股骨大粗隆围刺配合针刺血海穴缓解老年股骨粗隆间骨折术后疼痛的临床研究  

Observation on the Clinical Effect of Acupuncture around the Greater Tuberosity of Femur Combined with Acupuncture at Xuehai Point to Relieve Postoperative Pain of Elderly Patients with Intertrochanteric Fracture of Femur

作　　者：徐泽 卢卫忠[2] 姜仁建[2] 侯伯男 邓磊 匡雷[2] 匡志平[2] 何震 王加俊[2] Xu Ze;Lu Weizhong;Jiang Renjian;Hou Bonan;Deng Lei;Kuang Lei;Kuang Zhiping;He Zhen;Wang Jiajun(Guizhou University of Traditional Chinese Medicine,Guizhou,Guiyang 550002,China)

机构地区：[1]贵州中医药大学,贵州贵阳550002 [2]重庆市中医院,重庆400021

出　　处：《中国中医急症》2020年第2期241-244,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：重庆市科委科技惠民计划项目(cstc2015jcsf10011-2)

摘　　要：目的观察股骨大粗隆围刺配合针刺血海穴缓解老年股骨粗隆间骨折术后疼痛的临床效果并探讨其作用机制。方法69例患者随机分为治疗组与对照组,对照组采取口服塞来昔布,治疗组采取口服塞来昔布加股骨大粗隆围刺配合针刺血海穴治疗,7 d为1个疗程。结果治疗后第3日,两组VAS评分均低于治疗前(均P<0.05),且治疗3 d后比较,治疗组VAS评分低于对照组(P<0.05);治疗7 d后,两组治疗后的VAS评分与治疗前比较,均明显降低(均P<0.05),且治疗组降低更显著(P<0.05)。术后第1日,两组患者局部创伤反应均较重,肿胀明显,渗液较多,C反应蛋白(CRP)较高,高出正常值近10倍,通过采取治疗措施后,局部肿胀、渗液等创伤反应逐渐减轻,CRP迅速下降,治疗后第5日,局部肿胀明显减轻,渗液明显减少,与治疗前比较,两组患者CRP均低于治疗前(均P<0.05),且治疗组降低更明显(P<0.05)。治疗后第10日,局部肿胀基本消退,已无渗液,治疗组患者的C反应蛋白基本恢复正常,对照组也大幅度下降,与治疗前比较,两组患者的CRP均低于治疗前(均P<0.05),且治疗组CRP低于对照组(P<0.05)。两组患者术前伤侧髋关节因疼痛、畸形、骨折不稳定等功能极差,不能活动,经手术复位固定骨折及术后综合措施处理后,伤侧髋关节逐渐恢复,术后14 d时,两组患者均可在床上行术肢髋关节主动活动功能锻炼,部分患者可以扶双拐术肢非负重下床活动。两组患者伤肢髋关节Harris评分与术前比较,均显著升高(均P<0.05),且治疗组患者伤肢髋关节Harris评分高于对照组(P<0.05)。治疗组总有效率为83.33%,高于对照组的72.73%(P<0.05)。结论股骨大粗隆围刺配合针刺血海穴能明显缓解老年股骨粗隆间骨折术后患者疼痛。Objective:To observe the clinical effect of acupuncture around the greater tuberosity of femur combined with acupuncture at Xuehai point to relieve postoperative pain of elderly patients with Intertrochanteric fracture of femur(IFF).Methods:69 elderly patients were randomly divided into the treatment group and the control group.The control group received oral Celecoxib,while the treatment group received oral Celecoxib plus acupuncture around the greater tuberosity of the femur combined with acupuncture at Xuehai point.The treatment period lasted for 7 days.Results:The VAS score and c-reactive protein of both groups on 3 rd and 7 th days after treatment were lower than those before treatment,and the treatment group were significantly lower than the control group(P<0.05).Harris scores of hip joint were significantly higher than those before treatment.The treatment group were significantly higher than the control group(P<0.05).The total effective rate of the treatment group was83.33%,significantly higher than that of the control group(72.73%)(P<0.05).Conclusion:Acupuncture around the greater tuberosity of the femur combined with acupuncture at Xuehai point can significantly relieve postoperative pain of elderly IFF patients.

关 键 词：股骨粗隆间骨折 老年 针刺 股骨大粗隆围刺 血海穴 

分 类 号：R274.12[医药卫生—中医骨伤科学]