中药熏洗在慢性踝关节不稳自体腓骨短肌腱重建中的应用

Application of fumigation and washing with traditional Chinese medicine in reconstruction of autogenous peroneus brevis tendon in the treatment of chronic lateral ankle instability

目的探讨中药熏洗在慢性踝关节外侧不稳自体腓骨短肌腱重建的临床疗效。方法将本院收治的56例慢性踝关节外侧不稳患者按照手术方式不同随机分为试验组(n=28)和对照组(n=28)。对照组采用自体腓骨短肌腱重建术进行治疗,试验组在此基础上进行中药熏洗。比较2组患者美国矫形外科足踝协会(AOFAS)评分、视觉模拟评分法(VAS)评分和平均住院时间。结果术后1、3、6个月,2组AOFAS足功能评分均较治疗前显著升高,且试验组显著高于对照组(P<0.05)。术后1、3、6个月,2组VAS评分均较治疗前降低,且试验组显著低于对照组(P<0.05)。试验组平均住院时间及切口愈合时间均短于对照组,差异有统计学意义(P<0.05)。试验组切口愈合不良1例;对照组切口愈合不良4例,感染2例,2组并发症发生率比较,差异无统计学意义(P>0.05)。结论自体腓骨短肌腱重建治疗慢性踝关节外侧不稳辅以中药熏洗,可有效改善踝关节功能,缓解疼痛,促进切口愈合,并缩短住院时间。

Objective To explore the clinical effect of fumigation and washing with traditional Chinese medicine (TCM) in reconstruction of autogenous peroneus brevis tendon in the treatment of chronic lateral ankle instability (CLAI). Methods A total of 56 patients with CLAI admitted in our hospital were randomly divided into experimental group (n = 28) and control group (n = 28)according to different surgery methods. The control group was treated with autogenous peroneus brevis tendon reconstruction. On this basis,the experimental group was given fumigation and washing with TCM. American Orthopaedic Foot & Ankle Society (AOFAS) score,Visual Analogue Scale (VAS)score and average hospitalization time of the two groups were compared. Results AOFAS scores at 1 month,3 and 6 months after surgery in two groups were significantly higher in the experimental group than those in the control group (P < 0. 05). VAS scores at 1 month,3 and 6 months after surgery in two groups were all lower than those before treatment,and the experimental group was significantly lower than the control group (P < 0. 05). The average hospitalization time and wound healing time in the experimental group were shorter than those in the control group (P < 0. 05). Poor wound healing occurred in 1 case in the experimental group,and in 4 cases in the control group,and 2 cases in the control group were found to be infected. There was no significant difference in the incidence of complications between the two groups (P > 0. 05). Conclusion Reconstruction of autogenous peroneus brevis tendon assisted by fumigation and washing with TCM in the treatment of CLAI can effectively improve ankle joint function,relieve pain,promote incision healing and shorten hospitalization time.