针刺小节穴配合理筋手法对踝关节扭伤镇痛消肿作用的影响

Impacts on analgesia and detumescence in ankle sprain treated with acupuncture at Xiaojie point combined with tendon-regulation manipulation

目的:比较针刺小节穴配合理筋手法与单纯针刺小节穴、理筋手法对踝关节扭伤镇痛消肿作用的疗效差异。方法:将60例踝关节扭伤患者随机分为联合治疗组、单刺小节组和理筋手法组,每组20例。分别采用针刺小节穴配合理筋手法、单刺小节穴、单纯理筋手法治疗,均每日1次,共治疗3次。观察3组患者治疗前后各症状评分包括疼痛、瘀斑、肿胀、功能障碍积分及总积分,比较各组治疗前后疼痛、肿胀积分差值,并进行疗效对比。结果:3组总有效率均为100.0%(20/20),但痊愈率联合治疗组85.0%(17/20)、单刺小节组65.0%(13/20)、理筋手法组55.0%(11/20)。各组治疗后疼痛、瘀斑、肿胀、功能障碍等症状评分和总积分较治疗前均有改善(P<0.01,P<0.05);联合治疗组和单刺小节组治疗后疼痛积分低于理筋手法组(0.20±0.41、0.15±0.37vs 0.60±0.50,均P<0.05);单刺小节组和理筋手法组治疗后肿胀评分比较差异有统计学意义(0.65±0.49vs 0.20±0.41,P<0.05)。联合治疗组和单刺小节组治疗前后疼痛差值大于理筋手法组(2.35±0.59、2.45±0.51vs 2.00±0.46,均P<0.05);理筋手法组治疗前后肿胀差值大于单刺小节组(2.30±0.57vs 1.60±0.60,P<0.05)。结论:针刺小节穴配合理筋手法对踝关节扭伤镇痛消肿作用较单纯针刺小节穴或单纯理筋手法效果明显。

Objective To compare the efficacy difference of analgesia and detumescence on ankle sprain among acupuncture at Xiaojie point combined with tendon-regulation manipulation,acupuncture at Xiaojie point and tendon-regulation manipulation.Methods Sixty cases of ankle sprain were randomized into a combined therapy group,a Xiaojie point group and a tendon-regulation manipulation group,20cases in each one.The combined therapy of acupuncture at Xiaojie point and tendon-regulation manipulation,the acupuncture at Xiaojie point and the simple application of tendon-regulation manipulation were applied respectively in the three groups,once a day,3treatments were required.The symptom score such as pain,ecchymosis,swelling and motor dysfunction and the total score were observed before and after treatment in the three groups.The different values of pain and swelling scores were compared before and after treatment in the three groups.The efficacy was compared among the groups.Results The total effective rate was 100.0%（20/20）in each group.But the curative rate was 85.0%（17/20）in the combined group,65.0%（13/20）in the Xiaojie point group,55.0%（11/20）in the tendon-regulation manipulation group.After treatment,the symptom scores of pain,ecchymosis,swelling and motor dysfunction and the total score were all improved as compared with those before treatment in the three groups（P〈0.01,P〈0.05）.The pain score in either the combined therapy group or Xiaojie point group was lower than that in the tendon-regulation manipulation group after treatment（0.20±0.41,0.15±0.37vs 0.60±0.50,both P〈0.05）.Swelling score in the Xiaojie point group was different significantly from that in the tendon-regulation manipulation group after treatment（0.65±0.49vs 0.20±0.41,P〈0.05）.The different value of pain score in either the combined therapy group or Xiaojie point group was higher than that in the tendon-regulation manipulation group before and after treatment（2.35±0.59,2.45±0.51vs 2.00±0.46,both P〈0.05）.The different value of swelling score in the tendon-regulation manipulation group was higher than that in the Xiaojie point group before and after treatment（2.30±0.57vs 1.60±0.60,P〈0.05）.Conclusion Acupuncture at Xiaojie point combined with tendon-regulation manipulation achieve an apparent effect of analgesia and detumescence on ankle sprain.