CAJ | 학술논문

目的：观察复式针刺补泻对臀大肌挛缩术后患者运动步态髋、膝关节屈伸角度的影响。方法：将66例臀大肌挛缩术后患者按随机数字表分为两组，每组33例。观察组在康复治疗基础上，予针刺患侧秩边、环跳、居髎，行透天凉泻法；患侧髀关、伏兔、足三里、丰隆、血海、地机、阳陵泉，行烧山火补法。对照组仅予与观察组相同的基础康复治疗。每日治疗1次，30天为1个疗程，连续治疗3个疗程，疗程间休息1星期。使用Lokomat全自动机器人步态评定系统对患者进行运动步态髋、膝关节的屈伸角度测定。结果：观察组患者髋关节屈曲角度值(HFA-FF)、髋关节屈曲角度最大值(MAX-HFA)、髋关节伸展角度最大值(MAX-HEA)、膝关节屈曲角度值(KFA-FF)、支撑相膝关节屈曲角度最大值(MAX-KFA-TP)、摆动相膝关节屈曲角度最大值(MAX-KFA-WP),及对照组患者髋关节屈曲角度值(HFA-FF)、髋关节伸展角度最大值(MAX-HEA)和膝关节屈曲角度值(KFA-FF)与治疗前均有统计学差异(P＜0.05)。观察组髋关节屈曲角度值(HFA-FF)、髋关节屈曲角度最大值(MAX-HFA)、髋关节伸展角度最大值(MAX-HEA)、膝关节屈曲角度值(KFA-FF)及支撑相膝关节屈曲角度最大值(MAX-KFA-TP)与对照组差异有统计学意义(P＜0.05)。结论：复式针刺补泻可提高臀大肌挛缩术后髋、膝关节功能，改善步态运动。
목적：관찰복식침자보사대둔대기련축술후환자운동보태관、슬관절굴신각도적영향。방법：장66례둔대기련축술후환자안수궤수자표분위량조，매조33례。관찰조재강복치료기출상，여침자환측질변、배도、거료，행투천량사법；환측비관、복토、족삼리、봉륭、혈해、지궤、양릉천，행소산화보법。대조조부여여관찰조상동적기출강복치료。매일치료1차，30천위1개료정，련속치료3개료정，료정간휴식1성기。사용Lokomat전자동궤기인보태평정계통대환자진행운동보태관、슬관절적굴신각도측정。결과：관찰조환자관관절굴곡각도치(HFA-FF)、관관절굴곡각도최대치(MAX-HFA)、관관절신전각도최대치(MAX-HEA)、슬관절굴곡각도치(KFA-FF)、지탱상슬관절굴곡각도최대치(MAX-KFA-TP)、파동상슬관절굴곡각도최대치(MAX-KFA-WP),급대조조환자관관절굴곡각도치(HFA-FF)、관관절신전각도최대치(MAX-HEA)화슬관절굴곡각도치(KFA-FF)여치료전균유통계학차이(P＜0.05)。관찰조관관절굴곡각도치(HFA-FF)、관관절굴곡각도최대치(MAX-HFA)、관관절신전각도최대치(MAX-HEA)、슬관절굴곡각도치(KFA-FF)급지탱상슬관절굴곡각도최대치(MAX-KFA-TP)여대조조차이유통계학의의(P＜0.05)。결론：복식침자보사가제고둔대기련축술후관、슬관절공능，개선보태운동。
Objective: To observe the effect of complex reinforcing-reducing manipulations of acupuncture on flexion and extension angles of hip and knee in patients after surgical treatment of gluteus maximus contracture. <br> Methods: A total of 66 cases following surgery of gluteus maximus contracture were randomly allocated into an observation group and a control group by the random digits table, 33 in each group. In addition to basic treatment, cases in the observation group were treated with reducing manipulation [Tou T ian Liang (Heaven-penetrating Cooling)] on Zhibian (BL 54), Huantiao (GB 30) and Juliao (GB 29) on the affected side and reinforcing manipulation [Shao Shan Huo (Mountain-burning Fire)] on Biguan (ST 31), Futu (ST 32), Zusanli (ST 36), Fenglong (ST 40), Xuehai (SP 10), Diji (SP 8) and Yanglingquan (GB 34). Patients in the control group only received the same basic treatment as the observation group. The treatment was done once a day, 30 d for a course and a 1-week interval between two courses. Then the flexion and extension angles of hip and knee were evaluated using the Lokomat full automatic robot gait evaluation system after 3 courses of treatment. <br> Results:There were intra-group statistical differences in hip flexion angle on foot followed (HFA-FF), the maximum of hip flexion angle (MAX-HFA), the maximum of hip extension angle (MAX-HEA), knee flexion angle on foot followed (KFA-FF), the maximum of knee flexion angle on stance phase (MAX-KFA-TP) and the maximum of knee flexion angle on swing phase (MAX-KFA-WP) in the observation group and in HFA-FF, MAX-HEA and KFA-FF in the control group (P<0.05). There were between-group statistical differences in HFA-FF, MAX-HFA, MAX-HEA, KFA-FF and MAX-KFA-TP (P<0.05). <br> Conclusion: The complex reinforcing-reducing manipulations of acupuncture can effectively improve the hip/knee functions following surgery of gluteus maximus contracture.