栀黄止痛散治疗急性踝关节扭伤的疗效及对损伤韧带形态学的影响

The Effect of Zhihuang Zhitong Powder on Acute Ankle Sprain and Morphology of Injured Ligament

目的观察栀黄止痛散治疗急性踝关节扭伤的疗效及对损伤韧带形态学的影响。方法将92例急性踝关节扭伤患者随机分为对照组与观察组各46例,对照组采用基础疗法联合双氯芬酸二乙胺软乳胶剂外敷,观察组采用基础疗法联合栀黄止痛散外敷,共治疗14 d。比较2组治疗前后视觉模拟评分表(VAS)疼痛评分及血清氧化应激因子水平、踝关节周径、踝关节跖屈、背伸活动度、损伤韧带厚度及踝关节功能的变化;观察2组疼痛、关节肿胀缓解时间和皮肤不良反应情况。结果治疗后,2组VAS评分、距腓前韧带厚度与跟腓韧带厚度、踝关节周径明显下降(P<0.05),踝关节跖屈及背伸活动度、踝与后足功能评价表评分明显改善(P<0.05),超氧化物歧化酶(SOD)活性明显升高(P<0.05),丙二醛(MDA)、成纤维细胞生长因子(FGF)-2、转化生长因子(TGF)-β1、基质金属蛋白酶(MMP)-9和白介素-1β(IL-1β)水平明显下降(P<0.05),观察组优于对照组(P<0.05)。观察组总有效率优于对照组(P<0.05),观察组疼痛缓解时间及关节肿胀恢复时间均短于对照组(P<0.05),2组皮肤不良反应发生率比较无统计学意义(P>0.05)。结论栀黄止痛散治疗急性踝关节扭伤疗效优于双氯芬酸二乙胺软乳胶剂,提升抗氧化因子活性,抑制氧化应激反应,改善患侧韧带形态,促进踝关节功能恢复。

OBJECTIVE To discuss the effect of Zhihuang Zhitong Powder on acute ankle sprain and morphology of injured ligament.METHODS The 92 patients with acute ankle sprain were randomly divided into the control group and the observation group,46 cases each.The control group was given the basic therapy combined with Diclofenac Diethylamine Emulgel while the observation group was given the basic therapy combined with Zhihuang Zhitong Powder.The course lasted 14 days.The efficacy of the two groups were compared after treatment in terms of those indexes,including the pain score of visual analogue scale(VAS),the level of serum oxidative stress factors,the ankle circumcision,the ankle flexion,the activity of back extension,the thickness of damaged ligament and the changes in ankle function.The period of pain relief and swollen joint recovery along with adverse skin reactions in the two groups were recorded.RESULTS After treatment,the pain score of VAS,the thickness of the anterior cruciate ligament and the anterior cruciate ligament,the ankle circumcision,scores of the ankle flexion,the activity of back extension,as well as the ankle and hind foot function evaluation table were significantly improved(P<0.05).The activity of superoxide dismutase(SOD)was higher than before treatment(P<0.05).The level of alondialdehyde(MDA),fibroblast growth factor(FGF)-2,conversion growth factor(TGF)-β1,matrix metalloproteinases(MMP)-9 and interleukin-1β(IL-1β)were lower than those of the same group before treatment.the observation group was higher than that in the control group(P<0.05).The total efficiency of the observation group was better than that of the control group(P<0.05).The period of pain relief and swollen joint recovery in the observation group were shorter than those of the control group(P<0.05).There was no statistical difference in the incidence of adverse skin reactions in the two groups(P>0.05).CONCLUSION The effect of Zhihuang Zhitong Powder in the treatment of acute ankle sprain was better than that of Diclofenac Diethylamine Emulgel,which can enhance antioxidant activity,inhibit oxidative stress response,improve lateral ligament morphology,and promote the recovery of ankle function.