Zhao Yong, Dong Qing-Qing, Qin Wei-Kai, Yan An, Zhang Kuan, Zhao Guo-Dong, Wang Gang, Geng Jin-Chao, Wang Zhan-Feng, Lu Ze-Ming
Wangjing Hospital of China Academy of Chinese Medical Science, Beijing 100102, China;
Wangjing Hospital of China Academy of Chinese Medical Science, Beijing 100102, China.
Zhongguo Gu Shang. 2017 Jan 25;30(1):42-46. doi: 10.3969/j.issn.1003-0034.2017.01.010.
To evaluate efficacy and advantages of the Traditional Chinese Medicine (TCM) synthetic rehabilitation therapy in the treatment of wrist dysfunction after distal radius fractures.
From May 2014 to October 2015, 72 patients with distal radius fracture meeting standards were treated using central randomization system for clinical research. All the patients were divided into two groups: 36 patients in test group and 36 in control group. Sixty-nine cases were finished treatment and followed up in the end. The test group fell off 1 case, and the control group fell off 2 cases. The test group was given TCM synthetic rehabilitation (manipulative therapy, joint mobilization, soaking-washing with Chinese medicinal herbs, functional exercise), and the control group was given functional exercise as well as soaking-washing with Chinese medicinal herbs, 3 weeks for both. Five evaluation standards were used in this research, which were grip strength, patient-rated wrist evaluation (PRWE), Gartland and Werley wrist score, self-rating anxiety scale(SAS) and the overall curative effect evaluation. Before treatment(baseline), after 3 weeks of treatment and 3 months after fracture were the three points in time when collected the data.
After 3 weeks of treatment and 3 months after fracture, the test group had a significantly better results than those of control group in the PRWE, G-W wrist score and the overall curative effect evaluation(<0.05). In terms of grip strength recovery, after 3 weeks of treatment, the intergroup difference between the test group and the control group were statistically significant relative to the baseline regarding grip strength of ipsilateral wrist by group t-test(<0.05). However, the test group and the control group had no statistically significant relative to the baseline at 3 months after fracture in grip strength(<0.05). For the anxiety of patients, compared with the test group and control group at before and after rehabilitation treatment, the anxiety of both test group and control group cases was eased(<0.05). However, The degree of anxiety relief in test group and control group cases had no difference(>0.05).
The TCM synthetic rehabilitation therapy has better curative effects on the treatment of functional disability of wrist joints after distal radius fractures than the general therapy of soaking-washing with Chinese medicinal herbs and functional exercise.
评估中医综合康复疗法治疗桡骨远端骨折后腕关节功能障碍的疗效及优势。
2014年5月至2015年10月，采用临床研究中央随机系统对72例符合标准的桡骨远端骨折患者进行治疗。所有患者分为两组：试验组36例，对照组36例。最终完成治疗并随访69例。试验组脱落1例，对照组脱落2例。试验组给予中医综合康复治疗（手法治疗、关节松动术、中药熏洗、功能锻炼），对照组给予功能锻炼及中药熏洗，均为3周。本研究采用5项评价标准，分别为握力、患者自评腕关节评价（PRWE）、Gartland和Werley腕关节评分、自评焦虑量表（SAS）及总体疗效评价。治疗前（基线）、治疗3周后及骨折后3个月为采集数据的3个时间点。
治疗3周后及骨折后3个月，试验组在PRWE、G-W腕关节评分及总体疗效评价方面均明显优于对照组（<0.05）。在握力恢复方面，治疗3周后，试验组与对照组同侧腕关节握力与基线相比组间差异有统计学意义（<0.05）。然而，骨折后3个月试验组与对照组握力与基线相比无统计学意义（<0.05）。对于患者的焦虑情况，试验组和对照组康复治疗前后相比，两组患者焦虑均减轻（<0.05）。然而，试验组和对照组患者焦虑缓解程度无差异（>0.05）。
中医综合康复疗法治疗桡骨远端骨折后腕关节功能障碍的疗效优于单纯中药熏洗及功能锻炼的常规疗法。
