针刺联合关节松动手法应用于踝关节骨折术后患者的康复效果及对骨代谢指标和血清IL-1β、IL-8、MMP-13的影响

Rehabilitation Effect of Acupuncture Combined with Joint Loosening Manipulation on Patients with Ankle Fracture after Operation and its Effect on Bone Metabolism Indexes and Serum IL-1β,IL-8 and MMP-13

目的:观察针刺联合关节松动手法应用于踝关节骨折术后患者的康复效果及对骨代谢指标和血清白细胞介素(IL)-1β、IL-8、基质金属蛋白酶(MMP)-13的影响。方法:选取2020年3月~2023年3月期间在南方医科大学第三附属医院接受治疗的踝关节骨折患者138例。根据随机数字表法将患者分为对照组(接受常规康复训练联合关节松动手法治疗,n=69)和研究组(对照组基础上接受针刺治疗,n=69)。对比两组视觉模拟评分(VAS)、美国足踝外科协会(AOFAS)评分、踝关节背屈及跖屈活动度、血清IL-1β、IL-8、MMP-13及骨代谢指标[骨钙素(BGP)骨碱性磷酸酶(BALP)、β-胶原降解产物(β-CTX)]变化情况。结果:治疗1个月后,研究组VAS评分低于对照组,AOFAS评分高于对照组(P<0.05)。治疗1个月后,研究组背伸、跖屈活动度高于对照组(P<0.05)。治疗1个月后,研究组IL-1β、IL-8、MMP-13低于对照组(P<0.05)。治疗1个月后,研究组β-CTX低于对照组,BGP、BALP高于对照组(P<0.05)。结论:针刺联合关节松动手法应用于踝关节骨折术后患者,可有效减轻炎症因子水平和疼痛程度,促进踝关节功能改善和骨代谢。

Objective:To observe the rehabilitation effect of acupuncture combined with joint loosening manipulation on patients with ankle fracture after operation and its effect on bone metabolism indexes and serum interleukin(IL)-1β,IL-8 and matrix metalloproteinase(MMP)-13.Methods:138 patients with ankle fractures who were treated in the Third Affiliated Hospital of Southern Medical University from March 2020 to March 2023 were selected.Patients were divided into control group(receiving routine rehabilitation training combine with joint loosening manipulation,n=69)and study group(receiving acupuncture treatment on the basis of control group,n=69)according to the random number table method.The changes of visual analogue scale(VAS),American Orthopaedic Foot and Ankle Society(AOFAS)score,ankle dorsiflexion and plantar flexion activity,serum IL-1β,IL-8,MMP-13 and bone metabolism indexes[osteocalcin(BGP),bone alkaline phosphatase(BALP),β-collagen degradation products(β-CTX)]were compared between two groups.Result:1 month after treatment,the VAS score in study group was lower than that in control group,and the AOFAS score was higher than that in control group(P<0.05).1 month after treatment,the activity of dorsal extension and plantar flexion in study group were higher than those in control group(P<0.05).1 month after treatment,the levels of IL-1β,IL-8 and MMP-13 in study group were lower than those in control group(P<0.05).1 month after treatment,β-CTX in study group was lower than that in control group,BGP and BALP were higher than those in control group(P<0.05).Conclusion:The application of acupuncture combine with joint loosening manipulation on patients with ankle fracture after operation,which can effectively reduce the level of inflammatory factors and the degree of pain,and promote the improvement of ankle function and bone metabolism.