针刀治疗足跟痛症患者足底压力异常区域的临床研究

摘要

Objective To explore the effect of specific acupotomy therapy on mechanical changes of plantar in patients with calcaneodynia,and to provide theoretical basis for specific acupotomy therapy.Methods Thirty patients diagnosed with unilateral calcaneodynia in Orthopedics and Traumatology of Hospital of Integrated Chinese and Western Medicine,Southern Medical University from June 2015 to June 2016 were included in the this experiment.The abnormal area of plantar pressure in each patient was detected,and the abnormal area of plantar pressure was treated by acupotomy therapy.The peak force of 10 zones of affected pelma [the 1st base of phalanx (T1),the 2nd-5th base of phalanx (T2-T5),1th metatarsal (M1),2nd metatarsal (M2),3rd metatarsal (M3),4th metatarsal (M4),5th metatarsal (M5),middle foot bottom (MID),heel lateral (HL) and heel medial (HM)] was tested with Footscan USB2 system before treatment and after treatment for 2 weeks.Results Before treatment,the peak pressure of M1,HL and HM between the affected side and normal side was significantly different (P ＜ 0.05).After treatment for 2 weeks,the plantar pressure of M1,HL and HM area was significantly decreased (P ＜ 0.05),but there were no significant differences in other zones (P ＞ 0.05).Conclusion Acupotomy therapy for the abnormal area of plantar pressure in patients with calcaneodynia can improve the plantar pressure of abnormal area,and make the plantar pressure become normal.Clinically,we may try to treat the patients' plantar pressure in abnormal area with acupotomy therapy,and it may achieve the purpose of treating the calcaneodynia.%目的 探讨针刀特异性治疗对足跟痛症患者足底应力学变化的影响,为针刀的特异性治疗提供理论依据.方法 纳入30例2015年6月～2016年6月在南方医科大学中西医结合医院骨伤科就诊的单侧跟痛症患者,检测每位患者其患侧足底压力的异常区域,并对患侧足底压力分布异常的区域进行针刀治疗.治疗前和治疗2周后,采用平板式足底压力测试系统(Footscan USB2)测定患侧足底10个区域[第1趾骨底(T1)、第2～5趾骨底(T2～T5)、第1跖骨底(M1)、第2跖骨底(M2)、第3跖骨底(M3)、第4跖骨底(M4)、第5跖骨底(M5)、足中部底(MID)、足跟外侧底(HL)及足跟内侧底(HM)]的峰值压力变化.结果 治疗前患者的健侧与患侧的M1、HL与HM区域峰值压力差异有统计学意义(P＜0.05);治疗2周后,患者患侧足底的M1、HL与HM三区的足底压力均有所降低,且差异有统计学意义(P＜0.05);而其他区域足底压力治疗前后比较差异无统计学意义(P＞0.05).结论 对跟痛症患者患侧足底压力异常的区域进行针刀治疗,能够改善足底的压力异常区,使其足底压力恢复正常.临床上或许可以尝试对跟痛症患者足底的压力异常区域进行治疗,通过恢复足底压力异常区域达到治疗跟痛症的目的.