中药熏洗联合功能锻炼治疗成人踝关节术后关节强直的临床疗效及对炎症因子影响

Clinical effect of fumigation and washing with traditional Chinese medicine combined with functional exercise on ankylosis after ankle surgery in adults and the influence of inflammatory factors

目的:研究中药熏洗联合功能锻炼治疗成人踝关节术后关节强直的临床疗效及炎性因子影响。方法:选择2016年1月~2020年12月太和县中医院收治的踝关节术后关节强直患者100例,随机数字表法分为对照组和观察组,各50例。对照组给予常规功能锻炼,观察组在对照组基础上采用中药熏洗,连续治疗6周。比较两组患者治疗后的临床疗效及治疗前后疼痛视觉模拟(VAS)评分、踝关节功能评分(AOFAS踝-后足评分)、踝关节主动活动度(跖屈背伸角度)及炎性因子变化情况。结果:两组患者治疗后,VAS评分较治疗前有明显下降,且观察组的VAS评分比对照组更低(P<0.05);两组AOFAS踝-后足评分和踝关节跖屈背伸角度较治疗前升高,且观察组升高趋势更显著(P<0.05);炎性因子CRP、ESR水平较治疗前降低,且观察组降低较对照组更明显(P<0.05);治疗后与对照组比较,观察组治疗有效率为92.00%,显著高于对照组的74.00%,差异有统计学意义(P<0.05)。结论:中药熏洗治疗踝关节术后患者关节强直临床效果显著,有效减轻炎症反应,促进踝关节功能恢复,值得临床应用。

Objective To study the efficacy of traditional Chinese medicine fumigation and washing in the treatment of ankylosis patients with ankle fracture after operation.Method A total of 100ankylosis patients with ankle fracture after operation in our hospital between January 2016and December 2020were selected and divided into control group(n=50)and observation group(n=50)by using stratified randomization methods.The control group was given conventional functional exercise,and the observation group was treated with Chinese herbal fumigation on the basis of the control group.All patients were treated for 6weeks.The pain degree was tested by Visual Analogue Scale(VAS),AOFAS Ankle Hindfoot Scale was adopted to evaluate ankle function.Ankle dorsiflexion and plantar flexion angle、inflammatory factor and the efficacy were compared between two group after treatment.Results After 6weeks'treatment.The scores of VAS and CRP、ESR levels in two groups were decreased considerably(P<0.05),and the VAS score in the observation group was lower than that in the control group(P<0.05),and AOFAS scores as well as ankle joint extension angle and metatarsal flexion angle were obviously increased compared with those before treatment(P<0.05),and the trend of increase was more significant in the observation group(P<0.05);the levels of inflammatory factors CRP and ESR decreased compared with those before treatment,and the decrease was more significant in the observation group than in the control group(P<0.05).Conclusions The efficacy of traditional Chinese medicine fumigation and washing in the treatment of ankylosis patients with ankle fracture after operation is remarkable.It can effectively reduce the inflammatory response and promote the functional recovery of the ankle joint.The clinical application value is significantly.