消肿镇痛散外敷联合超短波治疗急性踝关节扭伤——基于距腓后韧带修复与足背动脉血流改善的机制探讨OA

Objective:Based on the traditional Chinese medicine(TCM)pathogenesis of Qi stagnation and blood stasis syn-drome,to verify the synergistic effect of external application of Xiaozhong Zhentong powder(XZTS)and ultra short wave therapy in patients with acute ankle sprain(AAS),and to clarify its underlying mechanism in promoting posterior talofib-ular ligament(PTFL)repair and improving dorsal foot artery hemodynamics.Methods:A total of 118 patients with AAS within 72 h and diagnosed with the syndrome of Qi stagnation and blood stasis were randomly assigned(1∶1)to single therapy group(ultra short wave alone)or combined therapy group(XZTS external application+ultra short wave),with 59 cases in each group,for a 2-weeks treatment course.Visual analogue scale(VAS)score,ankle circumference,PTFL thickness,peak systolic velocity(PSV),mean flow velocity(MFV)and resistance index(RI)of the dorsal foot artery were measured before and after treatment,and effect sizes(Cohen's d)were calculated.Results:At baseline,there were no significant differences in VAS score,ankle circum-ference,PTFL thickness(both about 3.7 mm)and PSV(both about 2.9 cm/s)between the two groups(all P>0.05).After 2 weeks of treatment,VAS score in the combined therapy group decreased from(7.07±0.87)points to(1.32±0.34)points,and ankle circumference decreased from(41.25±2.77)cm to(36.29±1.22)cm,both significantly lower than those in the single therapy group(P<0.001).Compared with the single therapy group,PTFL thickness in the com-bined therapy group showed an additional reduction of 0.28 mm(Cohen's d=0.89,P<0.001),while PSV increased by an additional 0.39 cm/s(Cohen's d=0.92,P<0.001),accompanied by a greater increase in MFV and a more pro-nounced decrease in RI.Mechanistically,the combined therapy regimen exerts a synergistic effect of"anti-inflammatory and anti-edema,improvement of microcirculation,and promotion of ligament repair",thereby simultaneously correcting PTFL thickness abnormalities and dorsal foot artery blood flow disturbances.Conclusion:External application of XZTS combined with ultra short wave therapy can significantly relieve acute pain and swelling,improve PTFL structural repair and dorsal foot artery hemodynamics in patients with AAS,providing a safe and effective integrative TCM and Western medicine option for acute ankle sprain.No serious adverse events occurred during the study;mild skin burning was repor-ted in 2 cases(3.39%)in the combined therapy group,and transient dizziness in 1 case(1.69%)in the single therapy group,all of which resolved after symptomatic management.