| 刘鹏军,韩 康,李卫勤,刘宏伟,周 勇,杨智泉.骨刺所致跟骨痛的新临床分型的提出及新治疗方案的探索[J].,2017,17(11):2144-2147 |
| 骨刺所致跟骨痛的新临床分型的提出及新治疗方案的探索 |
| Research on the New Clinical Classification and Treatment Methods for Heel Pain |
| 投稿时间：2016-10-22 修订日期：2016-11-19 |
| DOI：10.13241/j.cnki.pmb.2017.11.038 |
| 中文关键词: 跟骨 骨刺 substance p 疗效 |
| 英文关键词: Heel Calcaneal spurs Substance p Clinical efficacy |
| 基金项目:国家自然科学基金项目(81272441)；济南军区总医院院长基金项目(2015ZX01) |
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| 中文摘要: |
| 摘要 目的：介绍和建立一种新的骨刺所致跟骨痛的临床分型并对更为有效的治疗方案进行探索。方法：对2013.01-2015.01来在我院就诊，明确诊断为骨刺所致跟骨痛的共计45例患者（共60例足）纳入本次实验。1）探索患者的症状、功能评分等与新临床分型的关系，探索新临床分型的临床意义。并探索substance p 浓度与临床分型之间的关系。2）将上述45例患者随机分入3个治疗组：A组（单纯骨刺切除组）；B组（substance p抑制剂注射组）；C组（骨刺切除+substance p抑制剂注射）。比较治疗前后患者的VAS（Visual Analogue Scale）疼痛评分与AOFAS（American Orthopedic Foot and Ankle Society）功能评分。结果：1）I型和II型患者在疼痛及功能评分的比较中均有显著性差异(P<0.05)，但在骨刺指标中无显著差异(P>0.05)，从而提示新的临床分型具有较好的临床指示意义；2）substance p浓度与患者疼痛程度及临床分型之间均有显著性差异(P<0.05)，从而提示新临床分型有治疗意义且substance p 有可能可以作为治疗靶点；3）三组不同治疗方式患者在治疗后的疼痛及功能评分较治疗前均有显著性的改善(P<0.05)。且C组显著优于其他两组(P<0.05)。所有患者均未出现严重并发症。结论：新的临床分型具有良好的临床诊断及治疗意义；substance p浓度与患者症状正相关，且有可能作为新的治疗靶点；骨刺切除+substance p抑制剂注射的治疗方法较传统治疗有显著的优势，有望成为一种新的更为有效的骨刺所致跟骨痛的的治疗方法。 |
| 英文摘要: |
| ABSTRACT Objective: To introduce and evaluate a new clinical grouping and therapeutic schedule of heel pain caused by cal- caneal spurs and plantar fasciitis. Methods: 45 patients(60 feet) who were admitted in our hospital from 2013.01 to 2015.01 and diag- nosed as heel pain caused by calcaneal spurs and plantar fasciitis were admitted in our experiment. 1)The relationship between the symp- tom, function and the new clinical grouping and the relationship between substance p and the new clinical grouping were expored. 2) 45 patients were brought into 3 groups randomly: A: spurs excision; B: substance p inhibition; C:(both). Clinical outcomes were evaluated by visual analogue scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores. Results: 1) There were significant difference in the VAS and AOFAS between the I patients and the II patients. However, no difference were found in the spur index. 2) There were significant difference in the substance p, VAS and the clinical grouping. 3) All patients were improved after the therapy in all 3 groups and the group C was significantly better than other groups. No other complication was shown. Conclusion: The new clinical grouping has significant advantage in diagnosis and therapy. The new therapy methord of spurs excision and substance p in- hibition has notable dominance than the normal methord, which could be a new and effectivly better way to cure heel pain. |
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