补肾愈骨方辅助治疗肝肾不足、筋脉失养证慢性踝关节外侧不稳术后功能康复患者20例回顾性队列研究

Bushen Yugu Formula(补肾愈骨方)for Postoperative Functional Rehabilitation of Patients with Chronic Lateral Ankle Instability with Syndrome of Liver-Kidney Insufficiency and Sinews-Vessels Deprived of Nourishment:A Retrospective Cohort Study

目的分析补肾愈骨方辅助治疗肝肾不足、筋脉失养证慢性踝关节外侧不稳(CLAI)术后功能康复患者的有效性及安全性。方法回顾性收集40例接受外踝韧带修复手术治疗的肝肾不足、筋脉失养证CLAI患者的临床资料。根据是否服用补肾愈骨方分为治疗组和对照组各20例,对照组患者术后进行功能康复,治疗组在此基础上于术后第3、4周服用补肾愈骨方汤剂。分别于术前、术后3个月记录患者术侧踝关节美国足踝协会(AOFAS)量表评分,术侧踝关节屈伸活动度、内外翻活动度,术侧踝关节磁共振影像学评分,中医证候评分。检测患者术前及术后4周的肝肾功能,并记录治疗期间不良事件。结果与术前比较,两组患者术后3个月AOFAS量表评分升高、中医证候评分均降低(P<0.01),治疗组术侧踝关节内外翻活动度、影像学评分均升高(P<0.05或P<0.01),对照组术侧踝关节屈伸活动度降低(P<0.05)。术后3个月,治疗组AOFAS量表评分高于对照组,中医证候评分低于对照组(P<0.05或P<0.01)。治疗组报告胃肠道反应2例,停药后自行缓解,肝肾功能指标未见异常。结论补肾愈骨方可以促进肝肾不足、筋脉失养证CLAI患者术后踝关节功能康复,改善临床症状,且安全性较好。

Objective To investigate the effectiveness and safety of Bushen Yugu Formula(补肾愈骨方)promot⁃ing postoperative functional rehabilitation of patients with chronic lateral ankle instability(CLAI)with syndrome of liver-kidney insufficiency and sinews-vessels deprived of nourishment.Methods Clinical data were retrospectively collected from 40 patients with CLAI with syndrome of liver-kidney insufficiency and sinews-vessels deprived of nourishment who underwent external ankle ligament repair surgery.They were divided into 20 cases each in the treatment group and control group according to whether or not they took Bushen Yugu Formula;patients in the control group un⁃derwent postoperative functional rehabilitation,while patients in the treatment group took Bushen Yugu Formula in the 3rd and 4th postoperative weeks combined with the rehabilitation.The American Orthopaedic Foot and Ankle Society(AOFAS)scores,the flexion/extension and internal/external rotation,the imaging scores of the ankle joint on the operated side and the traditional Chinese medicine(TCM)syndrome scores were recorded in the preoperative and 3-month postoperative,respectively.The patients'liver and kidney functions were tested in the preoperative and 4-month postoperative,and adverse events during treatment were recorded.Results Compared with the preoperative period,the AOFAS scores were higher and the TCM syndrome scores were lower in both groups 3 months after surgery(P<0.01),and the ankle internal and external rotation mobility and imaging scores were higher in the treatment group(P<0.05 or P<0.01),and ankle flexion/extension mobility was lower in the control group(P<0.05).At 3 months after surgery,the AOFAS score was higher in the treatment group than in the control group,and the TCM syn⁃drome score was lower than in the control group(P<0.05 or P<0.01).Two cases of gastrointestinal reactions were reported in the treatment group,which relieved on their own after stopping the formula,and no abnormality was observed in liver and kidney function indexes.Conclusion Bushen Yugu Formula can promote functional rehabilita⁃tion of ankle joint and improve clinical symptoms in CLAI patients with syndrome of liver-kidney insufficiency and sinews-vessels deprived of nourishment,and it shows a good safety.