摘要
目的:评价温灸疗法在促进行股神经阻滞(FNB)镇痛的全膝关节置换术(TKA)患者术后股四头肌肌力恢复中的临床疗效。方法:将174例膝骨关节炎(KOA)患者随机分为温灸组和康复组,每组87例。温灸组采用艾灸结合常规股四头肌力量训练,康复组采用常规股四头肌力量训练,温灸组每天艾灸梁丘和足三里穴2次,7 d为一疗程,共治疗2个疗程。分别于FNB术前24 h,术后24、48、72、96 h记录并比较两组患者股四头肌肌力,记录相同时间点的静息和运动视觉模拟量表(VAS)疼痛评分,并比较两组患者术后首次下地时间和首次直腿抬高时间,观察两组不良反应的发生情况。结果:FNB术后24、48、72、96 h温灸组股四头肌肌力均优于康复组(P<0.05,P<0.01);FNB术后72 h和96 h,温灸组静息和运动VAS评分低于康复组(均P<0.001);温灸组平均首次直腿抬高时间为术后(31.03?10.78)h,康复组为术后(47.23?15.78)h,差异有统计学意义(P<0.001);温灸组平均首次下地时间为术后(25.76?7.00)h,康复组为术后(33.12?11.18)h,差异亦有统计学意义(P<0.001)。两组均未发生相关不良反应。结论:温灸配合常规股四头肌力量训练能够改善全膝关节置换术后行股神经阻滞患者股四头肌无力症状,加快关节功能康复,优于单纯常规股四头肌力量训练。
Objective To evaluate the clinical efficacy of warm moxibustion therapy in the recovery of quadriceps muscle strength in patients undergoing total knee arthroplasty(TKA) with analgesia of the femoral nerve block(FNB). Methods A total of 174 patients with KOA were randomized into a warm moxibustion group and a rehabilitation group, 87 cases in each group. In the warm moxibustion group, warm moxibustion combined with conventional quadriceps strength training were used.In the rehabilitation group, conventional quadriceps strength training was given. The warm moxibustion was applied at Liangqiu(ST 34) and Zusanli(ST 36), the treatment was given twice a day, 7 days for one course, with a total of 2 courses.The quadriceps muscle strength of the two groups was recorded and compared at 24 h before FNB, 24, 48, 72 and 96 h after surgery, and the resting and exercise VAS pain scores were also recorded at the same time point. And the first time for standing up and the first straight raising time in the two groups were compared, and the occurrence of adverse reactions in the two groups were observed. Results At 24, 48, 72 and 96 h after FNB, the quadriceps muscle strength in the warm moxibustion group was better than that in the rehabilitation group(P<0.05, P<0.01). At 72 h and 96 h after FNB, the resting and exercise VAS scores of the warm moxibustion group were lower than those of the rehabilitation group(both P<0.001). The average first straight leg raising time in the warm moxibustion group was postoperative(31.03?10.78) h, and the time in the rehabilitation group was postoperative(47.23?15.78) h. The difference was statistically significant(P<0.001). The average time of the first time for standing up in the warm moxibustion group was postoperative(25.76?7.00) h, and postoperative(33.12?11.18) h in the rehabilitation group. The difference was also statistically significant(P<0.001). No adverse reactions occurred in both groups.Conclusion Warm moxibustion combined with conventional quadriceps strength training can improve the symptoms of quadriceps weakness in patients with femoral nerve block after total knee arthroplasty, and accelerate the recovery of joint function, which is superior to conventional quadriceps strength training.
作者
鞠昌军
周鑫
董程程
林乐琴
刘海宁
侯燕
JU Chang-jun;ZHOU Xin;DONG Cheng-cheng;LIN Le-qin;LIU Hai-ning;HOU Yan(Department of Joint,Wendeng Osteopathic Hospital,Weihai 264400,Shandong Province,ChinaDepartment of Anesthesiology,Wendeng Osteopathic Hospital,Weihai 264400,Shandong Province,China)
出处
《中国针灸》
CAS
CSCD
北大核心
2019年第3期276-280,共5页
Chinese Acupuncture & Moxibustion
关键词
股四头肌
肌力
艾灸
股神经阻滞
全膝关节置换术
quadriceps
muscle strength
moxibustion
femoral nerve block
total knee arthroplasty
