自拟桂方伤痛膏结合手法治疗急性踝关节扭伤的临床研究

发布时间：2018-06-07 06:33

本文选题：桂方伤痛膏 + 扶他林乳胶剂　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:探讨自拟中药桂方伤痛膏结合手法治疗急性踝关节扭伤的临床疗效,探求其中临床疗效的差异,并对其中治疗原理进行初步分析,以求总结出一种简便效廉的治疗方案。方法:研究中共收录60例急性踝关节内翻扭伤的患者,随机分为桂方伤痛膏结合手法治疗的观察组及扶他林乳胶剂结合手法治疗的对照组。其中男性37例,女性23例,年龄在15~60岁之间。以《中医病证诊断疗效标准》(1994年)中关于踝关节扭伤部分作为诊断标准及治疗后疗效判定指标,并根据治疗前后x线正位片踝穴宽度、患踝肿胀程度、关节活动度、VAS疼痛评分的变化情况进行对比,来观察两种治疗方案的治疗效果,以及桂方伤痛膏与扶他林乳胶剂对比的疗效特点。将研究所得数据通过统计学分析整理,对两种疗法得出科学性、系统性的评价。结果:1.两组患者治疗前在性别、年龄、病程、踝穴宽度、患踝肿胀程度、关节活动度、VAS疼痛评分比较中差异均不具有统计学意义(P0.05),表明治疗前组间基线一致,具有可比性。2.两组患者治疗前后踝穴宽度的组间对比差异并无统计学意义(P0.05),治疗前后的组内对比差异均有统计学意义(P0.05),表明急性踝关节扭伤后发生踝穴形态改变,两种治疗方法均能恢复踝关节的解剖位置。3.两组患者患踝肿胀程度的对比中,两组治疗前后的组内对比差异均具有统计学意义(P0.05),表明两种疗法均可改善患踝肿胀。而组间对比中,治疗6天、9天后比较差异具有统计学意义(P0.05),桂方伤痛膏组的消肿效果更优。4.两组患者治疗前后关节活动度的组间对比差异具有统计学意义(P0.05),桂方伤痛膏在改善急性踝关节扭伤后关节活动度方面更有优势。5.两组治疗前后VAS疼痛评分比较,组内对比差异具有统计学意义(P0.05),可看出两种疗法均起到了止痛效果。治疗后两组相比较,两组间差异具有统计学意义(P0.05),扶他林乳胶剂组的止痛效果更强。治疗结束1月后的组间对比,差异无统计学意义(P0.05),表明两种治疗都取得不错的远期效果。6.两组疗效比较,治疗后总有效率均为100%,在总有效率上并无差异。但观察组治愈数上占优,治愈率优于对照组。结论:急性踝关节扭伤的治疗中正骨复位可及时纠正踝关节的错位,此方法迅速有效,而桂方伤痛膏在消肿、改善关节活动障碍中具有优势,扶他林乳胶剂作为经典的非甾体抗炎药,在缓解软组织损伤后的疼痛中得到到广泛认可。实际临床急性踝关节扭伤的治疗中,可考虑正骨复位后,桂方伤痛膏与扶他林乳胶剂联合应用,以发挥各自优势。
[Abstract]:Objective: To explore the clinical effect of the combined manipulation of Gui Fang Shang Tong paste combined with manipulation in the treatment of acute ankle sprain, and to explore the difference in the clinical effect, and to make a preliminary analysis of the principle of treatment in order to sum up a simple and efficient treatment scheme. Methods: a total of 60 patients with acute ankle varus sprain were collected and randomly divided. The control group was treated with Guifang Yi Tong ointment combined with manipulative treatment and the combined manipulation of vitamin A in the control group, of which 37 men and 23 women were aged between 15~60 years. The diagnosis standard of ankle joint sprain in 1994 (1994) was used as the diagnostic criterion and the evaluation index of the curative effect after treatment, and according to the X before and after treatment. The width of the line position of the ankle, the degree of swelling of the ankle, the degree of joint activity, and the change of the VAS pain score were compared to observe the therapeutic effect of the two treatments, and the curative effect of the comparison between the ointment ointment and the cream of the cream of the cream. The data obtained by the study were statistically analyzed, and the two treatments were scientific and systematic. Results: 1. the differences in sex, age, course of disease, ankle width, ankle swelling, joint activity and VAS pain score were not statistically significant before treatment in two groups (P0.05), indicating that the baseline between groups before treatment was consistent, and there was no statistical difference between group.2. two groups before and after treatment. P0.05, the differences in the group before and after treatment were statistically significant (P0.05), indicating the morphological changes of the ankle points after the acute ankle sprain, and the two treatments could restore the anatomical position of the ankle joint in the comparison of the degree of ankle swelling in the two groups of.3. groups, and the difference in the comparison between the two groups before and after the treatment was statistically significant (P 0.05), indicating that the two treatments could improve the swelling of the ankle. In the group contrast, the treatment was 6 days and 9 days later, the difference was statistically significant (P0.05). The swelling effect of the group of Gui Fang Tong Tong ointment was better than that of the group of.4. two. The difference of the joint activity between the two groups before and after treatment was statistically significant (P0.05), and the Gui Fang Tong Tong ointment was improved in the acute ankle joint. The degree of joint activity after sprain was more advantageous than the VAS pain score of.5. two groups before and after treatment. The difference in the contrast between the groups was statistically significant (P0.05), and the two treatments all had the analgesic effect. The difference between the two groups after treatment was statistically significant (P0.05), and the analgesic effect of the cream group was stronger. The difference between the groups after January was not statistically significant (P0.05), indicating that the two treatments had good long-term effects in.6. two groups, the total effective rate was 100%, and there was no difference in the total effective rate. However, the cure rate of the observation group was superior and the cure rate was superior to that of the contrast group. Conclusion: the treatment of acute ankle sprain is the bone reduction in the treatment of acute ankle sprain. It is quick and effective to correct the dislocation of the ankle joint in time, and the Gui Fang Tong Tong ointment has advantages in reducing swelling and improving joint activity. As a classic nonsteroidal anti-inflammatory drug, the cream is widely recognized in alleviating the pain after soft tissue injury. In the treatment of actual acute ankle sprains, the bone can be considered as a bone. After the reduction, the Kui Fang pain paste and the combination of the cream of the agent are effective in giving full play to their advantages.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.3

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