小针刀松解术序贯中药熏洗对顽固性跟痛症患者白细胞炎症因子及Maryland足功能评分的影响OA
Effect of sequential acupotomy release combined with Chinese herbal fumigation and washing on inflammatory cytokines and Maryland foot scores in patients with intractable heel pain
目的 探讨小针刀松解术序贯中药熏洗对顽固性跟痛症患者白细胞炎症因子及Maryland足功能评分的影响.方法 选取2021年1月—2024年8月上海市浦东新区中医医院收治的87例顽固性跟痛症患者,随机数字表法分为两组,观察组44例予以小针刀松解术序贯中药熏洗治疗,对照组43例予以中药熏洗治疗.比较两组临床疗效、治疗前后白细胞炎症因子水平[白细胞介素(IL)-6、IL-8]、疼痛视觉模拟评分法(VAS)评分、Maryland足功能评分、足底各区压力[足跟内侧缘(MHEEL)、足前掌内侧缘(MFF)、足前掌外侧缘(LFF)、足跟外侧缘(LHEEL)]、生活质量评分及差值,统计术后不良反应及复发情况.结果 研究期间观察组7例、对照组8例脱落或剔除.观察组总有效率94.59%(35/37)高于对照组的74.29%(26/35),治疗后3个月内观察组总复发率为5.71%(2/35)低于对照组的23.08%(6/26,P<0.05).治疗后,两组血清IL-6、IL-8水平、MFF、LFF压力及疼痛VAS评分均下降,MHEEL、LHEEL压力及Maryland足功能评分均升高(P<0.05);其中观察组血清IL-6、IL-8水平、LFF压力及疼痛VAS评分低于对照组,MHEEL、LHEEL压力及Maryland足功能评分高于对照组,且上述指标治疗前后差值大于对照组(P<0.05).治疗后3个月,观察组生活质量评分及差值均高于对照组(P<0.05).结论 小针刀松解术序贯中药熏洗对顽固性跟痛症治疗效果确切,可减轻炎症反应,缓解疼痛,改善足部压力分布及足功能,提高生活质量,并降低复发率.
Objective To investigate the impact of sequential acupotomy release combined with Chinese herbal fumigation and washing on inflammatory cytokines and Maryland foot scores in patients with intractable heel pain.Methods A total of 87 patients with intractable heel pain treated at Pudong New Area Hospital of Traditional Chinese Medicine in Shanghai from January 2021 to August 2024 were selected and divided into two groups according to random number table method.The observation group(n=44)received sequential acupotomy release combined with Chinese herbal fumigation and washing,while the control group(n=43)received Chinese herbal fumigation and washing alone.The clinical efficacy,as well as the levels of inflammatory cytokines[interleukin-6(IL)-6,IL-8],visual analog scale(VAS)pain scores,Maryland foot scores,plantar pressure in various areas[medial heel margin(MHEEL),medial forefoot margin(MFF),lateral forefoot margin(LFF),lateral heel margin(LHEEL)],quality of life scores,and changes from baseline was compared between the two groups.Postoperative adverse reactions and recurrence were statistically recorded.Results During the study,7 patients in the observation group and 8 patients in the control group were lost to follow-up or excluded.The total effective rate of the observation group was 94.59%(35/37),which was higher than 74.29%(26/35)of the control group.At 3 months after treatment,the total recurrence rate of the observation group was 5.71%(2/35),lower than 23.08%(6/26)of the control group(P<0.05).After treatment,serum IL-6 and IL-8 levels,MFF pressure,LFF pressure and VAS pain scores decreased in both groups,while MHEEL pressure,LHEEL pressure and Maryland foot scores increased(P<0.05).Compared with the control group,the observation group had lower serum IL-6,IL-8 levels,LFF pressure and VAS pain scores,and higher MHEEL,LHEEL pressures and Maryland foot scores,showing greater changes from baseline in the above parameters(P<0.05).At 3 months after treatment,the quality of life scores and their changes from baseline were higher in the observation group than in the control group(P<0.05).Conclusion Sequential acupotomy release combined with Chinese herbal fumigation and washing has definite therapeutic efficacy for intractable heel pain.It can alleviate inflammatory response,relieve pain,improve plantar pressure distribution and foot function,enhance quality of life and reduce recurrence rate.
顾丽君;黄志豪;龚杰;蔡艳华;周杰
上海市浦东新区中医医院治未病科,上海 201299上海市浦东新区中医医院麻醉科,上海 201299上海市浦东新区王港社区卫生服务中心针伤科,上海 201299上海市浦东新区中医医院推拿科,上海 201299上海市浦东新区中医医院骨伤科,上海 201299
跟痛症针刀中药熏洗足部压力白细胞介素-6足功能复发
heel painacupotomyChinese herbal fumigation and washingplantar pressureinterleukin-6foot functionrecurrence
《临床误诊误治》 2026 (13)
86-92,7
上海市卫生健康委员会中医药科研项目(2020LP005)浦东新区卫生健康委员会学科带头人项目(PWRd2020-05)
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