Shake Stamp Pull Technique In Treatment Of Acute Ankle Sprains Clinical Research

Background:Acute ankle sprain is a common sports injury, it accounts for more than one third of the ankle and foot injuries and about8%of all sporting injuries. It is in the first place of the joint ligament injury, which accounted for about90%of the damage caused by a varus. How to relieve patients’ pain, eliminating swelling and restore joint function as soon as possible are the keys to the early treatment.At present, the conventional treatment of acute ankle sprains in modern medicine is called "RICE", which consisted of, rest, ice, compression bandage and raise the limb. Among them, the ice has been widely applied because of the advantages in raise pain threshold, lower organizations temperature, slow metabolism, reduce inflammation.In traditional Chinese medicine, acute ankle sprains belongs to the category of "poking feet tendon injury", the basic pathogenesis of acute ankle sprain are that bone is dislocation, tendons get outside of the regular groove and blood run out of the meridians. Thus Li Jin treatment is one of the most principal means for acute ankle sprain in traditional Chinese medicine (TCM). Shake stamp pull technique is created by an old famous professor of traditional Chinese medicine named Sun Shuchun, Sun in the long-term clinical practice, according to the old theorys of TCM:meridians damage when bones and muscle break, leaving out of vein’s blood can become blood stasis, blood stasis and qi stagnation and "separating to get back together", created the sets for acute ankle sprains technique, the technique rapidly relieve pain, eliminating swelling. In the late of the process, less residual symptoms are left, the chance of repeated strain and incidence of chronic ankle instability are low.Analysis of nearly10years related literature about manipulation treatment of this disease, found that there are the following problems:first, on the diagnosis, there is no objective unified industry standards, and no disease location, no matter the medial malleolus, external ankle. or under the tibial phil joint. Second, most of the clinical reports have been preliminary summary of the individual clinical experience, not only lack of randomized design, but also less contraction with conventional therapy of modern medicine. Third, in effect on the choice of indicators, most of them made up their own standard or just summed up as "heal""very effective""effective" and so on, lack of objective comprehensive evaluation standard.Purpose:With the multicenter randomized prospective study method, studying the clinical curative effect roll stamp pull technique in treatment of acute ankle sprains, from the point of view of evidence-based medicine to evaluate the efficacy and safety, for the future objective comprehensive scientific basis was provided for clinical promotion.Methods:40patients who conformed to the method according to the standards.from Chinese academy of sciences wangjing hospital emergency orthopedic and tongzhou district hospital of traditional Chinese medicine emergency orthopedic, were randomly assigned into the experimental group (21cases) and control group (19cases). Experimental group gave rolled drawing stamp increase elastic bandage fixation technique, every other day and continuous treatment for two weeks; Controls gave an icepack add elastic bandage fixation, all of the patients adopt one-time since any bag, ice for one hour per day, ice three days in a row, elastic bandage fixed two consecutive weeks. Two groups of patients with the treatment cycle is2weeks, respectively, before treatment, treatment after1day,1week after treatment,2weeks after treatment and after treatment for3months five point data, using the VAS pain score, swelling degree and the Takakura function evaluation.All the data were counted with SPSS16.0:Metrics used mean+/-standard deviation, count index statistics describe use cases and percentage; measurement data using t test and single factor analysis of variance, count data by chi-square test.Result:Experimental group in the VAS pain. swelling degree and the Takakura function score, by the single factor analysis of variance, and each visit point into the group were significant statistical significance (P<0.01), the Dunnett"s T3tested multiple comparison, starting from the first day after the treatment of patients with pain and Takakura function score over time has been gradually ease, and the adjacent time point have significant statistical significance (P <0.01);1day after treatment, the patient’s swelling degree has not been significantly improved, and since day1, its swelling degree began to gradually reducing, and during the follow-up period, the swelling degree compared with the last treatment has no statistical significance (P>0.05). showing the stability of its curative effect.Control group in the VAS pain, swelling degree and the Takakura function score, by the single factor analysis of variance, and each visit point into the group were significant statistical significance (P<0.01). the Dunnett’s T3tested multiple comparison,1day after treatment, patients’ pain and Takakura functional score has not been improved significantly, and from the first day after between adjacent time point have significant statistical significance (P<0.01). suggesting that the pain and Takakura functions are improving step by step;1day after treatment in patients with swelling degree has not been improved significantly, since1week after the treatment of swelling, ease gradually, during the follow-up period, the swelling degree compared with the last treatment has no statistical significance (P>0.05), showing the stability of its curative effect.During2weeks of treatment, the VAS pain between baseline and various supervision point of the comparison of difference was statistically significant (P<0.05), Experimental group within two weeks of pain relief effect is better than the control group;3month follow-up with the comparison of difference between the baseline has no statistical significance (P>0.05), shows long curative effect in two groups in pain relief. In1days after treatment, two groups of swelling degree and the difference between the baseline comparison of no statistical significance (P>0.05), shows that in1day after the treatment, two groups of patients in the swelling level no obvious differences; After treatment for1day to follow-up period, the difference between the baseline and various supervision point of comparison between groups was statistically significant (P<0.05), indicating that in1day after treatment, the experimental group to alleviate swelling effect is better than the control group.In terms of total effective rate in experimental group markedly effective rate and effective rate were85.7%and14.3%, control group markedly effective rate and effective rate were31.6%and68.4%, via Wilcoxon rank and inspection, have very significant statistical significance difference (P<0.01), treatment group on Takakura function score curative effect evaluation is superior to the control group.Conclusion:(1) The two treatment in healing acute ankle sprain are all effective and can relieve pain, reduce swelling, improve ankle joint function.(2)In relieving pain, experimental group is faster and during the2weeks of treatment the curative effect is superior to control group, but in terms of long curative effect in the follow-up period, there was no significant difference between two groups.(3) Experimental group after treatment for1day to the follow-up period, the swelling degree of improved better than the control group.(4) Takakura function will improve the patients, the treatment group function improvement during treatment is superior to control group, and the forward curative effect is better.(5) As Takakura functional score of total effective rate in treatment group markedly effective rate and effective rate significantly higher than the control group.