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宁兴明, 刘峻宏, 刘亮, 巫宗德, 鲍沁蔚, 穆昕, 魏国华.郑氏伤科1号熏洗汤联合推拿手法对踝关节骨折患者术后疼痛症状及足踝部功能的改善作用[J].湖南中医药大学学报英文版,2025,45(12):2427-2434.[Click to copy
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| 郑氏伤科1号熏洗汤联合推拿手法对踝关节骨折患者术后疼痛症状及足踝部功能的改善作用 |
| 宁兴明,刘峻宏,刘亮,巫宗德,鲍沁蔚,穆昕,魏国华 |
| (四川省骨科医院足踝1科, 四川 成都 610000) |
| 摘要: |
| 目的 探究郑氏伤科1号熏洗汤联合推拿手法对踝关节骨折患者术后疼痛症状及足踝部功能的改善作用。方法 将2018年5月至2022年5月在四川省骨科医院接受切开复位内固定术治疗的192例踝关节骨折患者按随机数字表法分为对照组、熏洗汤组、推拿手法组及联合组，每组48例。对照组仅行常规康复训练；熏洗汤组在对照组基础上行郑氏伤科1号熏洗汤治疗，推拿手法组在对照组基础上行推拿手法治疗，联合组使用郑氏伤科1号熏洗汤联合推拿手法治疗，每组疗程均为1个月。比较4组患者治疗前后的视觉模拟量表（VAS）评分、美国矫形足踝协会（AOFAS）评分、踝关节肿胀值、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、碱性磷酸酶（ALP）、骨钙素（BGP）、肌电值、中医证候积分、临床疗效和不良反应。结果 与治疗前比较，治疗后对照组、推拿手法组、熏洗汤组和联合组VAS评分、肿胀值、IL-1β、TNF-α、ALP、中医证候各项积分及总分均降低（P＜0.05），AOFAS评分、BGP、胫骨前肌肌电值、腓骨长肌肌电值均升高（P＜0.05）。与对照组比较，推拿手法组、熏洗汤组和联合组VAS评分、肿胀值、IL-1β、TNF-α、ALP、中医证候各项积分及总分均降低（P＜0.05），AOFAS评分、BGP、胫骨前肌肌电值、腓骨长肌肌电值及临床疗效均升高（P＜0.05）。与推拿手法组、熏洗汤组比较，联合组VAS评分、肿胀值、IL-1β、TNF-α、ALP、中医证候各项积分及总分均降低（P＜0.05），AOFAS评分、BGP、胫骨前肌肌电值、腓骨长肌肌电值及临床疗效升高（P＜0.05）。4组不良反应比较，差异无统计学意义（P＞0.05）。结论 郑氏伤科1号熏洗汤联合推拿手法在踝关节骨折患者术后康复中可有效缓解患者术后疼痛、肿胀症状，改善踝关节功能、肌群收缩性与协调性，有利于术后康复。 |
| 关键词: 踝关节骨折 推拿手法治疗 郑氏伤科1号熏洗汤 美国矫形足踝协会评分 足踝部功能 |
| DOI：10.3969/j.issn.1674-070X.2025.12.027 |
| Received:July 30, 2025 |
| 基金项目:四川省中医药管理局科学技术研究专项课题（2020LC0184）。 |
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| Improvement effects of ZHENG’s Traumatology No.1 Fumigation-Washing Decoction combined with tuina manipulation on postoperative pain symptoms as well as foot and ankle function in patients with ankle fractures |
| NING Xingming, LIU Junhong, LIU Liang, WU Zongde, BAO Qinwei, MU Xin, WEI Guohua |
| (Department 1 of Foot and Ankle, Sichuan Province Orthopedic Hospital, Chengdu, Sichuan 610000, China) |
| Abstract: |
| Objective To investigate the improvement effects of ZHENG's Traumatology No.1 Fumigation-Washing Decoction combined with tuina manipulation on postoperative pain symptoms as well as foot and ankle function in patients with ankle fractures. Methods A total of 192 patients with ankle fractures who underwent open reduction and internal fixation in Sichuan Province Orthopedic Hospital from May 2018 to May 2022 were randomly divided into control group, fumigation-washing decoction group, tuina manipulation group, and combination group, with 48 patients in each group. The control group received only conventional rehabilitation training. The fumigation-washing decoction group received ZHENG's Traumatology No.1 Fumigation-Washing Decoction in addition to the control group's regimen. The tuina manipulation group received tuina manipulation in addition to the control group's regimen. The combination group received both ZHENG's Traumatology No. 1 Fumigation-Washing Decoction and tuina manipulation. The treatment course for each group was one month. Comparisons were made among the four groups in terms of Visual Analogue Scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, ankle swelling value, interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), alkaline phosphatase (ALP), bone Gla protein (BGP), electromyographic (EMG) value, TCM pattern score, clinical efficacy, and adverse reactions before and after treatment. Results Compared with before treatment, the VAS score, swelling value, IL-1β, TNF-α, ALP, and individual and total TCM pattern scores in the control, tuina manipulation, fumigation-washing decoction, and combination groups all decreased after treatment (P<0.05), while the AOFAS score, BGP, tibialis anterior EMG value, and peroneus longus EMG value all increased (P<0.05). Compared with the control group, the tuina manipulation, fumigation-washing decoction, and combination groups exhibited lower VAS score, swelling value, IL-1β, TNF-α, ALP, and individual and total TCM pattern scores (P<0.05), and higher AOFAS score, BGP, tibialis anterior EMG value, peroneus longus EMG value, and clinical efficacy (P<0.05). Compared with the tuina manipulation and fumigation-washing decoction groups, the combination group showed decreased VAS score, swelling value, IL-1β, TNF-α, ALP, and individual and total TCM pattern scores (P<0.05), and increased AOFAS score, BGP, tibialis anterior EMG value, peroneus longus EMG value, and clinical efficacy (P<0.05). There was no statistically significant difference in adverse reactions among the four groups (P>0.05). Conclusion In the postoperative rehabilitation of patients with ankle fractures, ZHENG's Traumatology No.1 Fumigation-Washing Decoction combined with tuina manipulation can effectively alleviate postoperative pain and swelling, improve ankle function, and promote muscle contraction and coordination, which is beneficial for postoperative recovery. |
| Key words: ankle fractures tuina manipulation ZHENG's Traumatology No.1 Fumigation-Washing Decoction American Orthopaedic Foot and Ankle Society score foot and ankle function |
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