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[1]林曉彤,吳宇峰,彭杰威.威楓骨科外洗散薰洗聯(lián)合神經(jīng)肌肉電刺激對前交叉韌帶重建術(shù)后膝關(guān)節(jié)功能恢復(fù)的影響[J].中醫(yī)正骨,2023,35(05):8-13.
　LIN Xiaotong,WU Yufeng,PENG Jiewei.Effects of steaming and washing therapy with Weifeng Guke(威楓骨科)external washing powder combined with neuromuscular electrical stimulation on knee function recovery after anterior cruciate ligament reconstruction[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(05):8-13.
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威楓骨科外洗散薰洗聯(lián)合神經(jīng)肌肉電刺激對前交叉韌帶重建術(shù)后膝關(guān)節(jié)功能恢復(fù)的影響()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年05期
頁碼:
8-13
欄目:
臨床研究
出版日期:
2023-05-20

文章信息/Info

Title:
Effects of steaming and washing therapy with Weifeng Guke(威楓骨科)external washing powder combined with neuromuscular electrical stimulation on knee function recovery after anterior cruciate ligament reconstruction
作者:
林曉彤; 吳宇峰; 彭杰威
(中山市中醫(yī)院,廣東 中山 528401)
Author(s):
LIN Xiaotong; WU Yufeng; PENG Jiewei
Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528401,Guangdong,China
關(guān)鍵詞:
前交叉韌帶重建術(shù);  薰洗療法;  神經(jīng)肌肉電刺激療法;  康復(fù);  關(guān)節(jié)功能
Keywords:
anterior cruciate ligament reconstruction;  steaming washing therapy;  neuromuscular electrical stimulation;  rehabilitation;  joint function
摘要:
目的:觀察威楓骨科外洗散薰洗聯(lián)合神經(jīng)肌肉電刺激(neuromuscular electrical stimulation,NMES)對前交叉韌帶(anterior cruciate ligament,ACL)重建術(shù)后膝關(guān)節(jié)功能恢復(fù)的影響。方法:將60例擬接受單側(cè)ACL重建術(shù)的患者隨機(jī)分為聯(lián)合組和常規(guī)組。由同一團(tuán)隊(duì)醫(yī)生實(shí)施ACL重建術(shù)后,常規(guī)組采用常規(guī)康復(fù)訓(xùn)練聯(lián)合NMES治療,聯(lián)合組在常規(guī)組干預(yù)措施基礎(chǔ)上采用威楓骨科外洗散薰洗。比較2組患者的膝關(guān)節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評分、膝關(guān)節(jié)主動活動度、大腿周徑萎縮指數(shù)、Lysholm膝關(guān)節(jié)評分及綜合療效。結(jié)果:①膝關(guān)節(jié)疼痛VAS評分。術(shù)后1 d時(shí),2組患者膝關(guān)節(jié)疼痛VAS評分的差異無統(tǒng)計(jì)學(xué)意義[(6.00,1.25)分,(6.00,3.00)分,Z=-0.241,P=0.809]; 術(shù)后4周和術(shù)后8周時(shí),聯(lián)合組的膝關(guān)節(jié)疼痛VAS評分均低于常規(guī)組[術(shù)后4周:(3.00,1.00)分,(4.00,2.00)分,Z=-2.710,P=0.007; 術(shù)后8周:(2.00,1.00)分,(3.00,1.00)分,Z=-3.294,P=0.001]。2組患者術(shù)后4周和術(shù)后8周時(shí)的膝關(guān)節(jié)疼痛VAS評分均較術(shù)后1 d時(shí)降低(聯(lián)合組:χ2=1.067,P=0.000; χ2=1.833,P=0.000; 常規(guī)組:χ2=0.900,P=0.001; χ2=1.800,P=0.000),術(shù)后8周時(shí)的膝關(guān)節(jié)疼痛VAS評分均較術(shù)后4周時(shí)降低(聯(lián)合組:χ2=0.767,P=0.009; 常規(guī)組:χ2=0.900,P=0.001)。②膝關(guān)節(jié)主動活動度。術(shù)前1 d時(shí),2組患者膝關(guān)節(jié)主動活動度的差異無統(tǒng)計(jì)學(xué)意義[(100.50°,28.25°),(104.50°,22.50°),Z=0.015,P=0.988]; 術(shù)后4周和術(shù)后8周時(shí),聯(lián)合組的膝關(guān)節(jié)主動活動度均大于常規(guī)組[術(shù)后4周:(116.50°,5.00°),(110.00°,10.00°),Z=5.057,P=0.000; 術(shù)后8周:(135.00°,4.25°),(135.00°,5.00°),Z=1.990,P=0.047]。