推拿影响膝关节置换术后康复随机平行对照研究

Postoperative Rehabilitation Randomized Controlled Study Massage on Knee Replacement

[目的]观察推拿影响膝关节置换术后康复疗效。[方法]使用随机平行对照方法,将72例门诊及住院患者按病志号抽签法简单随机分为两组。对照组36例康复训练：肌打锻炼及关节活动度锻炼、本体觉训和行走步态训练等。肌力训练和关节活动度训练,以改善和恢复关节功能;膝关节伸直练习：站立或平卧位,足跟放置在厚度为30cm软垫上,双手放于大腿远端位置,持续均匀按压至膝关节后方,直至出现牵拉或疼痛感,交换进行,30min/次,5次/d;坐位屈膝关节康复训练：坐床边,双腿自然下垂,收缩屈肌群,不断屈曲膝关节;卧位屈膝关节康复训练：臀部和足跟运动,不断屈伸膝关节。治疗组36例推拿,术后1d,取卧位和患肢功能位,轻柔点按承山穴、太冲穴;术后2-3d,自足底向上途经足背、小腿等位置,避开手术切口轻柔推擦大腿,承山穴、太冲穴;术后4-7d,继续予上述穴位按揉,可增加力度,加足三里、伏兔等穴位;术后7-14d,加外膝眼、阳陵泉、血海等;术后2-3周,加阳陵泉、阿是穴;均15min/次,2次/d。连续治疗21d为1疗程。观测临床症状、症状积分、HSS评分、VAS评分、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈18例,显效10例,有效6例,无效2例,总有效率94.44%。对照组痊愈11例,显效6例,有效8例,无效11例,总有效率69.44%。治疗组疗效优于对照组（P〈0.01）。症状积分两组均有改善（P〈0.05）,治疗组改善优于对照组（P〈0.05）。评分指标两组均有改善（P〈0.01）,治疗组改善优于对照组（P〈0.01）。[结论]推拿影响膝关节置换术后康复疗效满意,无严重不良反应,值得推广。

[Objective]To observe the effect of knee replacement surgery rehabilitation massage effect.[Methods]randomized,parallel controlled method,72 outpatients and inpatients by disease Zhi No.lottery method is simple and randomly divided into two groups.The control group of 36 patients rehabilitation： muscle and joint range of motion exercise playing exercise,proprioceptive training and gait training.Strength training and range of motion training,to improve and restore joint function;knee extension exercise： standing or supine position,the heel is placed on 30 cm thick cushion,put his hands on the thigh distal position,continued to press evenly behind the knee,pulling or pain until the exchange carried out,30min/day,5 times/d;sitting knee joint rehabilitation training： sit beside the bed,legs drooping naturally,shrink flexors,knee flexion constantly;lying Bit knee joint rehabilitation training：the hip and heel motion and constant knee flexion and extension.Massage treatment group of 36 patients,postoperative 1d,supine and limb function spaces,gentle tap Chengshan points,Taichong;after 2-3d,way up from the foot dorsum of the foot,leg and other locations,to avoid surgery Push gently rub the thigh incision,Chengshan points,Taichong;after 4-7d,continue to knead the above points,increase strength,plus the full three years,V rabbit and other points;after 7-14d,plus the outer knee eye Yanglingquan,a sea of blood and so on;after 2 to 3 weeks,plus Yanglingquan,Ashi;average 15min/times,2 times/d.21 d for a course of continuous treatment.Observation of clinical symptoms,symptom score,HSS score,VAS score,side effects.One course of treatment,to determine efficacy.[Results]The cure 18 cases,10 cases markedly effective in 6 cases,2 cases,the total efficiency of 94.44%.The control group recovered 11 cases,effective in 6 cases,8 cases,11 cases,the total efficiency of 69.44%.Treatment group than the control group（P〈0.01）.Symptom scores improved in both groups（P〈0.05）,treatment group was better than that in the control group（P〈0.05）.Rating indicators improved in both groups（P〈0.01）,the treatment group than the control group improved（P〈0.01）.[Conclusion]Massage on rehabilitation after knee replacement satisfactory effect,no side effects,worthy of promotion.