习惯性踝关节扭伤的发病机制及治疗研究进展

Research Progress on the Pathogenesis and Treatment of Habitual Ankle Sprain

踝关节扭伤是临床常见的运动损伤之一。踝关节扭伤后反复发作是习惯性踝关节扭伤的特征性表现。习惯性踝关节扭伤主要病因在于机械性踝关节不稳以及功能性踝关节不稳。其中功能性踝关节不稳是习惯性踝关节扭伤的主要病因,临床表现为韧带松弛、腓骨肌反应时相延长、本体感觉器受损以及肌力降低等。中医学中认为习惯性踝关节扭伤属于筋伤病的范畴,属“踝部伤筋”。“骨正筋柔、气血以流”是中医的基本观点之一,踝关节的稳定亦是如此。目前对习惯性踝关节扭伤的治疗方法包括手术(关节镜联合韧带重建)及保守治疗(针灸治疗、踝部贴扎技术、中药外用、正骨理筋手法、功能锻炼等)。本研究对习惯性踝关节扭伤的发病机制及治疗研究进展等进行综述,以期对该病的系统临床诊疗提供借鉴。

Ankle sprain is one of the common sports injuries in clinical practice.Recurrence after ankle sprain is the characteristic manifestation of habitual ankle sprain.The main causes of habitual ankle sprain are mechanical ankle instability and functional ankle instability,while functional ankle instability is the main cause of habitual ankle sprain.The cause of functional ankle instability includ ligament flabby,prolonged peroneal muscle reaction time,proprioception receptors damage and myodynamia decrease,etc.In traditional Chinese medicine,habitual ankle sprains belong to the category of tendon injuries and belong to"ankle tendons".At present,treatments for habitual ankle sprain includ surgery(such as arthroscopy joint ligament reconstruction),and conservative treatment(such as acupuncture treatment,the ankle stick technology,external application of traditional Chinese medicine,therapeutic manipulation for bone-setting,functional exercise,etc.).This article reviews the research progress on pathogenesis and treatment of habitual ankle sprain,so as to provide reference for the clinical diagnosis and treatment of this disease.