三聯(lián)療法治療慢性踝關(guān)節(jié)不穩(wěn)的臨床療效研究
發(fā)布時間：2018-07-23 18:43
【摘要】：目的:通過對經(jīng)功能鍛煉、理筋手法和中藥熏洗三聯(lián)療法治療前后的慢性踝關(guān)節(jié)不穩(wěn)患者踝關(guān)節(jié)等速肌力、本體感覺測試結(jié)果及踝關(guān)節(jié)AOFAS評分結(jié)果進(jìn)行比較,分析其療效,并與經(jīng)功能鍛煉結(jié)合超短波治療的慢性踝關(guān)節(jié)不穩(wěn)患者的測試及療效分析結(jié)果進(jìn)行對比,探討三聯(lián)療法治療慢性踝關(guān)節(jié)不穩(wěn)的臨床價值。方法:根據(jù)納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)選取35例單側(cè)慢性踝關(guān)節(jié)不穩(wěn)患者,隨機(jī)分為對照組和治療組,兩組患者在年齡、性別、病程、體重等方面經(jīng)統(tǒng)計學(xué)分析,無顯著性差異(P㧐0.05)。對照組采用踝關(guān)節(jié)功能鍛煉結(jié)合超短波進(jìn)行治療,治療組采用功能鍛煉、理筋手法及中藥熏洗三聯(lián)法進(jìn)行治療。于治療前及治療后4周,采用Biodex system-3多關(guān)節(jié)等速測試系統(tǒng)(Biodex corporation.Newyork.USA),分別對兩組患者進(jìn)行等速肌力及本體感覺測試,按AOFAS評分系統(tǒng)進(jìn)行對兩組患者評分,并按國家中醫(yī)藥管理局《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》進(jìn)行療效評定,做好結(jié)果記錄。對記錄結(jié)果采用SPSS17.0軟件進(jìn)行統(tǒng)計學(xué)處理,比較分析兩種治療方法治療慢性踝關(guān)節(jié)不穩(wěn)的治療效果。結(jié)果:①治療前,兩組患者等速肌力測試及本體感覺測試顯示慢性踝關(guān)節(jié)不穩(wěn)患者患側(cè)踝關(guān)節(jié)內(nèi)外翻肌群相對峰值力矩(RPT)及內(nèi)外翻肌群峰值力矩比(E/I)明顯低于健側(cè)(P0.05),患側(cè)踝關(guān)主動關(guān)節(jié)位置覺(JPSA)、被動關(guān)節(jié)位置覺(JPSP)及踝關(guān)節(jié)運動覺(KT)值明顯高于健側(cè)(P0.05),慢性踝關(guān)節(jié)不穩(wěn)患者存在踝關(guān)節(jié)肌力及本體感覺的缺失。②經(jīng)治療四周后,兩組慢性踝關(guān)節(jié)不穩(wěn)患者踝關(guān)節(jié)RPT值、E/I值明顯高于治療前,差異具有統(tǒng)計學(xué)意義(P0.05);踝關(guān)節(jié)AOFAS評分亦明顯高于治療前,差異具有統(tǒng)計學(xué)意義(P0.05);本體感覺測試踝關(guān)節(jié)JPSA、JPSP值及踝關(guān)節(jié)KT值明顯低于治療前,差異具有統(tǒng)計學(xué)意義(P0.05)。療效評定示總有效率,對照組84.2%,治療組93.8%;治愈率,對照組52.5%,治療組56.3%,說明踝關(guān)節(jié)功能鍛煉結(jié)合超短波治療與三聯(lián)療法均能提升慢性踝關(guān)節(jié)不穩(wěn)患者踝關(guān)節(jié)肌力、本體感覺,改善踝關(guān)節(jié)功能。而兩組間比較,顯示治療組各項觀察指標(biāo)均優(yōu)于對照組(P0.05),治療組治療效果優(yōu)于對照組。結(jié)論:三聯(lián)療法與功能鍛煉結(jié)合超短波治療均能有效恢復(fù)慢性踝關(guān)節(jié)不穩(wěn)患者踝關(guān)節(jié)周圍肌群肌力及本體感覺,改善踝關(guān)節(jié)不穩(wěn)癥狀,但三聯(lián)療法治療效果更為確切,對踝關(guān)節(jié)功能恢復(fù)效果更好,值得臨床推廣。
[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.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3
本文編號：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.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3
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