针刺配合手法治疗跟痛症的临床观察
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摘要
目的：观察针刺配合手法治疗跟痛症的临床疗效。
方法：60例足跟痛患者随机分为治疗组和对照组。治疗组接受针刺配合手法治疗,对照组接受单纯手法治疗。隔日治疗1次,共治疗5次评定疗效,如果在5次内已达到临床痊愈,即可停止治疗。观察指标包括临床疗效、McGill量表和何高洲的临床症状评定表的总分及各因子评分。
结果：两组总有效率没有显著差异(χ2=0.012,P=0.914)。两组疗效经两独立样本Wilcoxon秩和检验得(Z=2.099,P=0.036),两组比较有显著性差异,治疗组的总体疗效优于对照组。
两组治疗前后的简化McGill量表和临床症状评分经检验,P值均<0.001,可见,组内治疗前后的评分均有明显改善,说明两种方法对足跟痛的症状均有改善。
简化McGill量表结果：两组治疗前的PRI感觉、PRI情绪分、VAS分和PPI均未见明显差异(P>0.05),具有可比性。治疗后PRI感觉和VAS分组间比较经协方差分析显示存在显著性差异(P=0.002,0.004),两组治疗前后的PRI情绪分和PPI的改善程度经Wicoxon秩和检验亦发现存在显著差异(P<0.001),说明治疗组在各方面均优于对照组；
临床症状评分量表：两组治疗前的疼痛、肿胀、功能情况及症状总分的比较经Wilcoxon秩和检验均未见明显差异(P>0.05),具有可比性。治疗后两组的肿胀分值的变化无显著性差异(Z=0.348,P=0.701),说明两种治疗方法对跟痛症肿胀程度的改善未有差异；两组治疗前后疼痛、功能情况和症状总分的改善程度经Wilcoxon秩和检验比较有显著性差异(P<0.01),我们发现治疗组在疼痛、功能情况和总分等方面优于对照组。
结论：单纯手法、针刺配合手法,治疗足跟痛均有肯定性疗效,能降低简化McGill量表和临床症状评分。比较而言,针刺配合手法在各方面要优于单纯手法治疗足跟痛。
Objective:To observe the clinical effects of treating Painful heel syndrome with the combination of acupuncture and Massage.
Method:60 cases of Painful heel syndrome were randomly divided into 2 groups,30 in pure Massage (Group control), and 30 in the comprehensive treatment group (Group observe), were treated by acupuncture, Massage treatment and the combination of the two therapies respectively. Treatments were administered every other day for 5 treatment times. We can stop the treatment, if it reached in clinical cure less than five treatment times. Observations including the clinical effectiveness, McGill Pain Questionnaire, Clinical symptoms evaluation table by He Gaozhou and the untoward side effects. All the data were processed by SPSS17.0 soft ware for windows.
Results:There was not any difference of the total efficacy among the obseve group and the control group after the five treatment times (χ2=0.012, P=0.914). The curative effect of the treatment group was better than the control group by the Wilcoxon rank sum test (Z=2.099, P=0.036).
The scores of McGill Pain Questionnaire and Clinical symptoms evaluation table decreased obviously in both two groups after treatment (P<0.001). This means that two methods of Painful heel syndrome were effective.
The changing situation of McGill Pain Questionnaire:The comparison of the PRI feel, PRI emotion, VAS and PPI between the two groups showed no statistics meaning (P＞0.05) before treatment. The combination method was better than the control group in improving the PRI feel and VAS (P=0.002 or 0.004). And the combination method was better than the control group in improving the PRI feel and PPI (P＜0.001).
The changing situation of Clinical symptoms evaluation table:The comparison of the pain, swelling, function and the total between the two groups showed no statistics meaning (P>0.05) before treatment. The comparison of the swelling between the two groups showed no statistics meaning (P>0.05) after the treatment. The combination method was better than the control group in improving the pain, function and the total (P＜0.001).
Conclusion:Pure Massage treatment and the combination of acupuncture and Massage could treat Pain feel syndrome effectively. The comparison showed that the combination of acupuncture and Massage was better than pure Massage in improving in all directions.
