针刀配合手法治疗跖腱膜炎/跟骨骨刺综合征疗效研究

Curative effect research on acupotomy combined with tuina manipulationin treating plantar fasciitis or heel bone spur syndrome

目的:探讨针刀结合手法治疗跖腱膜炎/跟骨骨刺综合征(PF/HSS)的临床疗效,从生物力学及组织学等多方面探索针刀治疗PF/HSS的科学依据。方法:采用临床随机、对照法研究,将2013年10月-2015年1月我院针刀门诊60例PF/HSS患者,随机分为针刀手法治疗组(治疗组)和神经封闭对照组(对照组)。治疗组采用针刀配合手法治疗,对照组采用神经封闭治疗。两组均使用足底压力测试系统评价,对足底各部位GTS-1、McGill量表进行量化评定。结果:治疗组对GTS-1测量值改善程度均优于对照组(P<0.05),且治疗前后,GTS-1测量值与疼痛分级指数(PRI)及目测类比定级(VAS)存在显著相关性(P<0.05),随访期,治疗组显著降低PRI、VAS得分,较对照组差异显著(P<0.05,P<0.01)。结论:针刀配合手法是治疗PF/HSS安全有效的方案,今后临床PF/HSS临床疗效评价可采用GST-1与McGill量表等指标综合评价,在理论和实践上均有重要指导意义。

Objective：To explore the clinical effects of acupotomy combined with tuina manipulation in the treatment for plantar fasciitis or heel bone spur syndrome（PF/HSS）.Methods：A randomized controlled clinical trials was designed.Sixty PF/HSS outpatients from acupotomy department from December 2013 to January 2015 were randomly divided into treatment group and control group.The treatment group was given acupotomy and tuina manipulation,and the control group was assigned to give nerve-blockage therapy.Both groups of pantar pressure level were tested.The max load and time integration percentage of various parts of planta pedis was measured and McGill Quantitative Assessment Scale and GTS-1 was used to evaluate.Results：The treatment group with acupotomy and tuina manipulation had a significant improvement in GTS-1 measurement than the control group（P〈0.05）,before and after treatment,GST-1 and PRI,VAS,the two groups was significal relevance（P0.05）,and in the follow-up period,the treatment group could reduced PRI,VAS Scores when compared with the control group（P0.01,P0.05）.Conclusion：Acupotomy and tuina manipulation treatment are effective and safe in treating PF/HSS.The research provides a new pattern（GTS-1 and McGill Quantitative Assessment） for assessment methodology of PF/HSS and has an important guiding significance in theory and practice.