| The acute sprain of ankle is a common disease in orthopaedics. It happens when walking or running on rough surface, going upstairs or downstairs, losing his feet when walking on a slope, or falling down during exercise, which causes over varus or ecstrophy of ankles in a sudden. The main therapy in modern Chinese medicine for this disease is acupuncture with filiform needles, massage manipulation and external application. Though the problem is not life-threatening, without proper treatment, the ankle is not steady in later period which will result in the local swelling and pain when doing exercise or loading a burden and the ankles can't function normally and the daily life and work is seriously affected.The collateral bleeding therapy has a long history. It's been practiced in clinic to treat all kinds of diseases either in ancient or modern times. And the curative effect is satisfying, especially in acute and chronic injury of soft tissues. The effect is magnificent in modern clinic research. But there are not many reports about the application of bleeding therapy in acute sprain of ankles with analysis of clinic literature in late ten years. The few reports lacked of random, controlled research or mixed up bleeding therapy with acupuncture with filiform needles, TDP, etc. As a result, the high effective rate, or curative rate reported can't demonstrate the real effect of bleeding therapy. So this research has applied the randomized, controlled policy in clinic to give an objective assessment of curative effect of bleeding therapy in treating acute sprain of ankle.Methods:92 patients in clinic were distributed randomly into three groups: placebo control group (placebo group), collateral bleeding control group (bleeding group), and acupuncture control group (acupuncture group). In bleeding group, practitioners punctured pressure pain points on the affected side and the engorged vein around the points to let out blood, then drew out the stagnated blood with suction cups. In acupuncture group, the acupoints were selected based on the Acupuncture Therapeutics the 7th edition. The treatment for both groups were practiced once everyday, 5 days were a completed course. And the information was collected before and after the treatment and statistically analyzed. Patients in placebo group were given no treatment and were told to have some rest home, and reduce the amount of exercise. During the observation period, the patients in placebo group received no treatment. The clinic information was collected and analyzed with statistics during visits 5 days later. When the observation was accomplished, the patients in placebo group were given acupuncture or bleeding therapy for free. The main items for observation included pain, tenderness, swelling and function of ankles.Results:①The total effective rate and curative rate: The effective rate and curative rate were 100% and 90·3% in bleeding group, 100% and 67.7% in acupuncture group respectively. There was significant difference comparing the previous two groups with the placebo group (3·3%,0%()P﹤0·0001). The bleeding and acupuncture groups had better effect than placebo group. There was no difference between the previous two groups in total effective rate(P﹥0·05). But the bleeding group had better curative rate than acupuncture group(P=0·03). The score of symptoms after treatment had significant difference between the three groups(P﹤0·0001), that the bleeding group had less score than acupuncture one and acupuncture one less than placebo one.②The improvement of symptoms: the result showed that the pain, tenderness, swelling and function of ankles were all greatly improved in both bleeding and acupuncture group after 5 treatments. There was significant difference(P﹤0·0001) before and after the treatment in both groups. And there was significant difference(P﹤0·0001) comparing the acupuncture or bleeding group with placebo group. The curative effect of acupuncture or bleeding group was much better than that of placebo one. There was no difference (P﹥0·05)between the acupuncture and bleeding group with the improvement of pain, tenderness and ankle function. But the bleeding group had better effect(P=0·02) to improve the swelling than acupuncture one. There was significant difference(P﹤0·01)between the acupuncture and bleeding group in the score of pain after the first treatment and the bleeding group had a better effect. Furthermore, the pain and swelling of the ankles were significantly improved (P﹤0·0001)before and after treatment in placebo group. And there were also difference in improvement of tenderness(P=0·02).③There were no adverse reactions during research. Only two patients had blisters for the cupping time was a little bit longer. And the blisters were punctured with needles and the local skin was sterilized with iodine. And there were no complains from patients or their families.Discussion:①The rate of curative effect for bleeding therapy treating acute sprain of ankle have reached 90·3%,and the total effective rate is 100%. The number of cases with effect is higher than that of acupuncture group. The conclusion is that the bleeding therapy is a simple and effective way to treat acute sprain of ankles and it's worth popularized in clinic.②The bleeding therapy can significantly improve various symptoms and the effect is similarly to that of acupuncture with filiform needls. And the previous therapy has better effect in relieving swelling and pain of the injured ankle after the first treatment. This result shows that bleeding therapy has magnificent effect in relieving swelling and eliminating pain temporarily. So bleeding can stimulate the discharge of stagnated blood, promote the absorption of extravasate, release the symptoms like pain and swelling caused by compression from blood vessels, nerves and soft tissues around. And it will remove the stagnated blood and produce new blood, clear and activate the channels and collaterals, and reduce swelling and ease pain. ③The improvement of some symptoms before and after treatment in placebo group has statistical significance too, which illustrates that this disease has natural repairing tendency. But the improvement of symptoms with statistical significance doesn't promise patients a clinical recovery to or near the normal level before injury. As a result, the regular therapies are still needed for a long-term recovery. |
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