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电针疗法对膝关节骨折患者术后康复训练的临床研究OACSTPCDMEDLINE

Clinical study of electroacupuncture therapy on postoperative rehabilitation of patients with knee fractures

中文摘要英文摘要

目的:探究电针疗法对膝关节骨折患者术后康复训练的影响.方法:选取2020年7月至2021年7月膝关节骨折患者,按照双盲原则采用随机数字表法分为试验组和对照组.两组均给予手术治疗,术后均进行常规康复训练.对照组40例,男27例,女13例;年龄20~66(36.46±6.29)岁;术后采取持续被动运动(continuous passive motion,CPM)训练.试验组40例,男24例,女16例;年龄21~68(37.62±7.08)岁;在对照组基础上给予电针疗法.干预4周后,比较两组膝关节功能评分优良率,干预前后疼痛视觉模拟评分(visual analogue scale,VAS),采用酶联免疫吸附法检测血清疼痛介质:前列腺素E(prostaglandin E,PGE)、P物质(substance P,SP)、缓激肽(bradykinin,BK),关节活动范围及生活质量.结果:干预4周后,试验组膝关节功能Rasmussen评分(24.15±1.36)分,高于对照组(21.25±2.20)分(P<0.001);试验组干预4周后V AS(2.04±0.51)分,低于对照组(2.78±0.60)分(P<0.05);试验组干预4周后血清PGE(2.25±0.37)mg·L-1,SP(4.43±1.05)ng·ml-1,BK(2.67±0.68)ng·ml-1,低于对照组(3.91±0.44)mg·L-1,(6.12±1.37)ng·ml-1,(4.55±1.03)ng·ml-1(P<0.05);试验组干预4周后膝关节主动屈膝角度(108.63±9.76)°,主动伸膝角度(-2.46±0.70)°,被动屈膝角度(116.83±6.57)°,被动伸膝角度(1.44±0.38)°,优于对照组(100.24±8.15)°,(-3.51±0.86)°,(111.04±8.22)°,(0.78±0.24)°(P<0.05);干预4周后试验组心理评分(73.12±5.08)分,生理评分(72.26±5.89)分,社会功能评分(72.57± 4.23)分,总体健康评分(75.12±5.16)分,高于对照组(68.49±4.13)分,(68.13±5.27)分,(69.04±3.42)分,(70.88±3.97)分(P<0.05).结论:电针疗法辅助CPM训练应用于膝关节骨折术后可显著改善膝关节功能与活动范围,减轻疼痛程度,还可改善生活质量,降低不良事件发生率.

Objective To investigate the effect of electroacupuncture therapy on postoperative rehabilitation training of patients with knee fractures.Methods Patients with knee fractures from July 2020 to July 2021 were randomly assigned to ei-ther the experimental group or a control group according to the double-blind principle.Both groups were given surgical treat-ment and postoperative conventional rehabilitation training.There were 40 cases in the control group,including 27 males and 13 females;the age ranged from 20 to 66 years old with an average of(36.46±6.29)years old,continuous passive motion(CPM)training was performed after operation.There were 40 patients in the experimental group,including 24 males and 16 females.The age ranged from 21 to 68 years old with an average of(37.62±7.08)years old,on the basis of the control group,electroacupuncture was given.After 4 weeks of intervention,the excellent rate of knee function score,visual analogue scale(VAS)before and after intervention,serum pain mediators,prostaglandin E(PGE),substance P(SP),bradykinin(BK),joint range of motion and quality of life were compared between the two groups.Results After 4 weeks of intervention,the Ras-mussen score for knee function in the experimental group(24.15±1.36)scores was higher than that in the control group(21.25±2.20)scores(P<0.001).The VAS in the experimental group(2.04±0.51)scores was lower than that in the control group(2.78±0.60)after 4 weeks of intervention(P<0.05).Serum PGE(2.25±0.37)mg·L-1,SP(4.43±1.05)ng·ml-1,BK(2.67±0.68)ng·ml-1 in the experimental group were lower than those in the control group(3.91±0.44)mg·L-1,(6.12±1.37)ng·ml-1,(4.55±1.03)ng·ml-1 after4 weeks of intervention(P<0.05);in the experimental group,the active knee flexion angle of the knee joint was(108.63±9.76)°,the active knee extension angle(-2.46±0.70)°,passive knee flexion angle(116.83± 6.57)°,passive knee extension angle(1.44±0.38)° were better than control group(100.24±8.15)°,(-3.51±0.86)°,(111.04± 8.22)°,(0.78±0.24)°(P<0.05);the experimental group's psychological score(73.12±5.08),physiological score(72.26± 5.89),social function score(72.57±4.23),overall health score(75.12±5.16)were higher than that of the control group(68.49±4.13),(68.13±5.27),(69.04±3.42),and(70.88±3.97)respectvely(P<0.05).Conclusion Electroacupuncture com-bined with CPM training after knee fracture surgery can significantly improve knee function and range of motion,reduce pain levels,and also improve quality of life and reduce the incidence of adverse events.

李琼英;李思敏;杜金霞

四川大学华西医院康复医学中心四川大学华西护理学院,四川 成都 610041

临床医学

膝关节骨折电针疗法持续被动运动训练关节功能疼痛程度

Knee fractureElectroacupunctureContinuous passive exercise trainingJoint functionPain degree

《中国骨伤》 2024 (004)

368-373 / 6

成都重点科学技术研究项目计划(编号:2019SZ017)Chengdu Key Science and Technology Research Project Plan(No.2019SZ017)

10.12200/j.issn.1003-0034.20220156

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