针刀联合手法加足弓矫正器治疗跖筋膜炎的临床疗效观察

Clinical Efficacy of Acupotomy Combined with Pedicle Orthosis in Treatment of Plantar Fasciitis

摘要: 目的：探讨针刀联合手法加足弓矫正器对跖筋膜炎的疗效及对足弓功能重建的影响。方法：将120例患有跖筋膜炎的患者随机分成针刀治疗组、手法加足弓矫正器组和联合治疗组，每组各40例。针刀治疗组单纯予以针刀治疗，手法加足弓矫正器组予以手法加足弓矫正器治疗，联合治疗组为针刀治疗联合手法加足弓矫正器治疗。治疗前与治疗3个月后采用疼痛视觉模拟量表评分、美国足踝外科协会踝–后足评分比较进行评估。治疗3个月、1年后随访患者复发率。结果：治疗3个月后针刀治疗组、手法加足弓矫正器组和联合治疗组的患者晨起行走时视觉模拟评分值、美国矫形外科足踝协会评分值的比较均较治疗前改善，并且联合治疗组对晨起时的疼痛视觉模拟评分值、美国矫形外科足踝协会评分值的改善情况明显优于针刀治疗组和手法加足弓矫正器组，P < 0.05，其差异有统计学意义。治疗3个月后针刀治疗组、手法加足弓矫正器组和联合治疗组的复发率分别为25.00% (10/40)、22.50% (9/40)、10.00% (4/40)，P > 0.05，差异无统计学意义。治疗1年后针刀治疗组、手法加足弓矫正器组和联合治疗组的复发率分别为37.50% (15/40)、40.00% (16/40)、12.50% (5/40)，P < 0.05，差异有统计学意义。结论：针刀联合手法加足弓矫正器能够有效治疗跖筋膜炎的疼痛，整复其移位的跟骨，恢复其形变的足弓。

Abstract: Objective: To investigate the effect of acupotomy combined with manipulation and arch orthosis on plantar fasciitis and the effect on the reconstruction of arch function. Methods: 120 patients with digital fasciitis were randomly divided into acupotomy group, manipulation combined with arch orthosis group and combined treatment group, with 40 cases in each group. The acupotomy group was treated with acupotomy alone, the manual and arch orthotics group was treated with manual and arch orthotics, and the combined treatment group was acupotomy combined with manual and arch orthotics. The visual analogue scale of pain and the American Foot and Ankle Surgical Association’s ankle-posterior foot score were compared before treatment and 3 months after treatment. The recurrence rate was followed up 3 months and 1 year after treatment. Results: After 3 months of treatment, the visual analog scores and the American Orthopaedic Foot and Ankle Association scores of patients in the acupotomy group, the manual and arch orthotic group and the combined treatment group were improved compared with those before treatment. In addition, the improvement of the visual simulation score and the American Orthopaedic Foot and Ankle Association score in the combined treatment group was significantly better than that in the needle-knife treatment group and the manipulative foot orthotic group (P < 0.05), and the difference was statistically significant. After 3 months of treatment, the recurrence rates of acupotomy group, manual plus arch orthosis group and combined treatment group were 25.00% (10/40), 22.50% (9/40) and 10.00% (4/40), respectively, P > 0.05, with no statistical significance. After 1 year of treatment, the recurrence rates of acupotomy group, manual plus arch orthosis group and combined treatment group were 37.50% (15/40), 40.00% (16/40) and 12.50% (5/40), respectively, P < 0.05, and the difference was statistically significant. Conclusion: Acupotomy combined with pedicle orthosis can effectively treat the pain of plantar fasciitis, repair the displaced calcaneus and restore the deformed arch.