董氏倒马针法改善青年跑步爱好者胫骨内侧应力综合征康复结局:一项随机平行对照研究

Effects of Dong’s Reverse Horse Acupuncture Technique on recovery outcomes of youth running enthusiasts with medial tibial stress syndrome:A randomized parallel-controlled study

目的:探讨董氏倒马针法对青年跑步爱好者胫骨内侧应力综合征(MTSS)的康复治疗效果。方法:本研究为单中心、随机、对照、临床研究。连续纳入2021年1~12月在某三级医院门诊就诊的MTSS青年跑步爱好者,剔除不符合入组条件者,采用随机数字表法分为针刺组和对照组。两组均给予休息、口服止痛药、物理治疗等常规方法,针刺组在上述方法基础上加用董氏倒马针法,以倒马针直刺阳陵泉、阳交和绝骨三穴,每间隔10分钟运针1次,共计40分钟,每周5次,共4周,或总共20次。对照组按相同方法运用Park装置进行假针刺治疗。治疗2周、4周时观察患者康复效果,主要结局指标为疼痛视觉模拟评分法(VAS),次要结局指标为磁共振成像(magnetic resonance imaging,MRI)病情分级,其他结局指标为生活质量评估量表SF-12(包括躯体生活质量SF-12-PCS和心理生活质量SF-12-MCS),以及无痛跑步里程数。记录相关不良反应。结果:共招募青年MTSS跑步爱好者106例,剔除不符合入组条件者后,随机分入针刺组和对照组各44例。两组最终各有40例患者完成试验,干预保留率为91%,基线水平无显著性差异。治疗后2周和4周,针刺组VAS评分低于治疗前(P<0.05)且低于对照组(P<0.05);SF-12-PCS和SF-12-MCS评分高于治疗前(P<0.05)且高于对照组(P<0.05);无痛跑步里程高于治疗前(P<0.05)且高于对照组(P<0.05);MRI病情分级情况均较治疗前和对照组改善(P<0.05)。结论:董氏倒马针法可较好改善青年跑步爱好者胫骨内侧应力综合征的康复结局。

Objective To explore the therapeutic effect of Dong’s Reverse Horse Acupuncture Tech⁃nique(DRHAT)on the rehabilitation outcomes of youth runners with medial tibial stress syndrome(MTSS).Methods This was a single-center,randomized,controlled clinical trial conducted in 2021.Young MTSS runners who visited the outpatient clinic of a tertiary hospital were enrolled and random⁃ly divided into an acupuncture group and a control group,according to a random number table.Both groups received standard care,including rest,oral analgesics and physical therapy,while the acupunc⁃ture group underwent DRHAT additionally,which consisted of perpendicular needling at the Yan⁃glingquan,Yangjiao,and Juegu acupoints using the reverse horse technique.The needles were manipu⁃lated every 10 minutes over a total session duration of 40 minutes,five times per week for four con⁃secutive weeks or a cumulative total of 20 sessions.The control group received sham acupuncture us⁃ing a Park device for 2 weeks.Outcomes were assessed two and four weeks after the treatment.The primary outcome measurement was pain intensity evaluated by the Visual Analog Scale(VAS).The sec⁃ondary outcome measurements included MRI grading of the condition,while the other measurements covered the SF-12 Health Survey[including the Physical Component Summary(SF-12-PCS)and Mental Component Summary(SF-12-MCS)]and pain-free running mileage.Adverse reactions related to the in⁃terventions were also recorded.Results A total of 106 young MTSS patients were recruited,out of which 44 were randomly assigned to the acupuncture and control groups after exclusion,respectively.Ultimately,40 subjects from both groups completed the study,resulting in a retention rate of 91%.No significant differences were found between the two groups before the treatment.However,after two and four weeks of treatment,the acupuncture group demonstrated significantly lower VAS scores than before the treatment(P<0.05)and the control group at the same time point(P<0.05).Moreover,their SF-12-PCS and SF-12-MCS scores,as well as the pain-free running mileage were significantly high⁃er than before the treatment(P<0.05)and the control group at the same time point(P<0.05).Further⁃more,MRI grading of the condition improved in the acupuncture group compared to the control group after the intervention and before the treatment(P<0.05).Conclusion The application of DRHAT effec⁃tively enhances the rehabilitation outcomes in young runners with MTSS.