling circumference contrast, ankle function Takakura score, the difference between the visiting time point and the baseline was compared (P 0.05). There was no statistical significance, which indicated that the pain was improved at each time node in the trial group during the treatment period. The effects of swelling and joint function were similar to those of the control group. The total effective rate was tested by Wilcoxon rank sum test. The comparison of Takakura functional score between the two groups was not statistically significant (P 0.01), which indicated that the overall evaluation of Takakura functional score in the experimental group and the control group was similar. Conclusion the two treatment methods are effective for the treatment of the old ankle sprain. From the control results, the results of the test group were similar to those of the control group in terms of pain, swelling symptoms) and the total effective rate of Takakura score. The effect rate and effective rate of the test group were similar to those of the control group.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R244.1

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