针刺运动疗法联合早期康复训练对急性踝关节扭伤患者踝关节功能、血清炎症因子和致痛物质水平的影响

Effects of Acupuncture Exercise Therapy Combined with Early Rehabilitation Training on Ankle Function,Serum Inflammatory Factors and Pain Causing Substances in Patients with Acute Ankle Sprain

目的:观察针刺运动疗法联合早期康复训练对急性踝关节扭伤患者踝关节功能、血清炎症因子和致痛物质水平的影响。方法:选取湖南中医药大学第一附属医院2019年5月~2022年1月期间收治的116例急性踝关节扭伤患者。按照随机数字表法分为对照组(早期康复训练,n=58)和研究组(针刺运动疗法联合早期康复训练,n=58)。观察两组治疗前、治疗4周后的疗效、量表评分[视觉模拟评分(VAS)、美国足与踝关节协会(AOFAS)踝-后足功能评分]、踝关节功能、血清炎症因子[白细胞介素(IL)-1β、IL-6和肿瘤坏死因子-α(TNF-α)]和致痛物质[神经肽(NPY)、P物质(SP)]水平。结果:研究组的临床总有效率为96.55%,高于对照组的77.59%,差异有统计学意义(P<0.05)。治疗4周后,研究组的AOFAS评分高于对照组(P<0.05),VAS评分低于对照组(P<0.05),血清IL-6、TNF-α、IL-1β水平低于对照组(P<0.05),踝关节背伸活动度、踝关节跖屈活动度大于对照组(P<0.05),血清NPY、SP水平低于对照组(P<0.05)。结论:急性踝关节扭伤患者经针刺运动疗法联合早期康复训练干预后,可有效降低其血清致痛物质和炎症因子水平,有利于疼痛症状的缓解及踝关节功能的恢复。

Objective:To observe the effects of acupuncture exercise therapy combined with early rehabilitation training on ankle function,serum inflammatory factors and pain causing substances in patients with acute ankle sprain.Methods:116 patients with acute ankle sprain who were treated in our hospital from May 2019 to January 2022 were selected.They were divided into control group(early rehabilitation training,n=58)and study group(acupuncture exercise therapy combined with early rehabilitation training,n=58)according to the random number table method.The curative effect,rating scale[visual analogue scale(VAS),the American Orthopaedic Foot and Ankle Society(AOFAS)after ankle-foot function score],ankle function,serum inflammatory factors[interleukin(IL)-1β,IL-6 and tumor necrosis factor-α(TNF-α)]and pain causing substances[neuropeptide(NPY),substance P(SP)]in the two groups before treatment and 4 weeks after treatment were observed.Results:The total effective rate of the study group was 96.55%,which was higher than 77.59%of the control group,and the difference was statistically significant(P<0.05).4 weeks after treatment,the AOFAS score of the study group was higher than that of the control group(P<0.05),the VAS score was lower than that of the control group(P<0.05),the levels of serum IL-6,TNF-α,and IL-1βwas lower than those of the control group(P<0.05),the ankle dorsally extension range of motion and ankle plantarflexion range of motion were greater than those of the control group(P<0.05),and the levels of serum NPY and SP were lower than those of the control group(P<0.05).Conclusion:After intervention of acupuncture exercise therapy combined with early rehabilitation training in the patients with acute ankle sprain,which can effectively reduce the levels of serum pain causing substances and inflammatory factors,and they are beneficial to the relief of pain symptoms and the recovery of ankle joint function.