2組患者術(shù)后4周和術(shù)后8周時(shí)的膝關(guān)節(jié)主動活動度均較術(shù)前1 d時(shí)增大(聯(lián)合組:χ2=0.967,P=0.011; χ2=2.183,P=0.000; 常規(guī)組:χ2=0.933,P=0.016; χ2=1.900,P=0.000),術(shù)后8周時(shí)的膝關(guān)節(jié)主動活動度均較術(shù)后4周時(shí)增大(聯(lián)合組:χ2=1.217,P=0.001; 常規(guī)組:χ2=1.267,P=0.001)。③大腿周徑萎縮指數(shù)。術(shù)前1 d時(shí),2組患者大腿周徑萎縮指數(shù)的差異無統(tǒng)計(jì)學(xué)意義[(4.49±1.59)%,(4.28±2.17)%,t=0.429,P=0.669]; 術(shù)后8周時(shí),聯(lián)合組的大腿周徑萎縮指數(shù)小于常規(guī)組[(3.13±0.80)%,(3.72±1.27)%,t'=2.145,P=0.036]; 術(shù)后8周時(shí),2組患者的大腿周徑萎縮指數(shù)均較術(shù)前1 d時(shí)減小(聯(lián)合組:t=6.404,P=0.000; 常規(guī)組:t=2.626,P=0.014)。④Lysholm膝關(guān)節(jié)評分。術(shù)前1 d時(shí),2組患者Lysholm膝關(guān)節(jié)評分的差異無統(tǒng)計(jì)學(xué)意義[(60.47±17.11)分,(62.23±19.21)分,t=0.376,P=0.708]; 術(shù)后8周時(shí),聯(lián)合組的Lysholm膝關(guān)節(jié)評分高于常規(guī)組[(84.80±3.49)分,(78.37±5.90)分,t'=5.157,P=0.000]。術(shù)后8周時(shí),2組患者的Lysholm膝關(guān)節(jié)評分均較術(shù)前1 d時(shí)增高(聯(lián)合組:t=7.637,P=0.000; 常規(guī)組:t=4.067,P=0.000)。⑤綜合療效。術(shù)后8周時(shí),聯(lián)合組綜合療效優(yōu)22例、良4例、中3例、差1例,常規(guī)組綜合療效優(yōu)11例、良9例、中8例、差2例; 聯(lián)合組的綜合療效優(yōu)于常規(guī)組( R^-聯(lián)合組=24.97,R^-常規(guī)組=36.03; Z=2.715,P=0.007)。結(jié)論:威楓骨科外洗散薰洗聯(lián)合NMES能促進(jìn)ACL重建術(shù)后早期膝關(guān)節(jié)功能恢復(fù),提高康復(fù)治療效果。
Abstract:
Objective:To observe the effects of steaming and washing therapy with Weifeng Guke(威楓骨科,WFGK)external washing powder combined with neuromuscular electrical stimulation(NMES)on knee function recovery after anterior cruciate ligament reconstruction(ACLR).Methods:Sixty patients who would undergo unilateral ACLR were selected as the subjects and were randomly divided intocombination treatment group and conventional treatment group by using random digits table,30 cases in each group.All patients in the 2 groups were treated with unilateral ACLR by the same surgeons,followed by the same conventional rehabilitation training and NMES,more-over,the patients in combination treatment group were further treated with steaming and washing therapy with WFGK external washing powder.The knee pain visual analogue scale(VAS)score,active range of motion(ROM)of knee,atrophy index of thigh circumference,Lysholm knee score(LKS)and total clinical outcome were compared between the 2 groups.Results:①There was no statistical difference in knee pain VAS score between the 2 groups at postoperative day 1((6.00,1.25)vs(6.00,3.00)points,Z=-0.241,P=0.809).The knee pain VAS score was lower in combination treatment group compared to conventional treatment group at postoperative week 4 and 8(postoperative week 4:(((3.00,1.00)vs(4.00,2.00)points,Z=-2.710,P=0.007; postoperative week 8:(2.00,1.00)vs(3.00,1.00)points,Z=-3.294,P=0.001),and it decreased in the 2 groups at postoperative week 4 and 8 compared to postoperative day 1(combination treatment group:χ2=1.067,P=0.000; χ2=1.833,P=0.000; conventional treatment group:χ2=0.900,P=0.001; χ2=1.800,P=0.000),and it was lower at postoperative week 8 compared to postoperative week 4 in the 2 groups(combination treatment group:χ2=0.767,P=0.009; conventional treatment group:χ2=0.900,P=0.001).