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中华老年骨科与康复电子杂志

中华老年骨科与康复电子杂志 ›› 2024, Vol. 10 ›› Issue (02) : 103 -110. doi: 10.3877/cma.j.issn.2096-0263.2024.02.006

髋部骨折

电针联合等速训练对THA术后髋关节生物力学的影响
孙阳1, 杨帅2, 贾晋瑄2, 杜震3, 周凌峰1, 魏贤振4,†()   
  1. 1. 200071　上海中医药大学附属市中医医院康复医学科
    2. 200025　上海交通大学医学院附属瑞金医院康复医学科
    3. 200071　上海中医药大学附属市中医医院医务处
    4. 200071　上海中医药大学附属市中医医院骨伤科
  • 收稿日期:2023-09-20 出版日期:2024-04-05
  • 通信作者: 魏贤振
  • 基金资助:
    上海市卫生健康委员会科研课题(20204Y0262); 上海市进一步加快中医药传承创新发展三年行动计划（2021年-2023年）(ZY（2021-2023）-0201-04)

Study on the effect of electroacupuncture combined with isokinetic training on the biomechanics of hip joint in patients after THA surgery

yang Sun1, shuai Yang2, Jinxuan Jia2, Zhen Du3, Lingfeng Zhou1, Xianzhen Wei4,†()   

  1. 1. Department of Rehabilitation Medicine, Shanghai Municipal Hospital of Traditinmal Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
    2. Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    3. Medical Service, Shanghai Municipal Hospital of Traditinmal Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
    4. Orthopedics and Traumatology Department, Shanghai Municipal Hospital of Traditinmal Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
  • Received:2023-09-20 Published:2024-04-05
  • Corresponding author: Xianzhen Wei
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引用本文：

孙阳, 杨帅, 贾晋瑄, 杜震, 周凌峰, 魏贤振. 电针联合等速训练对THA术后髋关节生物力学的影响[J]. 中华老年骨科与康复电子杂志, 2024, 10(02): 103-110.

yang Sun, shuai Yang, Jinxuan Jia, Zhen Du, Lingfeng Zhou, Xianzhen Wei. Study on the effect of electroacupuncture combined with isokinetic training on the biomechanics of hip joint in patients after THA surgery[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(02): 103-110.

目的

探究电针联合等速肌力训练对全髋关节置换术后患者髋关节生物力学的影响。

方法

选取全髋关节置换术后患者72例，采用完全随机化方法分为观察组和对照组各36例（观察组脱失1例）。观察组采用电针联合等速肌力训练疗法，对照组采用传统康复训练疗法。于术后3个月时对所有患者进行等速肌力测定并记录各项数据。

结果

共72例患者获得随访，随访时间3个月。其中男性22例，女性49例，平均年龄（75.17±10.49）岁。术后3个月时，观察组患者健侧伸肌群PT[（79.11±7.11）N·m，t=2.589，P=0.012]，患侧屈肌群PT[（73.23±9.40）N·m，t=2.158，P=0.034]、PTA[（73.00±18.58）°，t=3.020，P=0.004]、TW[（113.80±39.75）J，t=2.395，P=0.019]，伸肌群PT[（67.09±8.69）N·m，t=3.035，P=0.003]、PT/BW[（108.27±23.50）%N·m/Kg，t=2.252，P=0.028]，健侧内收肌群AP[（14.09±3.72）W，t=0.239，P=0.020]、患侧外展肌群PT[（61.43±15.02）N·m，t=4.158，P=0.000]、PT/BW[（98.25±26.25）%N·m/Kg，t=3.721，P=0.000]、PTA[（29.11±11.06）°，t=2.011，P=0.048]、TW[（121.29±33.21）J，t=6.204，P=0.000]，内收肌群PT[（48.54±15.92）N·m，2.768，P=0.007]、PT/BW[（78.70±28.93）%N·m/Kg，t=2.531，P=0.014]、TW[（50.43±15.16）J，t=7.186，P=0.000]，以上指标均具有统计学差异（P<0.05）；患侧与健侧指标比较，除观察组屈肌群TW[（113.80±39.75）J，t=5.258，P=0.264]、外展肌群TW[（121.29±33.21）J，t=2.467，P=1.552]、内收肌群TW[（50.43±15.16）J，t=7.176，P=0.089]，对照组伸肌群PTA[（85.42±16.00）°，t=3.099，P=5.599]、伸肌群TW[（122.33±35.41）J，t=2.965，P=0.157]外，其他指标差异均有统计学意义（P<0.05）。

结论

通过分析髋关节生物力学特征证实，电针联合IST有助于改善THA术后患者髋周各肌群肌力，增强髋关节稳定性，值得临床广泛推广使用。

关键词: 电针, 等速肌力训练, 全髋关节置换术, 生物力学
Objective

To investigate the effect of electroacupuncture combined with isokinetic muscle strength training on the biomechanics of the hip joint in patients after total hip arthroplasty.

Methods

72 patients who underwent total hip arthroplasty were selected and randomly divided into an observation group and a control group, with 36 cases in each group (1 case of dislocation in the observation group). The observation group received electroacupuncture combined with isokinetic muscle strength training therapy, while the control group received traditional rehabilitation training therapy.

