石氏针药结合治疗急性踝关节扭伤中期疗效的临床研究

Clinical Trail of Mid-term Efficacy of Shi's Acupuncture Combined with Plaster for Treating Acute Ankle Injury

目的:观察石氏针药结合治疗急性踝关节扭伤的中期症状改善特点。方法:对前期完成石氏针药治疗的270例受试者,分别于扭伤后第6个月及第12个月进行电话随访与观察,评价石氏针药结合治疗后踝关节扭伤再发次数、美国足踝外科学会AOFAS踝后足评分量表、VAS疼痛评分及VAS满意度评分等,明确石氏针药结合疗法治疗的优效性和安全性。结果:前期按随机数字表1∶1∶1的比例随机分配至针药结合组、绷带固定组或功能锻炼组,在扭伤后第6个月和第12个月进行随访,3组在临床疗效观察中,组间AOFAS踝后足量表评价、VAS疼痛分级及满意度等级比较差异无统计学意义(P>0.05),扭伤后第6个月随访时3组AOFAS总分疗效指数评价总有效率均为100%;伤后第12个月随访时3组总有效率均为100%.3组中期疗效指数评价结局一致,安全性评价3组组间比较差异无统计学意义(P>0.05)。扭伤后第6个月随访时石氏针药结合组VAS满意度变化改善率为86.8%,绷带固定组VAS满意度变化改善率为78.8%,功能锻炼组VAS满意度变化改善率为68.5%;扭伤后第12个月随访时石氏针药结合组VAS满意度变化改善率为80.2%,绷带固定组VAS满意度变化改善率为77.6%,功能锻炼组VAS满意度变化改善率为76.6%;石氏针药结合组满意度变化优于绷带固定组和功能锻炼组。踝关节扭伤的再发率3组一致,无关节不稳或出现反复扭伤。结论:石氏针药结合方案治疗急性踝关节扭伤的中期疗效确切,临床运用安全,VAS满意度改善率优于绷带固定方案和功能锻炼方案。

Objective：To investigate the improvement of characteristics of mid-term symptom for treating with Shi＇s acupuncture combined with plaster.Methods：All 270 cases with acute ankle sprain on the early completion of Shi＇s acupuncture treatment subjects,were followed-up and observation at 6 th and 12 th months respectively.The number of ankle sprain recurrence,AOFAS ankle-hind foot score,VAS pain grade and satisfaction grade were observed after the treatment,to detective the efficacy and safety of the combination of Shi＇s acupuncture and plaster.Results：According to the proportion of random number table 1∶1∶1,they were randomly assigned to the combination of acupuncture and medicine group,bandage fixation group,and functional exercise group.The sprain was followed up at 6 th and 12 th months.The AOFAS anklehind foot score,VAS pain grade and satisfaction grade were not different in the three groups（P〉0.05）.At 6 th months＇ follow-up,the total effective rate of AOFAS in the three groups was 100%.At 12 th months＇ follow-up,the total effective rate of the three-treatment group was 100%.The results of the three groups were consistent,and the safety evaluation was not different between the three groups.At 6 th months＇ follow-up,the improvement rate of satisfaction with VAS in Shi＇s acupuncture and plaster group,bandage fixed group,and functional exercise group were 86.8%,78.8%,and 68.5% respectively.At 12 th months＇ follow-up,the improvement rate of satisfaction with VAS in Shi＇s acupuncture and plaster group,bandage fixed group,and functional exercise group were 80.2%,77.6%,and 76.6%respectively.The satisfaction degree of Shi＇s acupuncture combined with medicine group was better than that of bandage fixation group and functional exercise group.The recurrence rate of ankle sprain was not different in the three groups,no joint instability or repeated sprain.Conclusion：Shi＇s acupuncture combined with plaster in the treatment of acute ankle sprain in the mid-term effect is accurate.The satisfaction of VAS is better than those of bandage fixation and functional exercise.