中西医结合微创技术治疗拇趾外翻的多中心研究

A Multi-Center Study of Integrated Traditional Chinese and Western Medicine in Minimally Invasive Treatment of Hallux Valgus

目的通过采用多中心、自身前后对照的方法进行研究,验证中西医结合微创技术治疗拇趾外翻的科学性、有效性及其在基层推广应用的一致性。方法自2006年1月～2007年6月,中国中医科学院望京医院、华北电网有限公司北京电力总医院及中国中医科学院广安门医院(以下简称望京医院、电力医院、广安门医院)三家分中心采用中西医结合微创技术共治疗拇趾外翻94足(望京医院31足;广安门医院31足;电力总医院32足)。患者年龄:31～75岁,平均57岁;女性92足,男性2足。术后随访周期平均12.5个月。均摄负重正位X线片,测量拇外翻角和第1、2跖骨角、胫侧籽骨位置,并行AOFAS及第一跖趾关节内侧VAS评分。根据分型标准将研究对象分为轻、中、重三组;比较三组术前、术后评价指标,验证该微创技术的有效性、科学性;并比较三家分中心拇外翻足的手术前后观察指标变化情况。验证该微创技术在三家分中心应用过程中的一致性。结果①三家分中心各项观察指标手术前后比较,均P<0.01,有显著性差异;②三家分中心手术前后各项观察指标差值比较,均P﹥0.05,无显著性差异。结论中西医结合微创技术在三家分中心推广应用,经临床验证,疗效肯定、可靠,易于推广。

Objective To investigate 94 feet with hallux valgus with multi-center and the self-control before and after surgery in three sub-center and verify the minimally invasive technique science, effectiveness and consistency of application of integrated traditional Chinese and western medicine in treatment of hallux valgus.Methods The study of minimally invasive techniques of integrated traditional Chinese and western medicine in treatment of hallux valgus included 94 feet with hallux valgus between January 2006 and June 2007 in the three sub-centerszWangjing Hospital affiliated to China Academy of Traditional Chinese Medicine, Beijing General Hospital of the North China Power Grid Co., Ltd. and Guang＇An Men Hospital affiliated to China Academy of Traditional Chinese Medicine （Wangjing Hospital 31 feet; Guang＇An Men Hospital 31 feet; General power Hospital 32 feet）. There were 92 females and 2 males. The mean age was 57 years old （31-75 years old） .An average follow-up period was 12.5 months. All patients＂ feet were evaluated with weight-bearing X ray film by measuring HAV, IM, TSP, AOFAS and VAS of the inside of the first metatarsophalangeal joint. According to the sub-standard study subjects were divided into light, medium and heavy groups. After the standardization process of the treatment of hallux valgus, ①To compare a preoperative and postoperative evaluation and verify minimally invasive technique effectively and scientifically;②Comparison of the observed changes in the situation before and after surgery could verify the minimally invasive technique consistency in the three subcenters.Results ①To compare with the observed indicators before and aft6r surgery in three sub-center, all P 〈0.01, there was a significant difference; ②To compare with the observed difference before and after surgery in three sub-center, all P〉 0.05, there was not statistically significant. Conclusion Minimally invasive technology integrated in traditional Chinese and Western Medicine has the certain ef- fect and is reliable and easy-to-promotion by clinical validation in popularization and application of the three sub-centers.