目的 探讨股四头肌筋膜手法治疗胫骨疲劳性骨膜炎的临床疗效。方法 选择2022-09至2023-06在武警某训练基地进行集训的新兵且发生胫骨疲劳性骨膜炎患者90例为研究对象,采用随机数字表法分为筋膜手法组和对照组,筋膜手法组采用筋膜手法处理患侧股四头肌,对照组采用常规治疗方法(膏药配合电磁波治疗仪)进行治疗。两组均1次/d治疗,5次为1个疗程,休息2 d后开始下1个疗程,共治疗2个疗程。分别于治疗前、治疗2个疗程后对两组进行数字评价量表(NRS)评分、胫骨前肌肌肉状态检测及比较,并对两组的疗效进行分析。结果 与治疗前比较,治疗2个疗程后筋膜手法组NRS评分由(5.18±0.91)分降至(1.31±0.73)分,对照组NRS评分由(5.24±0.93)分降至(1.16±0.82)分,差异均有统计学意义(P<0.05);但治疗后两组NRS评分比较,差异无统计学意义。与治疗前相比,治疗后两组振荡频率(F值)、动态硬度(S值)均明显降低,差异有统计学意义(P<0.05);两组机械压力释放时间(R值)明显增加,差异有统计学意义(t=9.129,P<0.01);但两组治疗后胫骨前肌的F值、S值、R值比较,差异均无统计学意义。结论 股四头肌筋膜手法治疗胫骨疲劳性骨膜炎与常规治疗方法疗效均显著,建议军事训练中推广应用。
Abstract
Objective To observe the clinical effect of quadriceps fascia manipulation on tibial fatigue periostitis, and to provide a simple and effective treatment for tibial fatigue periostitis. Methods A total of 90 new recruits with tibial fatigue periostitis who were trained in a training base of Chinese People’s Armed Police Force from September 2022 to June 2023 were selected and divided into the fascia manipulation group and the control group by random number table method. The fascia manipulation group was treated with fascia manipulation of the affected quadriceps muscle, and the control group was treated with conventional treatment (plaster combined with TDP) for the affected tibial lesions. Two groups were treated for 2 weeks. Numerical Evaluation Scale (NRS) score was used before treatment and 2 weeks after treatment, and the efficacy of the two groups was compared before and after the detection of the muscle status of the tibialis anterior muscle. Results After 2 courses of treatment, the NRS score in the fascia manipulation group decreased from 5.18±0.91 to 1.31±0.73, and the difference was statistically significant (t=29.000,P<0.01), while the NRS score in the conventional treatment group decreased from 5.24±0.93 to 1.16±0.82. The difference was statistically significant (t=27.541, P<0.01).There was no significant difference in NRS score between the two groups after treatment. Compared with before treatment, the oscillation frequency (F value) in the fascia manipulation group decreased (t=7.961, P<0.01), with statistically significant difference (P<0.01). There were no significant differences in F value, S value or R value of the anterior tibial muscle between the two groups after treatment. Conclusions Compared with conventional treatment, the quadriceps fascia manipulation is also effective in the treatment of tibial fatigue periostitis, which is recommended to be popularized in military training.
关键词
筋膜手法 /
股四头肌 /
治疗 /
疲劳性骨膜炎
Key words
fascia manipulation /
quadriceps /
treatment /
fatigue periostitis
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参考文献
[1] 周 凯.平刺阿是穴配合冲击波治疗青少年运动员胫骨骨膜炎临床观察[J].光明中医,2020,35(7):1031-1033.
[2] Matcuk G R, Mahanty S R, Skalski M R,et al.Stress fractures: pathophysiology, clinical presentation, imaging features, andtreatment options[J]. Emerg Radiol, 2016,23(4):365-375.
[3] 于向丽,刘 辉.武警某部新兵新训期间胫骨疲劳性骨膜炎发病情况的调查[J].武警医学,2020,31(1):91-92.
[4] 徐变霞,马艳伟,柴慈靖,等.部队军事训练伤的现状研究[J].中华灾害救援医学,2022,10(3):152-155.
[5] 覃雪峰.超短波联合中药熏洗治疗胫骨疲劳性骨膜炎的临床疗效探究[J].世界最新医学信息文摘,2019,19(17):164-166.
[6] 魏 彬, 程智涛, 聂善化,等. 武警某队属医院收治的骨关节训练伤特点及膝关节损伤的危险因素[J]. 武警医学, 2022, 33(11): 945-949.
[7] 王 霞,沈银英,汤 博,等.浮针疗法治疗胫腓骨疲劳性骨膜炎40例[J].武警医学,2022,33(1):67-69.
[8] 韩 严,杨宗保,黄妙森,等.透刺针法治愈胫骨疲劳性骨膜炎验案一则[J].中医药通报,2020,19(2):66-67.
[9] Lohrer H, Malliaropoulos N, Korakakis V,et al . Exercise-induced leg pain in athletes: diagnostic, assessment, and management strategies[J]. Phys Sportsmed,2019,47(1):47-59.
[10] David L, Riegleman M D,Julie A. Creech.Successful treatment of medial tibial stress syndrome with interosseous membrane acupuncture: a case series[J].Medical Acupuncture,2021,33(2):150-152.
[11] Charles Milgrom, Elchanan Zloczower,Chen Fleischmann, et al.Medial tibial stress fracture diagnosis and treatment guidelines[J].Journal of science and medicine in sport,2020,24(6):526-530.
[12] 胡 慧.《针灸临证备查手册》[M].北京:人民卫生出版社,2011:78-110.
[13] 高树中.《一针疗法》[M].济南:济南出版社,2018:35-37.
[14] 高海峰,苑亚东,孙 杨,等.MRI早期诊断胫骨疲劳性骨折的价值[J].武警医学,2022,33(7):625-626.
[15] 关 玲,周维金,翁长水.《解剖列车:徒手与动作治疗的肌筋膜经线》[M].3版,北京:北京科学技术出版社,2016:109-126.
[16] 印 辉,乔 峰,陈绍军,等.七步推拿法治疗对膝骨性关节炎患者股四头肌肌力的影响[J].湖北中医杂志,2023,45(1):47-49.
[17] 温红梅,兰 月,窦祖林,等.Myoton-3肌肉检测仪在健康成人肌张力测量中的评价者间信度[J].中国康复理论与实践,2013,19(11):1058-1060.
[18] 谢丽娜,吴明德,黄燕青,等.基于数字化弹性触诊仪监测偏振光结合推拿治疗中青年慢性下腰痛的临床疗效[J].广东医学,2023,44(2):229-234.
[19] 陈钢锐,肖爱华,秦学林,等.基于无创肌肉诊断技术对花剑运动员下肢肌肉状态测试的应用研究[J].南京体育学院学报,2022,21(7):50-54.
[20] 黄 健.超声影像学在骨折诊治中的应用进展[J].襄阳职业技术学院学报,2021,20(5):87-90.
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