跟痛症的针刀分型论治

目的:将跟痛症进行分型,针对不同分型运用小针刀给予不同的治疗以提高疗效。方法:2005年8月至2008年12月治疗200例266跟,门诊189例251跟,住院11例15跟;男83例,女117例;年龄26～72岁,平均46岁;病史3～36个月,平均6.8个月。按笔者分型标准,分为跖筋膜炎型67跟,跟骨下滑囊炎型61跟,足底脂肪垫炎型36跟,跟骨内压增高型6跟,神经卡压型21跟,混合型75跟。采用小针刀针对不同的分型运用不同的疗法进行治疗。结果:完成治疗后1个月跖筋膜炎型治愈31跟,显效36跟;跟骨下滑囊炎型治愈32跟,显效29跟;足底脂肪垫炎型治愈9跟,显效20跟,好转4跟,无效3跟;跟骨内压增高型治愈1跟,显效3跟,好转2跟;神经卡压型治愈11跟,显效8跟,好转1跟,无效1跟;混合型治愈16跟,显效46跟,好转5跟,无效8跟。完成治疗后6个月以上的电话随访,跖筋膜炎型治愈21跟,显效40跟,好转5跟,无效1跟;跟骨下滑囊炎型治愈30跟,显效28跟,好转3跟,无效0跟;足底脂肪垫炎型治愈15跟,显效18跟,好转2跟,无效1跟;跟骨内压增高型治愈0跟,显效3跟,好转3跟,无效0跟;神经卡压型治愈7跟,显效11跟,好转1跟,无效2跟;混合型治愈10跟,显效45跟,好转11跟,无效9跟。结论:在临床工作中不能用单一的发病机制来解释跟痛症的病因,更不能用单一的方法来治疗,应将跟痛症进行分型,并针对不同的分型给予不同的治疗,这样才能提高跟痛症的治愈率。

Small needle-knife for the treatment of heel pain according to its classification

Objective: To treat heel pain with small needle-knife according to its classification,so as to improve the therapeutic effects. Methods: From August 2005 to December 2008,200 patients with 266 heel pain were treated according to the author's classification standards. There were 83 males and 117 females,ranging in age from 26 to 72 years,with a mean age of 46 years;the course of the disease ranged from 3 to 36 months,averaged 6.8 months. According to the classification:67 heels with plantar fasciitis type,61 heels with calcaneal bursitis type,36 heels with plantar fat pad inflammation-based type,6 heels with calcaneus high pressure-type,21 heels with nerve compression type,75 heels with mixed type. All the patients were treated with small needle-knife by using different methods according to its classification. Results: After 1 month treatment,among the patients with plantar fasciitis-type,31 heels got an excellent result,36 good;among the patients with calcaneal bursitis type,32 heels got an excellent result,29 good;among the patients with plantar fat pad inflammation-based type,9 heels got an excellent result,20 good,4 poor and 3 bad;among the patients with calcaneus high pressure-type,1 patient got an excellent result,3 good and 2 poor;among the patients with nerve compression type,11 heels got an excellent result,8 good,1 poor and 1 bad;among the patients with mixed type,16 heels got an excellent result,46 good,5 poor and 8 bad. At the 6th month after treatment,among the patients with plantar fasciitis-type,21 heels got an excellent result,40 good,5 poor and 1 bad;among the patients with calcaneal bursitis type,30 heels got an excellent result,28 good and 3 poor;among the patients with plantar fat pad inflammation-based type,15 heels got an excellent result,18 good,2 poor and 1 bad;among the patients with calcaneus high pressure-type,0 patient got an excellent result,3 good and 3 poor;among the patients with nerve compression type,7 heels got an excellent result,11 good,1 poor and 2 bad;among the patients with mixed type,10 heels got an excellent result,45 good,11 poor and 9 bad. Conclusion: The causes of heel pain can't be explained by using single pathogenesy,and also can't be treated with one method. The patients with calcaneal pain should be treated with different methods according to classification of heel pain,and thus the therapeutic effects can be improved.