尚元疏筋通络洗剂对Denis-Weber B型踝关节骨折术后康复治疗作用研究
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摘要
【目的】研究尚元疏筋通络洗剂外洗结合功能锻炼对Denis-Weber B型踝关节骨折术后功能康复的治疗效果。【方法】将56例住院接受手术治疗的Denis-Weber B型踝关节骨折患者随机分为观察组和对照组,每组各28例。观察组患者术后给予尚元疏筋通络洗剂外洗结合功能锻炼治疗,对照组患者术后单纯给予功能锻炼。观察2组患者治疗前后踝关节背伸、跖屈活动度及疼痛视觉模拟评分法(VAS)评分的变化情况,并根据AOFAS评分评价疗效。【结果】(1)术后第1天,2组患者VAS疼痛评分比较,差异均无统计学意义(P>0.05)。术后第60天,2组患者VAS疼痛评分均较术后第1天明显降低(P<0.05),且观察组对VAS评分的降低作用明显优于对照组(P<0.05)。(2)术后2组患者踝关节主动活动度明显降低,术后第1天,2组患者踝关节背伸、跖屈活动度比较,差异均无统计学意义(P>0.05)。而术后第60天,2组患者踝关节背伸、跖屈活动度均较术后第1天明显提高(P<0.05),且观察组对关节活动度的改善作用明显优于对照组(P<0.05)。(3)术后第90天,观察组的AOFAS评分明显优于对照组,差异有统计学意义(P<0.05)。(4)根据AOFAS评分表评定疗效,观察组优良率为82.1%,对照组为53.6%;观察组的优良率和总体疗效均优于对照组,差异均有统计学意义(P<0.05)。(5)治疗期间,观察组患者均未出现皮肤过敏、药疹等不良反应。【结论】应用尚元疏筋通络洗剂外洗结合功能锻炼治疗Denis-Weber B型踝关节骨折术后患者,其疗效优于单纯功能锻炼,能有效缓解疼痛,恢复关节屈伸活动功能,改善患者生活质量,缩短康复时间,提高患者满意度。
Objective To observe the therapeutic effect of Shangyuan Shujin Tongluo Lotion(SSTL)washing combined with functional training for functional recovery of Denis-Weber B type ankle joint fractures after surgery.Methods A total of 56 inpatients with Denis-Weber B type ankle fractures after surgery were randomly dividedin to study group and control group, 28 cases in each group. The study group was treated with SSTL washing combined with functional training,and the control group was treated with functional training alone. Before and after treatment, the movement range of dorsiflexion and plantar flexion of ankle joint and the scores of Visual Analogue Scale(VAS)for ankle pain were observed. The scores of AOFAS(a clinical rating system for the ankle-hindfoot,midfoot,hallux and lesser toes)were calculated for the evaluation of the therapeutic effect of the two groups. Results(1)On the first postoperative day,the differences of VAS pain scores between the two groups were insignificant(P>0.05). On the 60 th postoperative day, VAS pain scores of the two groups were decreased as compared with those on the first postoperative day(P<0.05),and the decrease in the study group was superior to that in the control group(P<0.05).(2)The active movement range of the ankle joint of the two groups was obviously decreased after operation as compared with that before operation. The movement range of dorsiflexion and plantar flexion of ankle joint in the two groups showed no significant difference on the first postoperative day(P>0.05), while was much improved on the 60 th postoperative day(P<0.05 compared with that on the first postoperative day),and the improvement in the study group was superior to that in the control group(P<0.05).(3)On the 90 th postoperative day,the AOFAS scores of the study group were superior to those in the control group(P<0.05).(4)The excellent rate evaluated with AOFAS scores of the study group was 82.1%,and that of the study group was 53.6%;the excellent rate and overall efficacy of the study group were superior to those of the control group(P<0.05).(5)During the treatment,no adverse reaction of skin allergy or drug rash was found in the two groups. Conclusion SSTL washing combined with functional training exerts better effect for the treatment of Denis-Weber B type ankle joint fractures after surgery than functional training alone,with the actions of relieving pain,recovering the ankle joint movement,improving the quality of life of patients,shortening recovery time,and increasing the patients' satisfaction.
