CAJ | 학술논문

目的：探讨动气针法在踝关节骨折术后中后期康复中的应用效果。方法：将60例踝关节骨折患者随机分为2组，每组30例，于术后中后期分别采用动气针法和中频电疗法进行康复治疗。分别于治疗前和治疗15 d 后记录并比较2组患者踝关节疼痛视觉模拟评分（visual analogue score，VAS）和 Mazur 踝关节功能评分，并于治疗15 d 后比较2组患者的临床疗效。结果：治疗前2组患者的踝关节 VAS 评分及 Mazur 踝关节功能评分比较，组间差异均无统计学意义[（6．83±1．68）分，（6．33±1．53）分， t ＝－1．201，P ＝0．235；（4．03±1．07）分，（4．07±1．55）分，t ＝－0．085，P ＝0．932]。治疗15 d 后，2组患者的踝关节 VAS 评分较治疗前均降低[（3．90±1．94）分，（6．83±1．68）分，t ＝－4．853，P ＝0．000；（2．30±1．44）分，（6．33±1．53）分，t ＝－4．818，P ＝0．000]，而 Mazur 踝关节功能评分较治疗前均升高[（5．50±1．66）分，（4．03±1．07）分，t ＝－1．981，P ＝0．048；（6．60±1．23）分，（4．07±1．55）分，t ＝－2．067，P ＝0．039]；动气针法组踝关节 VAS 评分下降幅度及 Mazur 踝关节功能评分升高幅度均大于中频电疗组[（4．03±1．22）分，（2．93±1．72）分，t ＝3．561，P ＝0．001；（2．53±0．78）分，（1．47±0．73）分，t ＝2．375，P ＝0．011]。按照Mazur 踝关节评分系统评价疗效，动气针法组优4例、良11例、可12例、差3例，中频电疗组优1例、良6例、可16例、差7例，动气针法组的临床疗效优于中频电疗组（Z ＝－2．209，P ＝0．022）。结论：在踝关节骨折术后中后期采用动气针法进行康复治疗，可以缓解踝关节疼痛，改善踝关节功能，康复效果确切，值得临床推广应用。
목적：탐토동기침법재과관절골절술후중후기강복중적응용효과。방법：장60례과관절골절환자수궤분위2조，매조30례，우술후중후기분별채용동기침법화중빈전요법진행강복치료。분별우치료전화치료15 d 후기록병비교2조환자과관절동통시각모의평분（visual analogue score，VAS）화 Mazur 과관절공능평분，병우치료15 d 후비교2조환자적림상료효。결과：치료전2조환자적과관절 VAS 평분급 Mazur 과관절공능평분비교，조간차이균무통계학의의[（6．83±1．68）분，（6．33±1．53）분， t ＝－1．201，P ＝0．235；（4．03±1．07）분，（4．07±1．55）분，t ＝－0．085，P ＝0．932]。치료15 d 후，2조환자적과관절 VAS 평분교치료전균강저[（3．90±1．94）분，（6．83±1．68）분，t ＝－4．853，P ＝0．000；（2．30±1．44）분，（6．33±1．53）분，t ＝－4．818，P ＝0．000]，이 Mazur 과관절공능평분교치료전균승고[（5．50±1．66）분，（4．03±1．07）분，t ＝－1．981，P ＝0．048；（6．60±1．23）분，（4．07±1．55）분，t ＝－2．067，P ＝0．039]；동기침법조과관절 VAS 평분하강폭도급 Mazur 과관절공능평분승고폭도균대우중빈전료조[（4．03±1．22）분，（2．93±1．72）분，t ＝3．561，P ＝0．001；（2．53±0．78）분，（1．47±0．73）분，t ＝2．375，P ＝0．011]。안조Mazur 과관절평분계통평개료효，동기침법조우4례、량11례、가12례、차3례，중빈전료조우1례、량6례、가16례、차7례，동기침법조적림상료효우우중빈전료조（Z ＝－2．209，P ＝0．022）。결론：재과관절골절술후중후기채용동기침법진행강복치료，가이완해과관절동통，개선과관절공능，강복효과학절，치득림상추엄응용。
Objective:To explore the effect of Dongqi acupuncture(动气针法)on postoperative rehabilitation in the middle-late period in patients with ankle joint fractures.Methods:Sixty patients with ankle joint fractures were randomly divided into 2 groups,30 cases in each group.The patients were treated with Dongqi acupuncture and medium-frequency electrotherapy respectively for ankle rehabilitation in the middle-late period after surgery.The ankle pain visual analogue score(VAS)and Mazur ankle function score were recorded and com-pared between the 2 groups before the treatment and after 15 -day treatment,and the clinical curative effects was also compared between the 2 groups after 15 -day treatment.Results:There was no statistical difference in ankle VAS score and Mazur ankle function score be-tween the 2 groups before the treatment(6.83 +/-1.68 vs 6.33 +/-1.53 points,t =-1.201,P =0.235;4.03 +/-1.07 vs 4.07 +/-1.55 points,t =-0.085,P =0.932).The ankle VAS score decreased while the Mazur ankle function score increased in both of the 2 groups af-ter 15 -day treatment(3.90 +/-1.94 vs 6.83 +/-1.68 points,t =-4.853,P =0.000;2.30 +/-1.44 vs 6.33 +/-1.53 points, t =-4.818,P =0.000;5.50 +/-1.66 vs 4.03 +/-1.07 points,t =-1.981,P =0.048;6.60 +/-1.23 vs 4.07 +/-1.55 points, t =-2.067,P =0.039).The decreased ankle VAS score and the increased Mazur ankle function score were greater in Dongqi acupuncture group than in medium -frequency electrotherapy group(4.03 +/-1.22 vs 2.93 +/-1.72 points,t =3.561,P =0.001;2.53 +/-0.78 vs 1.47 +/-0.73 points,t =2.375,P =0.011).According to Mazur evaluation criteria for ankle function,Four patients obtained an excellent result,11 good,12 fair and 3 poor in the Dongqi acupuncture group;while 1 patients obtained an excellent result,6 good,16 fair and 7 poor in the medium-frequency electrotherapy group.The Dongqi acupuncture group surpassed the medium-frequency electrotherapy group in the total curative effect(Z =-2.209,P =0.022).Conclusion:Dongqi acupuncture can relieve ankle pain and improve ankle function in the middle -late period after the surgery for ankle fractures,and it is worthy of popularizing in clinic for its reliable rehabilitative effect.