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台灣中醫臨床醫學雜誌

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篇名 巨刺配以動氣療法治療急性閉合性踝扭傷的臨床研究
卷期 15:3、15:3
並列篇名 Clinical Research of Opposing Needling with Qi-Activating Technique on Acute Close Ankle Sprain
作者 鄭集誠賴新生
頁次 171-194
關鍵字 急性踝扭傷巨刺動氣療法Acute ankle sprainOpposing needlingQi-activating technique
出刊日期 200909

中文摘要

研究目的:本研究旨在觀察巨刺配以動氣療法治療急性閉合性踝扭傷的臨床療效,採用前瞻性隨機對照試驗及公認的診療標準,爲巨刺配以動氣療法治療急性閉合性踝扭傷提供循證醫學證據,也爲臨床治療急性閉合性踝扭傷提供療效確切、簡便廉驗的治療方法。研究方法:篩選無開放性傷口,發病在2周內,以往患踝無扭傷史的患者,並排除中度損傷中不能行走者及嚴重損傷如血管神經韌帶斷裂,骨折需行外科骨科治療者,共收集急性閉合性踝扭傷病人64例,將其按損傷程度及疾病分期進行分層隨機,得治療組32人和對照組32人。治療組取對側外關透內關、後溪透合谷,配合動氣療法。對照組取阿是穴、申脈、丘墟、解溪、照海、崑崙、太溪。針用瀉法,每次留針30分鐘。每天針刺一次,7天爲1個療程。治療前、治療中(第四天)及1療程後對患者的關節疼痛、活動障礙、紅熱、腫脹、壓痛等症狀進行評分,對測評結果進行統計分析。研究結果:臨床觀察結果顯示,治療組和對照組治療後的評分總分值比治療前均有顯著性差異(P<0.05),治療組治療前後的評分總差值與對照組治療前後的評分總差值有顯著性差異(P<0.05),提示巨刺配以動氣針法治療急性閉合性踝扭傷和傳統取穴治療急性閉合性踝扭傷均有療效,而前者的療效更優。結論:用巨刺配以動氣針法遠道取穴治療急性踝扭傷,在改善改善關節的活動障礙,關節疼痛、紅腫、壓痛方面有顯著療效,既繼承運用了古代九刺之一的巨刺法的“左取右,右取左”的思想,又融入了現代解剖學中“運動具有止痛作用”的理論,是古代中醫與現代醫學的完美結合。對於急性閉合性踝扭傷,針刺治療介入越早,治療效果越好。無論是Ⅰ度還是Ⅱ度,無論是急性期還是亞急性期、恢復期的急性閉合性踝扭傷,巨刺配以動氣針法均有較好療效。

英文摘要

Objective: The research provides effective and convenient treatment protocol for acute close ankle sprain by observing the clinical effectiveness of applying opposing needling with Qi-activating technique under prospective randomized controlled study and recognized clinical standards. Methods: Subjects with no open wounds, no history of ankle sprain, and onset less then 2 weeks are selected. Subjects who were moderately injured with no ability to walk or seriously injured with torn ligaments, vessels or nerves, fractures were ruled out. Total 64 subjects are divided into treatment group and control group evenly in terms of degree and stage of injury. Treatment group uses opposing SJ5 (WaiGuan) punctures PC6 (NeiGuan) and SI3 (HouXi) puncture LI4 (HeGu) with qi-activating technique. Control group uses A-shi points, BL62 (ShenMai), GB40 (QiuXu), ST41 (JieXi), KD6 (ZhaoHai), BL60 (KunLun), KD3 (TaiXi). Deduction technique is used with 30 minute needle retention. The course of treatment is 7 days with 1 session daily. Assessment is based on symptoms of joint pain, limited range of motion, redness, warmth, swelling and tender before, during (the 4(superscript th) day) and after 1 course of treatment. Results: Both treatment and control group has significant difference comparing after and before treatment (p<0.05) while the difference of assessment scores before and after within treatment and control group is also statistically significant (p<0.05). This indicates the advanced effectiveness of applying opposing needling with Qi-activating technique on acute close ankle sprain when compared with traditional treatment. Conclusion: Applying opposing needling with Qi-activating technique in treating acute close ankle sprain can effectively improve limited range of motion, pain, redness, swelling, tenderness of joints. This is a excellent combination of traditional Chinese medicine needling technique with modern anatomy theory. Opposing needling with Qi-activating technique can reach satisfying result when applied in stage one or two, acute, sub-acute or chronic ankle sprain.

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