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[1]蔣擁軍,汪偉,邵開(kāi)超,等.平樂(lè)正骨輕推滑皮走手法用于踝關(guān)節(jié)骨折術(shù)后早期腫痛治療的臨床療效和作用機(jī)制研究[J].中醫(yī)正骨,2024,36(05):26-31.
　JIANG Yongjun,WANG Wei,SHAO Kaichao,et al.Clinical outcomes and mechanism of Pingle Zhenggu(平樂(lè)正骨)gently-pushing&sliding-on-skin manipulation for treatment of early swelling and pain after the ankle fracture surgery[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(05):26-31.
點(diǎn)擊復(fù)制

平樂(lè)正骨輕推滑皮走手法用于踝關(guān)節(jié)骨折術(shù)后早期腫痛治療的臨床療效和作用機(jī)制研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數(shù):
2024年05期
頁(yè)碼:
26-31
欄目:
臨床研究
出版日期:
2024-05-20

文章信息/Info

Title:
Clinical outcomes and mechanism of Pingle Zhenggu(平樂(lè)正骨)gently-pushing&sliding-on-skin manipulation for treatment of early swelling and pain after the ankle fracture surgery
作者:
蔣擁軍; 汪偉; 邵開(kāi)超; 艾怡然; 陳佳旭; 何夢(mèng)凡; 嚴(yán)翔
深圳平樂(lè)骨傷科醫(yī)院/深圳市坪山區(qū)中醫(yī)院,廣東 深圳 518010
Author(s):
JIANG Yongjun; WANG Wei; SHAO Kaichao; AI Yiran; CHEN Jiaxu; HE Mengfan; YAN Xiang
Shenzhen Pingle Orthopedic Hospital(Shenzhen Pingshan District Hospital of Traditional Chinese medicine),Shenzhen 518010,Guangdong,China
關(guān)鍵詞:
踝部骨折;  疼痛; 手術(shù)后;  腫;  推拿療法
Keywords:
ankle fractures;  pain; postoperative;  swelling;  tui na therapy
摘要:
目的:觀察平樂(lè)正骨輕推滑皮走手法用于踝關(guān)節(jié)骨折術(shù)后早期腫痛治療的臨床療效和安全性,探討其可能的作用機(jī)制。方法:選取踝關(guān)節(jié)骨折術(shù)后早期患者68例,隨機(jī)分為手法組和對(duì)照組,每組各34例。2組患者均在入組后第1天開(kāi)始治療,共治療7 d。對(duì)照組采用包括藥物治療、物理治療、康復(fù)鍛煉在內(nèi)的常規(guī)治療,手法組在常規(guī)治療的基礎(chǔ)上采用平樂(lè)正骨輕推滑皮走手法治療。比較2組患者患側(cè)踝關(guān)節(jié)疼痛視覺(jué)模擬量表(visual analogue scale,VAS)評(píng)分、踝關(guān)節(jié)腫脹值、踝關(guān)節(jié)主動(dòng)活動(dòng)度,以及外周血中白細(xì)胞介素-6(interleukin-6,IL-6)、C-反應(yīng)蛋白、血漿纖維蛋白原和D-二聚體水平。觀察并記錄2組患者切口感染、骨折端再移位等并發(fā)癥發(fā)生情況。結(jié)果:治療結(jié)束后,2組患者患側(cè)踝關(guān)節(jié)疼痛VAS評(píng)分、踝關(guān)節(jié)腫脹值均低于治療前[(4.81±1.98)分,(2.46±0.71)分,t=33.496,P=0.000;(4.92±1.81)分,(2.97±0.82)分,t=30.207,P=0.000;(14.87±5.12)mm,(8.02±2.78)mm,t=27.532,P=0.000;(15.11±6.67)mm,(9.45±3.02)mm,t=23.114,P=0.000],踝關(guān)節(jié)主動(dòng)活動(dòng)度均大于治療前(20.17°±5.23°,32.76°±8.18°,t=16.893,P=0.000; 18.92°±6.12°,28.45°±7.64°,t=15.622,P=0.000); 且手法組患側(cè)踝關(guān)節(jié)疼痛VAS評(píng)分、踝關(guān)節(jié)腫脹值均低于對(duì)照組(t=2.742,P=0.008; t=2.031,P=0.046),患側(cè)踝關(guān)節(jié)主動(dòng)活動(dòng)度大于對(duì)照組(t=2.245,P=0.028)。治療結(jié)束后,2組患者外周血中IL-6、C-反應(yīng)蛋白、血漿纖維蛋白原和D-二聚體水平均低于治療前[(7.11±0.78)pg·mL-1,(5.59±0.49)pg·mL-1,t=43.453,P=0.000;(7.43±0.82)pg·mL-1,(6.01±0.58)pg·mL-1,t=40.369,P=0.000;(12.07±4.11)mg·L-1,(8.18±2.92)mg·L-1,t=22.164,P=0.000;(12.41±4.45)mg·L-1,(9.87±3.01)mg·L-1,t=20.628,P=0.000;(5.14±1.09)μg·L-1,(2.07±0.31)μg·L-1,t=32.723,P=0.000;(5.21±1.22)μg·L-1,(2.61±0.82)μg·L-1,t=28.129,P=0.000;(2.34±0.79)mg·L-1,(1.05±0.26)mg·L-1,t=25.601,P=0.000;(2.56±0.87)mg·L-1,(1.28±0.34)mg·L-1,t=21.114,P=0.000],且手法組均低于對(duì)照組(t=3.225,P=0.002; t=2.350,P=0.022; t=3.592,P=0.001; t=3.133,P=0.003)。2組患者均未發(fā)生切口感染、骨折端再移位等并發(fā)癥。結(jié)論:平樂(lè)正骨輕推滑皮走手法用于踝關(guān)節(jié)骨折術(shù)后早期腫痛的治療,可有效緩解關(guān)節(jié)疼痛,減輕關(guān)節(jié)腫脹,改善關(guān)節(jié)活動(dòng)度,且安全性高; 作用機(jī)制可能與其可降低患者外周血中IL-6、C-反應(yīng)蛋白、血漿纖維蛋白原和D-二聚體水平有關(guān)。
Abstract:
