苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床观察

Clinical Effect of Sujin Tongluo Prescription(苏筋通络方)Combined with“Regulating Qi and Activating Blood Circulation”Acupuncture in Treatment of Acute Ankle Sprain

目的观察苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床效果。方法将医院创伤骨科门急诊就诊的102例急性踝关节扭伤患者(2020年5月—2022年7月)纳入研究,以随机数字表法将患者分为两组,每组51例,对照组采取西医常规治疗,观察组采取西医常规治疗同时结合苏筋通络方及“行气活血”针刺法治疗。数据比较:临床治疗效果、中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分变化、踝关节跖屈活动度与背伸活动度变化、视觉模拟评分(Visual Analogue Scale,VAS)变化、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝-后足评分变化、血清疼痛物质(神经生长因子、神经肽、P物质)水平变化、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-1β(Interleukin-1β,IL-1β)、超敏C反应蛋白(Hypersensitive C-reactive protein,hs-CRP)变化。结果观察组患者与对照组患者治疗总有效率相比[98.04%(50/51)vs86.27%(44/51)],P<0.05;治疗后各组患者中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分、踝关节跖屈活动度与背伸活动度、VAS评分、AOFAS踝-后足评分、神经生长因子、神经肽、P物质、IL-6、IL-1β、hs-CRP等指标均改善,观察组患者治疗后中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分、踝关节跖屈活动度与背伸活动度、VAS评分、AOFAS踝-后足评分、神经生长因子、神经肽、P物质、IL-6、IL-1β、hs-CRP等指标均明显优于对照组患者,P均<0.05。结论苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床效果显著,患者经治疗后临床症状显著改善,疼痛缓解,踝关节功能改善,值得应用。

Objective To observe the clinical effect of Sujin Tongluo Prescription(苏筋通络方)combined with“regulating Qi and activating blood circulation”acupuncture on acute ankle sprain.Methods A total of 102 patients with acute ankle sprains(May 2020 to July 2022)attending the outpatient emergency department of the orthopaedic trauma hospital were included in the study.The patients were divided into two groups by random number table method,with 51 cases in each group.The control group received conventional Western medicine treatment,and the observation group received conventional Western medicine treatment combined with Sujin Tongluo Prescription and“regulating Qi and activating blood circulation”acupuncture treatment.The clinical treatment effect,changes in scores of TCM symptoms(ankle pain and swelling,subcutaneous ecchymosis,limited joint movement,etc),changes in ankle plantar-flexor motion and dorsiflexor motion,changes in pain scale[visual analog scale(VAS)],ankle-hind foot scoring system(AOFAS)changes,changes in serum levels of pain substances(nerve growth factor,neuropeptide,substance P)and levels of serum inflammatory cytokines[interleukin-6(IL-6),interleukin-1β(IL-1β),hypersensitive C-reactive protein(hs-CRP)]were observed.Results The total effective rate of the observation group and the control group was significant(P<0.05)(98.04%vs 86.27%).Before treatment,the scores of TCM symptoms(ankle pain and swelling,subcutaneous ecchymosis,limited joint movement,etc.),ankle plantar flexor and dorsi extension of motion,VAS score,AOFAS score,nerve growth factor,neuropeptide,substance P,the levels of IL-6,IL-1β,hs-CRP and other indexes were improved in both groups.After treatment,the scores of TCM symptoms(ankle pain and swelling,subcutaneous ecchymosis,limited joint movement,etc.),ankle plantarsal flexor and dorsiflexor motion,VAS score,AOFAS score,nerve growth factor,neuropeptide,substance P,the levels of IL-6,IL-1β,hs-CRP and other indexes in the observation group were significantly better than those in the control group(all P<0.05).Conclusion Sujin Tongluo Prescription combined with“regulating Qi and activating blood circulation”acupuncture method has remarkable clinical effect in the treatment of acute ankle sprain.After treatment,the patients'clinical symptoms are significantly improved,the pain is relieved and the ankle joint function is improved,worthy of application.