魏氏伤科治疗踝关节功能障碍的临床疗效研究及三维步态分析评价

Clinical 3D Gait Analysis and Evaluation of Wei's Manipulation for Treatment of Ankle Joint Dysfunction

目的:观察以"魏氏手法+特色中药外洗"和"主动功能锻炼+扶他林软膏"两种方法治疗踝关节扭伤或骨折后导致的踝关节功能障碍,对比其疗效。方法:将72例踝关节功能障碍患者按数字随机法分为治疗组和对照组,其中治疗组36例,应用"魏氏手法+特色中药外洗"治疗,疗程6周。对照组36例,应用"主动功能锻炼+扶他林软膏"治疗,疗程6周。应用AOFAS评分、Vicon三维步态分析系统及分级疗效评定进行组间及治疗前后观察指标比较和疗效评价。结果:两组治疗6周及半年后较治疗前AOFAS都有显著改善,治疗半年后治疗组AOFAS评分优于对照组;治疗6周后治疗组与对照组在步幅、步宽、步频、步速与治疗前对比均有明显改善(P<0.05),两组间比较差异无统计学意义(P>0.05);治疗半年后,治疗组与对照组在后单支撑相与双支撑相等方面与治疗前相比明显延长(P<0.05),治疗组与对照组在步速、步态周期时间、单支撑相时间方面比较差异有统计学意义(P<0.05)。结论:两组治疗方法均能改善踝关节扭伤或踝关节骨折后导致的踝关节功能障碍,且治疗组较对照组具有较好的远期治疗效果。

Objective：To comparatively study the curative effect of the ＂Wei＇s manipulation plus characteristic external Chi- nese medicine＂ and ＂active functional exercise plus Voltaren ointment＂ for the treatment of ankle joint dysfunction lead by ankle joint sprain or fracture. Methods：By randomized control study, 72 patients with ankle joint dysfunction were random- ly divided into treatment group and control group, 36 cases in each group. The treatment group was treated with ＂Wei＇s manipulation plus characteristic external Chinese medicine ＂for 6 weeks. And the control group was treated with ＂ active functional exercise plus Voltaren ointment＂for 6 weeks. According to the AOFAS, Vicon three--dimensional gait analysis system and grading evaluation of curative effect, the curative effect was compared before and after treatment. Results：AO- FAS score were significantly improved in both groups 6 weeks and six months after treatment compared with those before treatment. AOFAS score of treatment group was better than that of the control group. In both groups, the stride length, step width, cadence and walking speed 6 weeks after treatment were significantly improved than those before treatment （P 〈0. 05）, but there is no obvious difference between the two groups （P〉O. 05）. Compared with those before treatment, the single support and double support phase was significantly prolonged half a year after treatment in both groups （P〈0. 05）, and the pace, the gait cycle time and the single support phase time also has significant difference between both groups（P〈 0.05）. Conclusion： The treatment method of two groups can improve ankle sprains or ankle dysfunction caused by ankle joint sprain or fracture, and the treatment group had a better long-term effect than the control group.