方法：60例足跟痛患者随机分为治疗组和对照组。治疗组接受针刺配合手法治疗,对照组接受单纯手法治疗。隔日治疗1次,共治疗5次评定疗效,如果在5次内已达到临床痊愈,即可停止治疗。观察指标包括临床疗效、McGill量表和何高洲的临床症状评定表的总分及各因子评分。
结果：两组总有效率没有显著差异(χ2=0.012,P=0.914)。两组疗效经两独立样本Wilcoxon秩和检验得(Z=2.099,P=0.036),两组比较有显著性差异,治疗组的总体疗效优于对照组。
两组治疗前后的简化McGill量表和临床症状评分经检验,P值均<0.001,可见,组内治疗前后的评分均有明显改善,说明两种方法对足跟痛的症状均有改善。
简化McGill量表结果：两组治疗前的PRI感觉、PRI情绪分、VAS分和PPI均未见明显差异(P>0.05),具有可比性。治疗后PRI感觉和VAS分组间比较经协方差分析显示存在显著性差异(P=0.002,0.004),两组治疗前后的PRI情绪分和PPI的改善程度经Wicoxon秩和检验亦发现存在显著差异(P<0.001),说明治疗组在各方面均优于对照组；
临床症状评分量表：两组治疗前的疼痛、肿胀、功能情况及症状总分的比较经Wilcoxon秩和检验均未见明显差异(P>0.05),具有可比性。治疗后两组的肿胀分值的变化无显著性差异(Z=0.348,P=0.701),说明两种治疗方法对跟痛症肿胀程度的改善未有差异；两组治疗前后疼痛、功能情况和症状总分的改善程度经Wilcoxon秩和检验比较有显著性差异(P<0.01),我们发现治疗组在疼痛、功能情况和总分等方面优于对照组。
结论：单纯手法、针刺配合手法,治疗足跟痛均有肯定性疗效,能降低简化McGill量表和临床症状评分。比较而言,针刺配合手法在各方面要优于单纯手法治疗足跟痛。
Objective:To observe the clinical effects of treating Painful heel syndrome with the combination of acupuncture and Massage.
Method:60 cases of Painful heel syndrome were randomly divided into 2 groups,30 in pure Massage (Group control), and 30 in the comprehensive treatment group (Group observe), were treated by acupuncture, Massage treatment and the combination of the two therapies respectively. Treatments were administered every other day for 5 treatment times. We can stop the treatment, if it reached in clinical cure less than five treatment times. Observations including the clinical effectiveness, McGill Pain Questionnaire, Clinical symptoms evaluation table by He Gaozhou and the untoward side effects. All the data were processed by SPSS17.0 soft ware for windows.
Results:There was not any difference of the total efficacy among the obseve group and the control group after the five treatment times (χ2=0.012, P=0.914). The curative effect of the treatment group was better than the control group by the Wilcoxon rank sum test (Z=2.099, P=0.036).
The scores of McGill Pain Questionnaire and Clinical symptoms evaluation table decreased obviously in both two groups after treatment (P<0.001). This means that two methods of Painful heel syndrome were effective.
The changing situation of McGill Pain Questionnaire:The comparison of the PRI feel, PRI emotion, VAS and PPI between the two groups showed no statistics meaning (P＞0.05) before treatment. The combination method was better than the control group in improving the PRI feel and VAS (P=0.002 or 0.004). And the combination method was better than the control group in improving the PRI feel and PPI (P＜0.001).
The changing situation of Clinical symptoms evaluation table:The comparison of the pain, swelling, function and the total between the two groups showed no statistics meaning (P>0.05) before treatment. The comparison of the swelling between the two groups showed no statistics meaning (P>0.05) after the treatment. The combination method was better than the control group in improving the pain, function and the total (P＜0.001).
Conclusion:Pure Massage treatment and the combination of acupuncture and Massage could treat Pain feel syndrome effectively. The comparison showed that the combination of acupuncture and Massage was better than pure Massage in improving in all directions.
引文
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