| 急性外踝韧带损伤三期中药外治方案的早期临床疗效观察 |
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投稿时间：2024-09-13
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| 作者 | Author | 单位 | Address | E-Mail |
| 韩庆欣 |
HAN Qing-xin |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 张磊 |
ZHANG Lei |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
arthroartist@163.com |
| 吴俊莹 |
WU Jun-ying |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 刘晓华 |
LIU Xiao-hua |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 李妍 |
LI Yan |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 陈天鑫 |
CHEN Tian-xin |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 易宇 |
YI Yu |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 于美琪 |
YU Mei-qi |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第10期，第997-1002页 |
| DOI：10.12200/j.issn.1003-0034.20240730 |
| 基金项目:中国中医科学院科技创新工程-重大攻关项目(编号:CI2021A02009) |
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中文摘要:
目的: 观察新三期中药外治方案治疗急性外踝韧带损伤的临床疗效。
方法: 将2023年7月至2023年12月期间招募的64例急性外踝韧带损伤患者,按照治疗方法不同分为观察组和对照组,每组32例。观察组男17例,女15例;年龄25~36(30.59±3.10)岁;采用新三期中药外治方案联合"POLICE"治疗方案即保护(protect)、适当负重(optimal loading)、冰敷(ice)、加压包扎(compression)和抬高患肢(elevation)。对照组男14例,女18例;年龄24~37(30.03±3.19)岁;采用"POLICE"治疗方案。分别在初次入组和治疗第1、6周后采用视觉模拟评分(visual analogue scale,VAS)评估和Figure of 8测量法评估受试者踝关节疼痛和肿胀程度。同时采用美国足踝外科踝功能评分(American Orthopaedic Foot and Ankle Society,AOFAS)和Karlsson踝关节功能评分系统评价各阶段患者踝关节功能改善情况。通过MRI特定图像观察距腓前韧带生物愈合程度,通过计算信噪比(signal to noise ratio,SNR)评估,信噪比越低代表韧带含水量越低,愈合越好。
结果: 所有患者获得6周随访。治疗前两组VAS、AOFAS和Karlsson评分差异无统计学意义(P＞0.05),治疗1周和6周后,两组VAS、AOFAS评分和Karlsson评分均较治疗前显著改善(P＜0.05)。治疗1周后,观察组VAS(3.21±0.87)分,低于对照组(4.21±1.50)分(P＜0.05)。治疗1周后,观察组AOFAS和Karlsson评分[(50.84±4.70)分,(49.97±4.00)分],高于对照组[(46.91±5.56)分,(46.66±5.36)分],P＜0.05。MRI图像显示,治疗6周后,观察组SNR值75.25±16.59,低于对照组的85.81±15.55(P＜0.05)。
结论: 与对照组相比,新三期中药外治方案早期临床疗效显著,能够明显减轻急性外踝韧带损伤患者踝关节的疼痛和肿胀程度,提高韧带修复质量,促进患者踝关节功能的恢复。 |
| 【关键词】急性韧带损伤 中药外治 新三期理论 辨证论治 |
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| Early clinical efficacy study on the efficacy of a three-stage conservative Chinese medicine external treatment for acute lateral ankle ligament injuries |
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ABSTRACT
Objective To evaluate the clinical effect of a new three-phase Chinese medicine (CM) external treatment for acute lateral ankle ligament injuries.
Methods From July to December 2023,64 patients with acute lateral ankle ligament injuries were randomly assigned to receive either the new three-phase CM external treatment combined with the POLICE(protect,optimal loading,ice,compression,elevation) treatment (observation group) or the POLICE treatment (control group),with 32 cases in each group. The observation group consisted of 17 males and 15 females,with an average age of(30.59±3.10) years old ranging from 25 to 36 years old,while the control group included 14 males and 18 females,with an average age of(30.03±3.19) years old ranging from 24 to 37 years old. Visual analogue scale (VAS) evaluation and Figure of 8 measurement were used to evaluate the degree of ankle joint pain and swelling of the subjects at the initial enrollment and after 1 week and sixth weeks of treatment. At the same time,the American Orthopaedic Foot and Ankle Society (AOFAS) and Karlsson Ankle Function Score System were used to evaluate the improvement of ankle joint function in patients at all stages. MRI imaging was employed to observe the degree of biological healing of the anterior talofibular ligament,with the signal to noise ratio(SNR) indicating the level of healing. A lower SNR suggests better ligament healing,as it represents lower water content in the ligament..
Results All patients completed a 6-week follow-up. There was no significant difference in VAS,AOFAS score and Karlsson score between the two groups before treatment (P＞0.05). After 1 week and 6 weeks of treatment,the VAS,AOFAS score and Karlsson score of the two groups were significantly improved (P＜0.05). After 1 week of treatment,the VAS score of the observation group (3.21±0.87) was lower than that of the control group (4.21±1.50),and the difference was statistically significant (P＜0.05). After 1 weeks of treatment,the AOFAS and Karlsson scores[(50.84±4.70) points,(49.97±4.00) points] of the observation group were higher than those[(46.91±5.56) points,(46.66±5.36) points]of the control group (P＜0.05). MRI images showed that after 6 weeks of treatment,the SNR value of the observation group was significantly lower than that of the control group,and the difference was statistically significant(SNR of the observation group was 75.25±16.59,the contral gruop was 85.81±15.55),(P＜0.05).
Conclusion Compared with the control group,the new three-phase CM external treatment is significantly effective in reducing pain and swelling,enhancing ligament repair quality,and promoting functional recovery of the ankle joint in patients with acute lateral malleolar ligament injuries. |
| KEY WORDS Acute ligament injury TCM external treatment New three-phase theory Syndrome differentiation and treatment |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 韩庆欣,张磊,吴俊莹,刘晓华,李妍,陈天鑫,易宇,于美琪.急性外踝韧带损伤三期中药外治方案的早期临床疗效观察[J].中国骨伤,2024,37(10):997~1002 |
| 英文格式: | HAN Qing-xin,ZHANG Lei,WU Jun-ying,LIU Xiao-hua,LI Yan,CHEN Tian-xin,YI Yu,YU Mei-qi.Early clinical efficacy study on the efficacy of a three-stage conservative Chinese medicine external treatment for acute lateral ankle ligament injuries[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(10):997~1002 |
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