Objective To observe the therapeutic effect of Shangyuan Shujin Tongluo Lotion(SSTL)washing combined with functional training for functional recovery of Denis-Weber B type ankle joint fractures after surgery.Methods A total of 56 inpatients with Denis-Weber B type ankle fractures after surgery were randomly dividedin to study group and control group, 28 cases in each group. The study group was treated with SSTL washing combined with functional training,and the control group was treated with functional training alone. Before and after treatment, the movement range of dorsiflexion and plantar flexion of ankle joint and the scores of Visual Analogue Scale(VAS)for ankle pain were observed. The scores of AOFAS(a clinical rating system for the ankle-hindfoot,midfoot,hallux and lesser toes)were calculated for the evaluation of the therapeutic effect of the two groups. Results(1)On the first postoperative day,the differences of VAS pain scores between the two groups were insignificant(P>0.05). On the 60 th postoperative day, VAS pain scores of the two groups were decreased as compared with those on the first postoperative day(P<0.05),and the decrease in the study group was superior to that in the control group(P<0.05).(2)The active movement range of the ankle joint of the two groups was obviously decreased after operation as compared with that before operation. The movement range of dorsiflexion and plantar flexion of ankle joint in the two groups showed no significant difference on the first postoperative day(P>0.05), while was much improved on the 60 th postoperative day(P<0.05 compared with that on the first postoperative day),and the improvement in the study group was superior to that in the control group(P<0.05).(3)On the 90 th postoperative day,the AOFAS scores of the study group were superior to those in the control group(P<0.05).(4)The excellent rate evaluated with AOFAS scores of the study group was 82.1%,and that of the study group was 53.6%;the excellent rate and overall efficacy of the study group were superior to those of the control group(P<0.05).(5)During the treatment,no adverse reaction of skin allergy or drug rash was found in the two groups. Conclusion SSTL washing combined with functional training exerts better effect for the treatment of Denis-Weber B type ankle joint fractures after surgery than functional training alone,with the actions of relieving pain,recovering the ankle joint movement,improving the quality of life of patients,shortening recovery time,and increasing the patients' satisfaction.
引文
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[5]Spering C,Lesche V,Dresing K.Osteosynthesis of Weber B ankle fractures using the one-third tubular plate and refixation of the syndesmosis[J].Oper Orthop Traumatol,2015,27(4):317.
[6]Kitaoka H B,Alexander I J,Adellar R S,et al.Clinical rating systems for the ankle-hindfoot,midfoot,hallux and lesser toes[J].Foot Ankle Int,1994,15(7):349.
[7]徐善强,巫宗德,徐强,等.经皮微创内固定术治疗C型Danis-Weber踝关节骨折[J].中医正骨,2016,28(2):49.
[8]鲍朝海,黄晓伟.手术与手法复位治疗Weber-Denis C型踝关节骨折的临床对比分析[J].中国社区医师,2016,32(27):45.
[9]邹剑,章暐,张长青.踝关节骨折及骨折术后产生软组织并发症的高危因素[J].上海医学,2007,30(8):572.
[10]张向红.功能锻炼在骨折治疗中的地位及作用研究[J].临床医药文献杂志,2017,4(1):197.
[11]张宏斌.踝关节骨折手术后进行早期康复训练的远期疗效观察[J].医药前沿,2015,11(14):156.
[2]Goost H,Wimmer M D,Barg A,et al.Fractures of the ankle joint:investigation and treatment options[J].Dtsch Arztebl Int,2014,111(21):377.
[3]Thomas G,Whalley H,Modi C.Early mobilization of operatively fixed ankle fractures:a systematic review[J].Foot Ankle Int,2009,30:666.
[4]Ag??r i,Tun?er N,Kü?ükdurmaz F,et al.Functional comparison of immediate and late weight bearing after ankle bimalleolar fracture surgery[J].Open Orthop J,2015,9(1):188.
[5]Spering C,Lesche V,Dresing K.Osteosynthesis of Weber B ankle fractures using the one-third tubular plate and refixation of the syndesmosis[J].Oper Orthop Traumatol,2015,27(4):317.
[6]Kitaoka H B,Alexander I J,Adellar R S,et al.Clinical rating systems for the ankle-hindfoot,midfoot,hallux and lesser toes[J].Foot Ankle Int,1994,15(7):349.
[7]徐善强,巫宗德,徐强,等.经皮微创内固定术治疗C型Danis-Weber踝关节骨折[J].中医正骨,2016,28(2):49.
[8]鲍朝海,黄晓伟.手术与手法复位治疗Weber-Denis C型踝关节骨折的临床对比分析[J].中国社区医师,2016,32(27):45.
[9]邹剑,章暐,张长青.踝关节骨折及骨折术后产生软组织并发症的高危因素[J].上海医学,2007,30(8):572.
[10]张向红.功能锻炼在骨折治疗中的地位及作用研究[J].临床医药文献杂志,2017,4(1):197.
[11]张宏斌.踝关节骨折手术后进行早期康复训练的远期疗效观察[J].医药前沿,2015,11(14):156.