Results

A total of 72 patients were followed up for a period of three months. Among them, there are 22 males and 49 females, with an average age of (75.17 ± 10.49) years old. At 3 months post surgery, in the observation group, the healthy side extensor muscle group PT [(79.11±7.11)N·m, t=2.589, P=0.012], the affected side flexor muscle group PT[(73.23±9.40)N·m, t=2.158, P=0.034], PTA [(73.00±18.58)°, t=3.020, P=0.004], TW [(113.80±39.75)J, t=2.395, P=0.019], extensor muscle group PT [(67.09±8.69) N·m, t=3.035, P=0.003), PT/BW [(108.27±23.50) %N·m/Kg, t=2.252, P=0.028], and healthy side medial extension muscle group PT [(67.09±8.69)N·m, t=3.035, P=0.003]were observed. AP [(14.09±3.72)W, t=0.239, P=0.020], PT [(61.43±15.02)N·m, t=4.158, P=0.000], PT/BW [(98.25±26.25) %N·m/Kg, t=3.721, P=0.000], PTA [(29.11±11.06) °, t=2.011, P=0.048], TW[(121.29±33.21)J, t=6.204, P=0.000], PT[(48.54±15.92)N·m, t=2.768, P=0.007], PT/BW[(78.70±28.93) %N·m/Kg, t=2.531, P=0.014], TW[(50.43±15.16)J, t=7.186, P=0.000], all of the above indicators have statistical differences (P<0.05); Compared with the healthy side, except for the observation group's flexor muscle group TW [(113.80±39.75)J, t=5.258, P=0.264], abductor muscle group TW [(121.29±33.21, t=2.467, P=1.552], adductor muscle group TW [(50.43±15.16)J, t=7.176, P=0.089], the control group's extensor muscle group PTA [(85.42±16.00)°, t=3.099, P=5.599], and extensor muscle group TW [(122.33±35.41)J, t=2.965, P=0.157], all other indicators showed statistically significant differences (P<0.05).

Conclusion

By analyzing the biomechanical characteristics of the hip joint, it is confirmed that the combination of electroacupuncture and IST can improve the muscle strength of various muscle groups around the hip in patients after THA surgery, enhance the stability of the hip joint, and is worthy of widespread clinical promotion and use.

Key words: Electroacupuncture, Isokinetic muscle strength training, Total hip arthroplasty, Biomechanics
表1 两组全髋关节置换术后患者一般资料比较
组别 例数 性别（例，男/女） 年龄（岁，±s） 部位（例，左/右） 病程（d，±s） BMI指数（Kg/m2，±s）
观察组 36 10/26 75.03±10.02 22/14 3.34±2.18 22.50±5.27
对照组 35 12/23 76.17±10.95 23/12 4.16±2.04 23.35±4.22
t或χ2值   0.351 0.432 0.162 2.409 5.061
P值   0.614 0.187 0.806 0.116 0.899
表2 两组全髋关节置换术后患者治疗后双侧髋关节屈/伸肌群等速肌力测定指标
肌群 组别 侧别 PT PT/BW PTA TW AP
屈肌群 观察组 患侧 73.23±9.40* 119.63±27.20* 73.00±18.58* 113.80±39.75 17.23±4.63*
健侧 91.89±8.02 149.91±30.29 54.94±13.68 126.91±39.93 22.43±5.24
对照组 患侧 68.58±8.71* 108.03±23.08* 85.42±16.00* 94.69±26.28* 15.17±4.66*
健侧 91.72±7.87 144.23±25.14 51.47±16.03 128.19±36.48 23.83±4.56
t 患侧 2.158 1.940 3.020 2.395 1.868
健侧 0.087 0.860 0.980 0.141 1.207
P 患侧 0.034 0.056 0.004 0.019 0.066
健侧 0.931 0.393 0.330 0.888 0.232
伸肌群 观察组 患侧 67.09±8.69* 108.27±23.50* 29.54±12.93* 111.26±42.49* 10.40±3.66*
健侧 79.11±7.11 128.19±27.25 38.77±19.75 137.09±35.74 20.97±5.37
对照组 患侧 60.08±10.63* 95.26±25.14* 31.01±11.33 122.33±35.41 10.86±4.04*
健侧 74.81±6.91 117.51±19.28 34.64±19.25 127.86±36.54 20.25±4.38
t值 患侧 3.035 2.252 0.515 1.195 0.503
健侧 2.589 1.911 0.893 1.075 0.621
P值 患侧 0.003 0.028 0.608 0.236 0.617
健侧 0.012 0.060 0.375 0.286 0.537
表3 两组全髋关节置换术后患者治疗后双侧髋关节外展/内收肌群等速肌力测定指标比较
肌群 组别 侧 PT PT/BW PTA TW AP
外展肌群 观察组 患侧 61.43±15.02* 98.25±26.25* 29.11±11.06* 121.29±33.21 11.63±5.65*
健侧 77.20±11.35 125.32±31.09 34.09±7.64 122.29±29.53 18.29±8.17
对照组 患侧 48.58±10.70* 76.90±21.95* 24.25±9.27* 79.53±22.67* 10.22±4.97*
健侧 81.67±11.17 127.71±21.52 31.64±7.00 115.72±27.71 18.69±7.09
t值 患侧 4.158 3.721 2.011 6.204 1.114
健侧 1.671 0.377 1.407 0.966 0.225
P值 患侧 0.000 0.000 0.048 0.000 0.269
健侧 0.099 0.707 0.164 0.337 0.822
内收肌群 观察组 患侧 48.54±15.92* 78.70±28.93* 22.40±6.61* 50.43±15.16 8.78±4.51*
健侧 60.11±11.69 97.89±28.64 27.43±10.80 48.89±15.41 14.09±3.72
对照组 患侧 39.14±12.55* 62.38±25.33* 21.72±7.61* 26.47±12.86* 8.58±3.34*
健侧 58.28±11.92 91.29±21.15 26.94±10.44 49.31±17.08 11.89±4.01
t值 患侧 2.768 2.531 0.400 7.186 0.200
健侧 0.655 1.107 0.192 0.109 0.239
P值 患侧 0.007 0.014 0.690 0.000 0.842
健侧 0.514 0.272 0.848 0.914 0.020
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