“骨伤一号”治疗急性踝关节扭伤对患者血清TNF-α、IL-1β水平的影响

摘要/Abstract

摘要： 目的探讨“骨伤一号”治疗急性踝关节扭伤对患者血清肿瘤坏死因子（tumor necrosis factor,TNF）-α、白细胞介素（interleukin,IL）-1β水平的影响。方法选取2016年9月~2021年9月在江苏省扬州市中医院接受治疗的急性踝关节扭伤患者106例作为研究对象,按照随机数表法分为对照组（n=53）与观察组（n=53）。对照组给予推拿治疗,观察组在对照组治疗的基础上给予“骨伤一号”局部热敷治疗,两组均治疗观察20 d。观察两组的疗效,治疗前后疼痛评分,血清TNF-α、IL-1β、VEGF、PDGF含量及随访5个月踝关节功能优良率。结果观察组治疗后的总有效率为98.11%,稍高于对照组的86.79%,但是对比后差异无统计学意义（P>0.05）。观察组与对照组治疗后的疼痛视觉模拟评分（VAS）显著低于治疗前,差异有统计学意义（P<0.05）,观察组也显著低于对照组,差异有统计学意义（P<0.05）。观察组与对照组治疗后的血清TNF-α、IL-1β含量显著低于治疗前,差异有统计学意义（P<0.05）,观察组也显著低于对照组,差异有统计学意义（P<0.05）。观察组与对照组治疗后的血清血管内皮生长因子（VEGF）与血小板衍生生长因子（PDGF）含量显著高于治疗前,差异有统计学意义（P<0.05）,观察组也显著高于对照组,差异有统计学意义（P<0.05）。随访5个月,观察组踝关节功能优良率显著高于对照组,差异有统计学意义（P<0.05）。结论 “骨伤一号”治疗急性踝关节扭伤能促进VEGF、PDGF的分泌,还可抑制血清TNF-α、IL-1β的释放,有很好的近期与远期效果,还可促进持续缓解疼痛。

关键词: 骨伤一号, 急性踝关节扭伤, 肿瘤坏死因子-α, 白细胞介素-1β, 血管内皮生长因子, 小板衍生生长因子

Abstract: Objective To investigate the effect of Gushang No. 1 on the levels of serum tumor necrosis factor (TNF)-α and interleukin (IL)-1β in patients with acute ankle sprain. Methods From September 2016 to September 2021, 106 patients with acute ankle sprain who were diagnosed and treated in Yangzhou Hospital of Traditional Chinese Medicine, Jiangsu Province were retrospectively selected as the research objects, and they were divided into the observation group and the traditional group with 53 cases in each group according to the treatment methods. The traditional group was given massage therapy, and the observation group was given local hot compress on Gushang No. 1 on the basis of the treatment of the traditional group. The two groups were treated and observed for 20 d. The curative effects, pain scores, serum TNF-α, IL-1β, VEGF, PDGF levels before and after treatment, and the excellent and good rate of ankle joint function were observed in the 5-month follow-up. Results The total effective rate after treatment in the observation group was 98.11%, which was higher than 86.79% in the traditional group, but there was no statistical significance after comparison (P>0.05). The pain VAS scores in the the observation group and traditional group after treatment were significantly lower than those before treatment (P<0.05), and the observation group was also significantly lower than that in the traditional group (P<0.05). The levels of serum TNF-α and IL-1β in the the observation group and traditional group after treatment were significantly lower than those before treatment (P<0.05), and the observation group was also significantly lower than that in the traditional group (P<0.05). The levels of serum vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF) in the the observation group and traditional group after treatment were significantly higher than those before treatment (P<0.05), and the observation group was also significantly higher than the traditional group group (P<0.05). After 5 months of follow-up, the excellent and good rates of ankle function in the observation group and the traditional group were 98.11% and 83.02%, respectively, and the observation group was significantly higher than the traditional group (P<0.05). Conclusion Gushang No. 1 in the treatment of acute ankle sprain can promote the secretion of VEGF and PDGF, and can also inhibit the release of serum TNF-α and IL-1β. It has good short-term and long-term effects, and can also promote sustained pain relief.

