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电针辅助治疗桡骨远端骨折术后愈合的疗效:一项随机对照试验的研究方案。

Efficacy of electroacupuncture in assisting postoperative healing of distal radius fractures: study protocol for a randomized controlled trial.

机构信息

School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.

Department of Traditional Chinese Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China.

出版信息

J Orthop Surg Res. 2022 Dec 1;17(1):517. doi: 10.1186/s13018-022-03415-8.

DOI:10.1186/s13018-022-03415-8
PMID:36456969
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9713955/
Abstract

BACKGROUND

Manual reduction and surgical treatment are common methods for distal radius fractures (DRFs). The existing literature suggests that postoperative combined rehabilitation treatment and medication are effective for the healing of DRFs. However, the side effects of these treatments remain to be solved. Previous studies have shown that electroacupuncture (EA) can effectively relieve wrist swelling and improve the joint function in patients with DRFs, but more evidence is needed to prove the effectiveness of EA. This trial aims to explore the efficiency and feasibility of combined EA treatment in postoperative treatment of DRFs compared with routine treatment.

METHODS

This is a parallel randomized controlled trial. A total of 222 patients diagnosed with moderate DRFs will be recruited and randomly assigned to an EA group or a routine treatment group at a ratio of 1:1. Routine treatment group will receive medication and rehabilitation. Yangxi (LI 5), Yangchi (TE 4), Yanggu (SI 5), Hegu (LI 4), and Taiyuan (LU 9) will be selected in the EA group for intervention three times a week on the basis of routine treatment. Both groups will receive 8 weeks of treatment and 4 weeks of follow-up. The primary outcome will be ulnar positive variance. The secondary outcomes will include radiographic healing rate, bone strength, hemorheological indices, serum biochemical indicators and inflammatory factors, grip strength, wrist swelling score, patient-rated wrist evaluation, disabilities of arm, shoulder and hand, and visual analogue scale. Outcomes will be evaluated at baseline, postoperative 3rd day, 2nd, 4th, 6th, 8th, and 12th weeks.

DISCUSSION

The results of this study will help establish a more optimized scheme to treat patients with DRFs. Trial registration Chinese Clinical Trial Registry ChiCTR2200062857. Registered on 21 August 2022, www.chictr.org.cn/com/25/showproj.aspx?proj=175567 .

摘要

背景

手法复位和手术治疗是桡骨远端骨折(DRF)的常见方法。现有文献表明,术后联合康复治疗和药物治疗对 DRF 的愈合有效。然而,这些治疗方法的副作用仍有待解决。既往研究表明,电针(EA)可有效缓解腕部肿胀,改善 DRF 患者的关节功能,但需要更多证据证明 EA 的有效性。本试验旨在探讨与常规治疗相比,术后联合 EA 治疗 DRF 的效率和可行性。

方法

这是一项平行随机对照试验。共纳入 222 例中度 DRF 患者,按 1:1 比例随机分为 EA 组和常规治疗组。常规治疗组接受药物和康复治疗。在常规治疗的基础上,EA 组每周选择阳溪(LI5)、阳池(TE4)、阳谷(SI5)、合谷(LI4)和太渊(LU9)进行 3 次干预。两组均接受 8 周治疗和 4 周随访。主要结局指标为尺偏阳性方差。次要结局指标包括影像学愈合率、骨强度、血液流变学指标、血清生化指标和炎症因子、握力、腕部肿胀评分、患者腕部评价、上肢肩手残疾、视觉模拟评分。在基线、术后第 3 天、第 2、4、6、8 和 12 周进行评估。

讨论

本研究结果将有助于建立更优化的方案来治疗 DRF 患者。

试验注册

中国临床试验注册中心 ChiCTR2200062857。注册于 2022 年 8 月 21 日,www.chictr.org.cn/com/25/showproj.aspx?proj=175567。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15a/9713955/6e63035e8710/13018_2022_3415_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15a/9713955/6f3528f61095/13018_2022_3415_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15a/9713955/6e63035e8710/13018_2022_3415_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15a/9713955/6f3528f61095/13018_2022_3415_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15a/9713955/6e63035e8710/13018_2022_3415_Fig2_HTML.jpg

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本文引用的文献

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Medicine (Baltimore). 2021 Nov 24;100(47):e27951. doi: 10.1097/MD.0000000000027951.
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Acupuncture combined with TCM bonesetting in the treatment of distal radius fractures: A protocol for systematic review and meta-analysis.针刺结合中医正骨治疗桡骨远端骨折:系统评价和荟萃分析方案。
Medicine (Baltimore). 2021 Dec 17;100(50):e28279. doi: 10.1097/MD.0000000000028279.
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Acupuncture around the greater tuberosity of the femur combined with acupuncture at Xuehai acupoint alleviates the postoperative pain of elderly patients with intertrochanteric fracture.
股骨大转子周围针刺结合血海穴针刺可减轻老年股骨转子间骨折患者术后疼痛。
Am J Transl Res. 2021 Jul 15;13(7):8372-8378. eCollection 2021.
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Effect of acupuncture combined with early rehabilitation training on postoperative dysfunction and quality of life of patients undergoing total knee arthroplasty.针刺联合早期康复训练对全膝关节置换术患者术后功能障碍及生活质量的影响
Am J Transl Res. 2021 Jun 15;13(6):6407-6414. eCollection 2021.
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What Are the Tradeoffs in Outcomes after Casting Versus Surgery for Closed Extraarticular Distal Radius Fractures in Older Patients? A Statistical Learning Model.老年患者闭合性关节外桡骨远端骨折行石膏固定与手术治疗的结局权衡是什么?一项统计学习模型研究。
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