中药熏洗配合静态进展性牵伸治疗上肢骨折术后早期肘关节功能障碍临床观察

Clinical Study on Treatment of Early Elbow Joint Dysfunction after Upper Limb Fracture with Chinese Herbal Fumigation combined with Static Progressive Stretching

目的观察中药熏洗配合静态进展性牵伸治疗上肢骨折术后早期肘关节功能障碍的临床疗效。方法选取78例上肢骨折术后早期肘关节功能障碍患者,按随机数字表分为治疗组和对照组,每组39例。两组均采用常规康复治疗,即关节松动术与肌力训练,治疗组加中药熏洗配合静态进展性牵伸治疗,每日1次,共治疗4周。于治疗前后分别记录患者改良HSS肘关节功能评分(HSS),采用改良Barthel指数(MBI)评价患者日常生活活动能力(ADL),测量患者肘关节活动度。结果治疗组5例、对照组3例未完成全部康复治疗疗程,但已超过2周,计入疗效评价。与本组治疗前比较,治疗4周后,两组患者HSS、MBI评分以及肘关节活动度均升高(P<0.05),且治疗组HSS及肘关节活动度优于对照组(P<0.05)。两组治疗期间均未发生明显不良反应。结论在常规康复治疗的基础上,中药熏洗配合静态进展性牵伸能有效改善上肢骨折术后早期患者肘关节运动功能与关节活动度,提高生活自理能力。

Objective To observe the clinical effect of Chinese herbal fumigation combined with static progressive stretching in the treatment of early elbow joint dysfunction after upper limb fracture surgery.Methods Totally 78 patients with early elbow dysfunction after upper limb fracture surgery were assigned to the treatment group and control group according to random number table,39 cases in each group.All of the patients received routine rehabilitation,namely joint mobilization and muscle strength training.The treatment group was treated with Chinese herbal fumigation combined with static progressive stretching,once daily for 4 weeks.Before and after treatment,the modified HSS elbow function score(HSS)was recorded,the modified Barthel index(MBI)was used to evaluate the patient’s activity of daily living(ADL),and the elbow motion degree was measured.Results Five cases in the treatment group and three cases in the control group did not completed the whole course of rehabilitation treatment,while it had been more than 2 weeks,so it was included in the efficacy evaluation.After 4 weeks of treatment,the scores of HSS,MBI and the range of motion of elbow joint in the two groups were significantly higher than those in the same group before treatment(P <0.05),and the HSS and elbow joint activity in the treatment group were significantly better than the control group(P <0.05).There were no obvious adverse reactions and adverse events during the intervention.Conclusion On the basis of routine rehabilitation treatment,Chinese herbal fumigation combined with static progressive stretching can effectively improve elbow motion function and joint mobility of early elbow joint dysfunction after upper limb fracture surgery,and improve self-care ability.