Key words: Gushang No. 1, acute ankle sprain, tumor necrosis factor-α, interleukin-1β, vascular endothelial growth factor, platelet-derived growth factor

中图分类号:

R193

王韶光, 傅强, 田涛, 朱建奎, 仇宋明. “骨伤一号”治疗急性踝关节扭伤对患者血清TNF-α、IL-1β水平的影响[J]. 中华养生保健, 2022, 40(12): 12-16.

WANG Shao-guang, FU Qiang, TIAN Tao, ZHU Jian-kui, QIU Song-ming. Effects of Gushang No. 1 on the Levels of Serum TNF-α and IL-1β in patients with Acute Ankle Sprain[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(12): 12-16.

参考文献

[1] Guerra-Pinto F, Caetano J, Alçada R, et al.Consecutive Ankle Sprain Classification and Injury Systematization (CASCaIS), A New Lateral Ankle Sprain Classification Based on the Pivot Test: A Prospective Cohort Study[J].Acta Med Port,2022,3(21):113-119.
[2] Disanti J S, Marshall A N, Valier A R S, et al.High School Athletes’ Health-Related Quality of Life Across Recovery After Sport-Related Concussion or Acute Ankle Injury: A Report From the Athletic Training Practice-Based Research Network[J].Orthop J Sports Med,2022,10(2):68034-68039.
[3] 孙杰. 舒筋活血汤联合中医康复治疗对踝关节手术患者关节功能恢复的影响[J].现代中西医结合杂志,2018,27(7):737-740.
[4] 朱祥萍,吉辉,雷德会.舒筋活血汤联合功能锻炼用于踝关节骨折术后功能恢复的临床疗效[J].中华中医药学刊,2018,36(7):1704-1706.
[5] 张斌剑,王雷,孙鹏军,等.舒筋活血汤配合渐进式功能锻炼对踝关节骨折术后功能恢复的影响[J].国际中医中药杂志,2017,39(2):128-130.
[6] 方叶,王晓赟,尤佳锋,等.加味牛蒡子汤促进自发性类风湿关节炎小鼠淋巴管生成抑制炎症免疫反应[J].中国药理学通报,2021, 37(10):1469-1474.
[7] 杜世拔,李国政,郑靓,等.基于网络药理学的新加白虎汤治疗痛风性关节炎的作用机制及抗炎作用初步验证[J].药物评价研究,2022,45(2):266-273.
[8] 陈京峰,仝晓明,李治斌.补阳还五汤加减配合切开复位内固定术治疗旋后外旋型踝关节骨折的疗效观察[J].中华中医药学刊,2016, 34(4):1021-1024.
[9] 蔡云仙,胡柏松.冷热序贯疗法治疗闭合性踝关节骨折早期软组织肿胀疗效观察[J].中医正骨,2014,26(2):58-59.
[10] 吴文豹,许光辉,饶小康.人体软组织损伤学[M].广西:广西科学技术出版社,2002:466.
[11] 贾晓妮. 舒筋活血汤、运动疗法联合中药熏洗治疗踝关节骨折术后创伤性关节炎的疗效分析[J].贵州医药,2020,44(10):1592-1593.
[12] 汤宇. 慢性踝关节不稳定治疗新进展[J].中国康复理论与实践,2008,14(5):449-451.
[13] 汤浩锋,黄勇,谭俊,等.强筋活血复元汤加味治疗急性踝关节骨折的疗效观察[J].辽宁中医杂志,2021,48(2):94-96.
[14] 王磊,戴春宏,吕昊,等.桃红四物汤加减联合药物外敷对急性踝关节损伤患者致痛物质、肿胀程度及炎症因子的影响[J].中国中医急症,2021,30(12):2169-2172.
[15] 王琰,张华锴,王丹,等.舒筋活血汤联合中医康复治疗对踝关节骨折术后恢复的影响[J].中华中医药学刊,2021,39(4):102-105.
[16] 刘伟伟,刘秋玉,周子正,等.白虎加桂枝汤对高尿酸血症并急性痛风性关节炎大鼠抗炎作用机制探究[J].中华中医药杂志,2019, 34(5):2254-2259.
[17] 宜娟娟,曹玉举,郭永昌.芍药甘草汤联合针刺治疗急性踝关节扭伤疗效观察[J].中国中医急症,2020,29(2):326-328.
[18] 董琳琳,丰晨然,赵一颖,等.基于PPAR-γ/NF-κB信号通路探究芍甘附子汤对胶原诱导性关节炎大鼠的干预作用及作用机制[J].中南药学,2022,20(1):45-51.