针刀疗法联合透明质酸钠治疗创伤性踝关节炎的效果

Efficacy of acupotomy combined with intra-articular injection of sodium hyaluronate in the treatment of patients with traumatic ankle arthritis

目的 观察针刀疗法联合超声引导下透明质酸钠关节腔内注射治疗创伤性踝关节炎的临床效果.方法 创伤性踝关节炎患者60例,随机分为2组（n=30）：透明质酸钠组和联合针刀组.透明质酸钠组患者踝关节腔内注射透明质酸钠20 mg（2 ml）,联合针刀组患者在每个疗程首次关节腔内注射10 min后进行针刀治疗.所有患者均治疗2个疗程,每周1次,4周为1个疗程;于患者治疗前（T1）、2个疗程结束后1周（T2）时评定VAS、AOFAS评分,并统计并发症.结果 与透明质酸钠组比较,T2时联合针刀组VAS降低[（2.4±1.0）vs（3.5±1.1）],AOFAS升高[（82.8± 17.7）vs（70.1±21.4）],差异均有统计学意义（P＞0.05）.两组患者治疗相关并发症比较,差异无统计学意义（P＞0.05）.结论 针刀疗法联合透明质酸钠关节腔内注射治疗创伤性踝关节炎安全、有效.

Objective To observe the clinical efficacy of acupotomy combined with intra-articular injection of sodium hyaluronate guided by ultrasound in patients of traumatic ankle arthritis.Methods Sixty patients with traumatic ankle arthritis were randomly divided into 2 groups （n=30）：sodium hyaluronate group and combined acupotomy group.Patients in sodium hyaluronate group received intra-articular injection of sodium hyaluronate in ankle joint cavity;patients in combined acupotomy group were given the same drugs and acupotomy after injection at the first time of every course.All patients received two courses of treatment,once a week,4 weeks for one course.Visual analogue scale （VAS）,American Orthopaedic Foot and Ankle Society （AOFAS） Ankle Hindfoot Scale were recorded at T1 （before the treatment） and T2 （one week after the end of two treating courses）.Results Compared with sodium hyaluronate group,VAS was significantly decreased [（3.5±1.1）vs （2.40 ± 1.0）],AOFAS was significantly increased[（70.1 ± 21.4）vs（82.8 ± 17.7）] in combined acupotomy group.No difference was found in complications between the two groups （P〉 0.05）.Conclusion Acupotomy combined with intra-articular injection of sodium hyaluronate is safe and effective in the treatment of patients with traumatic ankle arthritis.