本文選題：跖腱膜炎 + 足弓��； 參考：《北京中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：目的：通過(guò)觀察跖腱膜炎足與對(duì)照組的負(fù)重與非負(fù)重內(nèi)外側(cè)足縱弓角度,探討跖腱膜炎足骨性足縱弓形態(tài)學(xué)分布規(guī)律特點(diǎn),病理變化及其代表的臨床意義。方法：收集資料,包括跖腱膜炎患者27例32足(合并有跟下脂肪墊炎5例6足),其中男11例15足,女16例17足,左足17例,右足15例；年齡38～70歲,平均57歲：病程2月～2年,平均7月。無(wú)足部疾病患者21例30足,其中男7例10足,女14例20足,左足15足,右足15足：年齡30～65歲,平均51歲。分別對(duì)32例跖腱膜炎足及30例對(duì)照組拍攝足側(cè)位X線片及負(fù)重側(cè)位X線片,分別測(cè)量?jī)?nèi)弓頂角、外弓頂角,并通過(guò)計(jì)算分別得出跖腱膜炎足與對(duì)照組內(nèi)弓頂角和外弓頂角在負(fù)重位與非負(fù)重位縱弓頂角的差值。比較跖腱膜炎足與對(duì)照組之間的差異,分別分析非負(fù)重位和負(fù)重位,跖腱膜炎足和對(duì)照組代表內(nèi)側(cè)足弓的內(nèi)弓頂角、代表外側(cè)足弓的外弓頂角的統(tǒng)計(jì)學(xué)意義及其變化特點(diǎn),并借助結(jié)構(gòu)力學(xué)方法加以驗(yàn)證。結(jié)果：27例試驗(yàn)組體重為74.2±12.3kg,體重中值為70kg。21例對(duì)照組中,體重為64.0±9.3kg,中值為60kg。27例試驗(yàn)組中,BMI值為26.7±3.5,中值為26.3；21例受試者中BMI值為24.0±2.1,中值為24.0。在非負(fù)重位中,試驗(yàn)組內(nèi)弓頂角為114.4°±7.3°,中值為114.5°,對(duì)照組為113.6°±4.9°,中值為114°；前者外弓頂角為135.9±9.1°,中值為134°,對(duì)照組為134.1°±5.1°,中值為132.5°；在負(fù)重位中,試驗(yàn)組內(nèi)弓頂角為128.9°±7.5°,中值為128.5°,對(duì)照組為129.3°±5.2°,中值為130°；前者外弓頂角為144.8°±9.4°,中值為145°,對(duì)照組為146.3°±5.5°,中值為148°。試驗(yàn)組從非負(fù)重位時(shí)至負(fù)重位時(shí),內(nèi)弓頂角改變值為14.6°±5.1°,中值為15.0°,對(duì)照組為15.7°±5.3°,中值為14.5°；外弓頂角改變值前者為8.9°±5.3°,中值為8.5°,對(duì)照組為12.2°±4.8°,中值為11°。試驗(yàn)組與對(duì)照組在非負(fù)重位與負(fù)重位時(shí)內(nèi)外側(cè)足縱弓形態(tài)無(wú)明顯差異(P0.05)；負(fù)重后二者的內(nèi)側(cè)足縱弓改變較負(fù)重前無(wú)顯著差異(P0.05),而外側(cè)足縱弓改變較負(fù)重前差異顯著(P0.05)。結(jié)論：1.超重是引起跖腱膜炎的原因之一；2.跖腱膜炎患者中在靜力條件下足弓形態(tài)往往與對(duì)照組無(wú)明顯差異；3.引起跖腱膜炎的本質(zhì)原因不在于靜態(tài)下縱弓的外形而在于負(fù)重后縱弓能不能通過(guò)足夠的形變以吸收應(yīng)力,站立時(shí)足部不能充分的通過(guò)外側(cè)縱弓形變吸收應(yīng)力,這可能是引起跖腱膜炎的另一個(gè)原因。
[Abstract]:Objective: To investigate the morphological distribution of the longitudinal arch of the foot of the foot of the plantaris aponeurotis and the clinical significance of the pathological changes and its clinical significance by observing the weight negative and non weight-bearing lateral foot longitudinal arch of the plantaris aponeurotis and the control group. Methods: collecting data, including 27 cases of plantar aponeurotis with 32 feet (with 5 cases of 6 feet with subheel fat cushion). There were 11 men with 15 feet, 16 women with 17 feet, 17 left feet and 15 right feet, 38~70 years old, with an average of 57 years, average July. 21 patients without foot disease were 30 feet, including 7 10, left foot, left foot, right foot, foot and right foot. The difference between the top angle of the metatarsal aponeurosis and the top angle of the external arch in the control group was compared with the control group. The difference between the plantar aponeurosis foot and the control group was compared, and the non weight negative and weight negative positions were analyzed, and the plantaris aponeurosis and the foot were analyzed. The control group represented the internal arch top angle of the medial arch, representing the statistical significance of the outer arch top angle of the lateral arch and the characteristics of its change, and verified by the structural mechanics method. Results: the weight of the 27 cases was 74.2 + 12.3kg, the median weight was 64 + 9.3kg in the control group and the median was 60kg.27 test group, and the BMI value was 2. The median is 6.7 + 3.5 and the median is 26.3. The BMI value of the 21 subjects is 24 + 2.1, the median is 24.0. in the non negative weight position, the arch top angle of the test group is 114.4? 7.3 degrees, the median is 113.6 [21], the median is 114 [degree]; the former is 135.9 + 0 degrees, the middle value is [degree], the middle value is deg. In the test group, the arch top angle in the test group is 128.9 + 7.5 degrees, the median is 128.5 degrees, the control group is 129.3 + 5.2 degrees, the median is 130 degrees, the former is 144.8? 9.4 degrees, the median is 145 degrees, the control group is 146.3 [129.3], and the median is 148 degree. The control group was 15.7 + 5.3 degrees, the median value was 14.5 degrees, the change of the top angle of the external arch was 8.9 + 5.3 degrees, the median was 8.5 degrees, the control group was 12.2? 4.8 degrees, and the median was 11 degrees. There was no significant difference between the experimental group and the control group in the shape of the medial and lateral foot longitudinal arch at the non negative weight position and the negative weight position (P0.05); the change of the medial foot longitudinal arch after the negative weight was not obvious before the negative weight. The difference (P0.05) was significant (P0.05) in the lateral foot longitudinal arch (P0.05). Conclusion: 1. overweight is one of the causes of the plantaris aponeurotis. The morphology of the arch in the static condition is often not significantly different from the control group. 3. the root cause of the plantaris aponeurotis is not the shape of the static lower longitudinal arch. The posterior longitudinal arch can not be subjected to sufficient deformation to absorb stress. The foot can not fully absorb stress through the lateral longitudinal arch when standing, which may be another cause of the plantaris aponeurotis.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R816.8

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