Objective:To observe the clinical outcomes and safety of Pingle Zhenggu(平樂(lè)正骨,PLZG)gently-pushing&sliding-on-skin manipulation for treatment of early swelling and pain after the surgery of ankle fracture,and to explore its underlying mechanism.Methods:Sixty-eight patients who just underwent surgery for ankle fracture were selected and randomized into manipulation group and control group,34 ones in each group.All patients in the 2 groups were treated with the conventional treatment including drug therapy,physical therapy and rehabilitation exercises; while the ones in manipulation group were further treated with PLZG gently-pushing&sliding-on-skin manipulation.All patients were treated from the first day after enrollment for consecutive 7 days.The affected ankle pain visual analogue scale(VAS)score,ankle swelling value,ankle active range of motion(ROM),and the levels of interleukin-6(IL-6),C-reactive protein (CRP),plasma fibrinogen(FIB)and D-dimer in peripheral blood were compared between the 2 groups.Furthermore,the complications,such as incision infection and re-displacement of the fractured end,in the 2 groups were observed and recorded.Results:The affected ankle pain VAS score was lower,the ankle swelling value was smaller,and the ankle active ROM was greater after the end of the treatment compared to pre-treatment(4.81±1.98 vs 2.46±0.71 points,t=33.496,P=0.000; 4.92±1.81 vs 2.97±0.82 points,t=30.207,P=0.000; 14.87±5.12 vs 8.02±2.78 mm,t=27.532,P=0.000; 15.11±6.67 vs 9.45±3.02 mm,t=23.114,P=0.000; 20.17±5.23 vs 32.76±8.18 degrees,t=16.893,P=0.000; 18.92±6.12 vs 28.45±7.64 degrees,t=15.622,P=0.000); and the affected ankle pain VAS score was lower,the ankle swelling value was smaller,and the affected ankle active ROM was greater in manipulation group compared to control group(t=2.742,P=0.008; t=2.031,P=0.046; t=2.245,P=0.028).The levels of IL-6,CRP,plasma FIB and D-dimer in peripheral blood decreased in the 2 groups after the end of the treatment compared to pre-treatment(7.11±0.78 vs 5.59±0.49 pg/mL,t=43.453,P=0.000; 7.43±0.82 vs 6.01±0.58 pg/mL,t=40.369,P=0.000; 12.07±4.11 vs 8.18±2.92 mg/L,t=22.164,P=0.000; 12.41±4.45 vs 9.87±3.01 mg/L,t=20.628,P=0.000; 5.14±1.09 vs 2.07±0.31 μg/L,t=32.723,P=0.000; 5.21±1.22 vs 2.61±0.82 μg/L,t=28.129,P=0.000; 2.34±0.79 vs 1.05±0.26 mg/L,t=25.601,P=0.000; 2.56±0.87 vs 1.28±0.34 mg/L,t=21.114,P=0.000),and they were lower in manipulation group compared to control group(t=3.225,P=0.002; t=2.350,P=0.022; t=3.592,P=0.001; t=3.133,P=0.003).No patients in the 2 groups suffered from complications,such as incision infection and re-displacement of the fractured end.Conclusion:PLZG gently-pushing&sliding-on-skin manipulation can effectively relieve joint pain,alleviate joint swelling,and improve joint ROM in treatment of early swelling and pain followed the surgery of ankle fracture,and it exhibits high safety.It may exert the effects by reducing the levels of IL-6,CRP,plasma FIB and D-dimer in peripheral blood.

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備注/Memo

備注/Memo:
基金項(xiàng)目:廣東省中醫(yī)藥局中醫(yī)藥科研項(xiàng)目(20221333)
通訊作者:蔣擁軍 E-mail:[email protected]
更新日期/Last Update: 1900-01-01