桃红四物汤联合电针及运动疗法治疗急性踝关节扭伤气滞血瘀证的效果

doi:10.3760/cma.j.cn441417-20250211-15025

摘要/Abstract

摘要：

目的　探讨桃红四物汤联合电针及运动疗法治疗急性踝关节扭伤气滞血瘀证的效果。方法　选取2023年1月至2024年9月延安市中医医院收治的120例急性踝关节扭伤患者作为研究对象。采用随机数字表法，将患者分为观察组和对照组，各60例。观察组男35例，女25例；年龄（40.32±7.65）岁；扭伤分级：Ⅰ度31例、Ⅱ度29例。对照组男31例，女29例；年龄（39.87±8.49）岁；扭伤分级：Ⅰ度30例、Ⅱ度30例。对照组采用常规运动疗法治疗，观察组在对照组基础上采用桃红四物汤联合电针治疗。两组均连续治疗2周。比较两组临床疗效，治疗前后踝关节周径和屈伸度、足踝功能和踝-后足功能［足踝功能量表-日常活动量表（FAAM-ADL）、足踝功能量表-运动量表（FAAM-S）、美国矫形外科足踝协会评分系统（AOFAS）］、中医证候积分、疼痛介质［神经肽Y（NPY）、神经生长因子（NGF）、前列腺素E2（PGE2）］，不良反应发生情况。采用独立样本t检验、配对t检验和χ²检验进行统计学分析。结果　观察组治疗总有效率高于对照组［96.67%（58/60）比86.67%（52/60）］（P<0.05）。治疗后，观察组踝关节周径小于对照组［（31.27±2.03）cm比（34.65±2.39）cm］，屈伸度大于对照组［（85.75±6.29）°比（76.38±6.43）°］（均P<0.05）；观察组FAAM-ADL、FAAM-S、AOFAS评分均高于对照组［（67.73±5.01）分比（62.18±5.24）分、（25.05±2.33）分比（21.57±1.84）分、（87.34±5.06）分比（83.23±5.37）分］（均P<0.05）；观察组中医证候积分（疼痛、肿胀、瘀斑、活动受限）均低于对照组（均P<0.05）；观察组血清NPY、NGF、PGE2水平均低于对照组（均P<0.05）。治疗期间，两组均未发生不良反应。结论　桃红四物汤联合电针及运动疗法治疗急性踝关节扭伤气滞血瘀证的效果较好，可促进关节功能恢复，降低疼痛介质水平。

关键词:

font-family:Calibri, font-size:10.5pt, "> font-size:9pt, ">急性踝关节扭伤；font-size:9pt, ">气滞血瘀证；font-size:9pt, ">运动疗法；font-size:9pt, ">电针；font-size:9pt, ">桃红四物汤；font-size:9pt, ">疼痛介质

Abstract:

Objective　To explore the efficacy of Taohong Siwu decoction combined with electroacupuncture and exercise therapy in the treatment of acute ankle sprain with qi stagnation and blood stasis syndrome. Methods　A total of 120 patients with acute ankle sprains who were admitted to Yan'an Traditional Chinese Medicine Hospital from January 2023 to September 2024 were selected as the research subjects. The patients were divided into the observation group and the control group by using the random number table method, with 60 cases in each group. There were 35 males and 25 females in the observation group, aged (40.32±7.65) years, sprain classification: grade Ⅰ in 31 cases, grade Ⅱ in 29 cases. There were 31 males and 29 females in the control group, aged (39.87±8.49) years, sprain classification: grade Ⅰ in 30 cases, grade Ⅱ in 30 cases. The control group received conventional exercise therapy, while the observation group received Taohong Siwu decoction combined with electroacupuncture in addition to the treatment methods of the control group. Both groups were treated continuously for 2 weeks. The clinical efficacy and occurrence of adverse reactions were compared between the two groups, as well as the ankle joint circumference and flexion/extension degree, foot-ankle function and ankle-hindfoot function [Foot and Ankle Ability Measure-Activities of Daily Living (FAAM-ADL), Foot and Ankle Ability Measure-Sports (FAAM-S), American Orthopedic Foot and Ankle Society Rating System (AOFAS)], traditional Chinese medicine syndrome scores, pain mediators [neuropeptide Y (NPY), nerve growth factor (NGF), prostaglandin E2 (PGE2)] before and after treatment. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　The total effective rate of treatment in the observation group was higher than that in the control group [96.67%(58/60) vs. 86.67%(52/60)] (P<0.05). After treatment, the ankle joint circumference of the observation group was smaller than that of the control group [(31.27±2.03) cm vs. (34.65±2.39) cm], and the ankle joint flexion/extension degree was greater than that of the control group [(85.75±6.29)° vs. (76.38±6.43)°] (both P<0.05); the scores of FAAM-ADL, FAAM-S, and AOFAS in the observation group were all higher than those in the control group [(67.73±5.01) points vs. (62.18±5.24) points, (25.05±2.33) points vs. (21.57±1.84) points, (87.34±5.06) points vs. (83.23±5.37) points] (all P<0.05); the scores of traditional Chinese medicine syndromes (pain, swelling, ecchymosis, and limited movement) in the observation group were all lower than those in the control group (all P<0.05); the levels of serum NPY, NGF, and PGE2 in the observation group were all lower than those in the control group (all P<0.05). During the treatment period, no adverse reactions occurred in either group. Conclusion　Taohong Siwu decoction combined with electroacupuncture and exercise therapy has a better effect in treating the syndrome of qi stagnation and blood stasis in acute ankle sprain. It can promote the recovery of joint function and reduce the levels of pain mediators.

Key words:

font-family:Calibri, font-size:10.5pt, "> font-size:9pt, ">Acute ankle sprain；Qi stagnation and blood stasis syndrome；Exercise therapy；Electroacupuncture；font-size:9pt, ">Taohong Siwufont-size:9pt, "> , decoction；Pain mediators

柳青姜宇郝龙.

桃红四物汤联合电针及运动疗法治疗急性踝关节扭伤气滞血瘀证的效果 [J]. 国际医药卫生导报, 2025, 31(15): 2592-2597.

Liu Qing, Jiang Yu, Hao Long.

The effect of Taohong Siwu decoction combined with electroacupuncture and exercise therapy in the treatment of acute ankle sprain with qi stagnation and blood stasis syndrome [J]. International Medicine and Health Guidance News, 2025, 31(15): 2592-2597.

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