浮针疗法联合康复功能训练促进老年桡骨远端骨折保守治疗后早期功能康复:随机对照研究

Floating Needle Therapy Combined with Rehabilitation Functional TrainingPromotes Early Functional Recovery after Conservative Treatment ofDistal Radius Fractures in the Elderly: A Randomized Controlled Trial

目的:通过对浮针疗法联合康复功能训练在老年桡骨远端骨折保守治疗康复早期功能恢复的临床疗效观察,对联合治疗与患者自主康复功能训练、医师辅助下康复功能训练疗效进行对比分析,为老年桡骨远端骨折患者提供有明确疗效的康复方案。方法:将90例老年桡骨远端骨折保守治疗患者随机分为患者自主康复功能训练组、医师辅助下康复功能训练组和浮针联合康复功能训练组(各30例)。3组患者均在石膏外固定6周后拆除石膏第1天予以干预,浮针联合康复功能训练组患者行康复功能训练后再行浮针治疗,康复功能训练5次/周,浮针治疗3次/周,1次/2 d,共治疗30 d;自主康复功能训练组及医师辅助下康复功能训练组,均为5次/周,共治疗30 d。采用VAS评分、Cooney腕关节评分和Mtrp数量,分别于治疗前、治疗后第15天、30天和90天评价患侧疼痛及功能状态。结果:与治疗前比较,3组在治疗第15天、30天,VAS评分均降低、Cooney腕关节评分均升高与MTrP数量均减少,差异具有统计学意义(P<0.05),但联合组的改善程度明显优于自主及医师辅助康复功能训练组,差异具有统计学意义(P<0.05);治疗第90天随访与第30天比较,联合组VAS评分降低、Cooney腕关节评分升高与MTrP数量减少,差异具有统计学意义(P<0.05),医师辅助康复功能训练组仅Cooney腕关节评分升高,差异具有统计学意义(P<0.05),VAS评分、MTrP数量差异无统计学意义(P>0.05);联合组VAS评分改善程度优于医师辅助康复功能训练,差异具有统计学意义(P<0.05);而自主康复功能训练组比较差异无统计学意义(P>0.05)。结论:浮针疗法联合康复功能训练在缓解老年桡骨远端骨折短期及中期疼痛方面疗效显著,后期随访时显示联合疗法也能起到缓解疼痛的作用,但作用不如短期和中期效果明显,可见联合疗法有利于患肢早期功能康复。

Objective:Through clinical observation of the early functional recovery efficacy of floating needle therapy combined with rehabilitation functional training in the conservative treatment of distal radius fractures in the elderly,a comparative analysis was conducted on the efficacy of combined therapy versus patient self-rehabilitation and physician-assisted rehabilitation training.Methods:90 patients with conservative treatment of distal radius fractures were randomly divided into self-rehabilitation training group(group A),the physician-assisted rehabilitation training group(group B),and the floating needle therapy combined with rehabilitation functional training group(group C),with 30 patients in each group.All the three groups were intervened on the first day after 6 weeks of gypsum fixing.Group C was intervened by rehabilitation function training,followed by floating needle therapy,the rehabilitation function training was 5 times a week,and the floating needle therapy was once every other day,3 times a week;the treatment duration was 30 days.Group A and group B were treated 5 times per week for 30 days.The pain and the functional status on the affected side were evaluated by VAS scores,Cooney wrist joint scores and MTRP quantities before the treatment,and on the 15th,30th and 90th days after the treatment.Results:Compared with those before the treatment,the VAS score decreased,the Cooney wrist score increased,and the number of MTrPs decreased in all three groups on the 15th and 30th days of the treatment(P<0.05);of which the improvements were more significant in the group C than those in the group A and the group B(P<0.05).On the 90th day of the treatment than those on the 30th day of the treatment,group C showed a decrease in the VAS score,an increase in the Cooney wrist score,and a decrease in the number of MTrPs(P<0.05);group B only showed an increase in Cooney wrist score(P<0.05),but showed no statistical difference in the VAS score and the MTrP number(P>0.05);the improvement of the VAS score was more significant in the group C than that in the group B(P<0.05);however,there were statistical differences in the group A(P>0.05).Conclusion:The combination of floating needle therapy and rehabilitation functional training has a significant therapeutic effect on alleviating short-term and medium-term pain in the elderly patients with distal radius fractures.Subsequent follow-up shows that the combined therapy can also alleviate pain,but its effect is not as significant as the short-term and medium-term effects.It shows that the combined therapy is beneficial for early functional rehabilitation of affected limbs.