针灸联合计算机辅助下可动式踝足关节计量矫形器治疗腓总神经损伤疗效观察

Efficacy of acupuncture combined with computer-aided movable and measurable ankle-foot orthosis(CMM-AFO) on injury of nervus peroneus communis

目的:观察西药、西药加康复训练与西药加康复训练及针刺治疗外伤性腓总神经损伤的疗效差异。方法:将81例患者随机分为对照组、观察1组、观察2组,脱落3例,78例进入统计分析,每组26例。对照组口服弥可保(甲钴胺)500μg/次,每日3次,服用60 d;观察1组在对照组治疗基础上应用计算机辅助下可动式踝足关节计量矫形器(CMM-AFO)进行康复训练;观察2组在观察1组治疗基础上联合针灸治疗,穴取患侧解溪、丰隆、阳陵泉、足三里等,留针30 min,每日1次,连续治疗60 d为一疗程。在治疗1个疗程结束后评价临床疗效,计算机评定足背伸和足趾屈的肌力大小及运动神经传导速度(MCV)和感觉神经传导速度(SCV)水平。结果:观察2组痊愈例数(20例)较对照组(8例)、观察1组(15例)明显增加(均P<0.05);观察2组计算机评定的肌力水平、MCV及SCV较对照组、观察1组明显提高(均P<0.05)。结论:针灸联合CMM-AFO治疗腓总神经损伤疗效显著,能明显改善肌力,提高MCV、SCV水平,较单纯西药和西药加康复训练疗效明显。

Objective To observe the efficacy difference among medication, medication plus rehabilitation training and medication plus rehabilitation training plus acupuncture on injury of nervus peroneus communis. Methods A total of81 patients were randomly divided into a control group, an observation 1 group and an observation 2 group; three patients dropped out and 78 patients were included into statistical analysis, 26 patients in each group. The patients in the control group were treated with oral administration of mecobalamin, 500 μg per time, 3 times a day for 60 days. Based on the treatment of control group, the patients in the observation 1 group were treated with rehabilitation training by computer-aided movable and measurable ankle-foot orthosis（CMM-AFO）. Based on the treatment of observation 1 group,the patients in the observation 2 group were treated with acupuncture at Jiexi（ST 41）, Fenglong（ST 40）, Yanglingquan（GB34） and Zusanli（ST 36）, etc, 30 min per treatment, once a day for 60 days. After 60-day treatment, the clinical efficacy was evaluated; the muscle strengths of foot dorsal stretch and digital flexion were evaluated; the motor nerve conduction velocity（MCV） and sensory nerve conduction velocity（SCV） were recorded. Results After treatment, 20 patients were cured in the observation 2 group, which was significantly higher than 8 patients in the control group and 15 patients in the observation 1 group（both P〈0.05）. The muscle strengths, SCV and MCV in the observation 2 group were significantly higher than those in the control group and the observation 1 group（all P〈0.05）. Conclusion Acupuncture combined with CMM-AFO have significant efficacy on injury of nervus peroneus communis, and improve muscle strengths, SCV and MCV,which are superior to medication alone and medication plus rehabilitation training.