②There was no statistical difference in knee active ROM between the 2 groups at preoperative day 1((100.50,28.25)vs(104.50,22.50)degrees,Z=0.015,P=0.988).The knee active ROM was greater in combination treatment group compared to conventional treatment group at postoperative week 4 and 8(postoperative week 4:(116.50,5.00)vs(110.00,10.00),Z=5.057,P=0.000; postoperative week 8:(135.00,4.25)vs(135.00,5.00),Z=1.990,P=0.047),and it increased in the 2 groups at postoperative week 4 and 8 compared to preoperative day 1(combination treatment group:χ2=0.967,P=0.011; χ2=2.183,P=0.000; conventional treatment group:χ2=0.933,P=0.016; χ2=1.900,P=0.000),and it was greater at postoperative week 8 compared to postoperative week 4 in the 2 groups(combination treatment group:χ2=1.217,P=0.001; conventional treatment group:χ2=1.267,P=0.001).③There was no statistical difference in atrophy index of thigh circumference between the 2 groups at preo-perative day 1(4.49±1.59 vs 4.28±2.17%,t=0.429,P=0.669).The atrophy index of thigh circumference was lower in combination treatment group compared to conventional treatment group at postoperative week 8(3.13±0.80 vs 3.72±1.27%,t'=2.145,P=0.036),and it decreased in the 2 groups at postoperative week 8 compared to preoperative day 1(combination treatment group:t=6.404,P=0.000; conventional treatment group:t=2.626,P=0.014).④There was no statistical difference in LKS between the 2 groups at preoperative day 1(60.47±17.11 vs 62.23±19.21 points,t=0.376,P=0.708).The LKSs were higher in combination treatment group compared to conventional treatment group at postoperative week 8(84.80±3.49 vs 78.37±5.90 points,t'=5.157,P=0.000),and it increased in the 2 groups at postoperative week 8 compared to preoperative day 1(combination treatment group:t=7.637,P=0.000; conventional treatment group:t=4.067,P=0.000).⑤The total clinical outcome was evaluated at postoperative week 8.Twenty-two patients obtained an excellent result,4 good,3 fair and 1 poor in combination treatment group; while 11 ones obtained an excellent result,9 good,8 fair and 2 poor in conventional treatment group.The total clinical outcome was better in combination treatment group compared to conventional treatment group(R^-combination treatment group=24.97,R^-conventional treatment group=36.03; Z=2.715,P=0.007).Conclusion:The steaming and washing therapy with WFGK external washing powder combined with NMES can promote the early knee function recovery and improve the rehabilitation effects after ACLR.

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更新日期/Last Update: 1900-01-01