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acupressure 疗法治疗急性踝关节扭伤:一项随机临床试验。

Acupressure Therapy for Acute Ankle Sprains: A Randomized Clinical Trial.

机构信息

Department of Orthopedics, Xixi Hospital of Hangzhou, Hangzhou, China.

Department of TCM Orthopedics, No. 60 Center Hospital of PLA, Dali, China.

出版信息

PM R. 2018 Jan;10(1):36-44. doi: 10.1016/j.pmrj.2017.06.009. Epub 2017 Jun 19.

Abstract

BACKGROUND

Ankle sprains occur frequently among young and active people, accounting for almost 2 million injuries per year. Previous reports suggest that acupressure therapy for acute ankle sprains may shorten the recovery time.

OBJECTIVE

To evaluate whether acupressure therapy can improve ankle sprain recovery compared with standard RICE (rest, ice, compression, and elevation) treatment.

DESIGN

A randomized controlled trial was conducted. The study protocol was registered in the Chinese Clinical Trial Registry with the study registration number: ChiCTR-TRC-14004794.

SETTING

Department of Traditional Chinese Medicine Orthopedics, PLA No.60 Center Hospital, Dali, China, and Department of Orthopedics, Xixi Hospital of Hangzhou, Hangzhou China, between June 2014 and January 2016.

PATIENTS

A total of 68 patients with acute ankle sprains were assessed for study eligibility, and a total of 62 patients were included in the present study.

METHODS

All patients with ankle sprains seen by the Orthopedics Department within 48 hours since the time of injury were identified. Consenting patients were randomized to either (1) standard treatment (ST group), (2) standard treatment + acupressure (AP group), or (3) standard treatment + mock acupressure (mock AP group).

MAIN OUTCOME MEASUREMENTS

Outcomes of interest included a volumetric measurement of the foot, ankle, and lower leg), range of ankle movement, and visual analog pain scores. The American Orthopedic Foot and Ankle Score) and SF12v2 scores were used to assess quality of life.

RESULTS

Among the 62 randomized patients, the mean (95% confidence interval [CI]) volumetric measurement of the foot, ankle, and lower leg in the AP group decreased from 185.24 (95% CI 142.80-227.67) to 62.14 (95% CI 44.03-80.25) after 3 sessions of acupressure treatment. This was a statistically significant difference (P < .01) compared with the means of ST group (119.00; 95% CI 89.14-148.86) and mock AP group (118.18; 95% CI 83.99-152.37). After the first treatment, the mean range of ankle movement, visual analog pain scores, and American Orthopedic Foot and Ankle Scores of the AP group were 31.67 (95% CI 27.78-35.55), 3.33 (95% CI 2.97-3.70), and 55.86 (95% CI 50.03-61.69), respectively. These scores were statistically better (P < .01) than the mean of the ST and mock AP group scores. In addition, the mean SF12v2 scores of AP group at 4 and 8 weeks were 109.95 (95% CI 107.29-112.62) and 119.67 (95% CI 119.27-120.05), respectively. These scores were also significantly greater than those of the ST group and mock AP groups (P < .01).

CONCLUSION

Acupressure therapy may improve recovery after acute ankle sprain injury, yielding shortened time of disability and improved quality of life.

LEVEL OF EVIDENCE

I.

摘要

背景

踝关节扭伤在年轻人和活跃人群中很常见,每年几乎有 200 万人受伤。先前的报告表明,急性踝关节扭伤的按压疗法可能会缩短康复时间。

目的

评估按压疗法是否能比标准的 RICE(休息、冰敷、加压和抬高)治疗更能改善踝关节扭伤的恢复情况。

设计

进行了一项随机对照试验。该研究方案在中国临床试验注册中心注册,注册号为 ChiCTR-TRC-14004794。

地点

中国大理解放军第 60 中心医院中医骨科和杭州西溪医院骨科,2014 年 6 月至 2016 年 1 月。

患者

共有 68 名急性踝关节扭伤患者接受了研究资格评估,共有 62 名患者纳入本研究。

方法

所有在受伤后 48 小时内到骨科就诊的踝关节扭伤患者均接受了评估。同意参加的患者被随机分为(1)标准治疗(ST 组)、(2)标准治疗+按压(AP 组)或(3)标准治疗+模拟按压(mock AP 组)。

主要观察指标

感兴趣的结果包括足部、踝关节和小腿的体积测量、踝关节活动范围和视觉模拟疼痛评分。美国骨科足踝协会评分和 SF12v2 评分用于评估生活质量。

结果

在 62 名随机患者中,AP 组在接受 3 次按压治疗后,足部、踝关节和小腿的平均(95%置信区间[CI])体积测量从 185.24(95%CI 142.80-227.67)减少到 62.14(95%CI 44.03-80.25)。与 ST 组(119.00;95%CI 89.14-148.86)和 mock AP 组(118.18;95%CI 83.99-152.37)相比,这是一个统计学上的显著差异(P <.01)。在第一次治疗后,AP 组的平均踝关节活动范围、视觉模拟疼痛评分和美国骨科足踝协会评分分别为 31.67(95%CI 27.78-35.55)、3.33(95%CI 2.97-3.70)和 55.86(95%CI 50.03-61.69)。这些评分均显著优于 ST 组和 mock AP 组的评分(P <.01)。此外,AP 组在 4 周和 8 周时的平均 SF12v2 评分分别为 109.95(95%CI 107.29-112.62)和 119.67(95%CI 119.27-120.05)。这些评分也明显高于 ST 组和 mock AP 组(P <.01)。

结论

按压疗法可能会改善急性踝关节扭伤后的恢复情况,缩短残疾时间,提高生活质量。

证据水平

I。

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