桂枝茯苓汤对下肢胫骨骨折术后血液粘度和下肢肿胀疼痛程度的影响  

Effect of Guizhi Fuling Decoction on Blood Viscosity and Lower Limb Swelling Pain after Tibial Fractures of Lower Limbs

作　　者：刘军 戴燚[2] 林吉良 LIU Jun;DAI Yan;LIN Jiliang(Department of Orthopedics,Huangshi Municipal Hospital of Traditional Chinese Medicine,Huangshi Hubei 435000,China;Department of Orthopedics,Wuhan Municipal Hospital of Traditional Chinese Medicine,Wuhan Hubei 430000,China)

机构地区：[1]黄石市中医医院骨伤科,湖北黄石435000 [2]武汉市中医医院骨伤科,湖北武汉430000

出　　处：《四川中医》2020年第3期144-146,共3页Journal of Sichuan of Traditional Chinese Medicine

基　　金：武汉市科技局青年科技晨光计划项目(编号:200950431215)。

摘　　要：目的:探究桂枝茯苓汤对下肢胫骨骨折术后血液粘度和下肢肿胀疼痛程度的影响。方法:将2017年1月~2018年1月于我院择期行内固定手术治疗的86例胫骨骨折患者按照随机对照原则分为观察组(n=43)和对照组(n=43),对照组给予常规西药治疗,观察组联合桂枝茯苓汤治疗,检测并比较两组患者治疗前后血液粘度指标、D-二聚体(D-D)水平、下肢肿胀疼痛程度,并记录两组术后感染、膝关节僵硬、骨折不愈合、深静脉血栓形成(DVT)并发症发生率。结果:治疗后两组全血高切粘度、全血低切粘度、血浆粘度及D-D水平均有显著降低,且观察组指标水平显著低于对照组,差异具统计学意义(t=7.465,8.436,6.827,5.000,P<0.05);观察组术后肿胀、疼痛程度均显著优于对照组,差异具统计学意义(U=7.812,9.451,P<0.05);观察组DVT发生率及并发症发生率显著低于对照组[4.65%(2/43) vs 18.65%(8/43),9.32%(4/43) vs 39.53%(17/43)],差异具统计学意义(χ~2=4.074,10.648,P<0.05)。结论:下肢胫骨骨折患者应用桂枝茯苓汤联合西药治疗,可显著改善患者术后血液流变性,镇痛消肿,降低并发症风险,具有较高临床应用价值。Objective:To explore the effect of Guizhi Fuling Decoction on blood viscosity and lower limb swelling pain after tibial fractures of lower limbs.Methods:86 cases of patients with tibial fractures treated with elective internal fixation in our hospital from January 2017 to January 2018 were randomly divided into observation group(n=43) and controlled group(n=43).The controlled group was given routine western medicine,and the observation group was combined with Guizhi Fuling Decoction.The blood viscosity indexes,D-dimer(D-D) level and lower limb swelling pain were detected and compared before and after treatment in the two groups,and the incidence rates of complications such as postoperative infections,knee joint stiffness,fracture nonunion and deep venous thrombosis(DVT) were recorded in the two groups.Results:After treatment,the blood viscosity,blood viscosity,plasma viscosity and D-D level of the two groups were significantly decreased,and the index level in the observation group was significantly lower than that in the controlled group(t=7.465,8.436,6.827,5.000,P < 0.05).The postoperative swelling pain in the observation group was significantly better than that in the controlled group(U=7.812,9.451,P < 0.05).The incidence rates of DVT and complications in the observation group were significantly lower than those in the controlled group [4.65%(2/43) vs 18.65%(8/43),9.32%(4/43) vs 39.53%(17/43)](χ~2=4.074,10.648,P < 0.05).Conclusion:Guizhi Fuling Decotion combined with western medicine for patients with tibial fractures of lower limbs can significantly improve postoperative blood rheology,relieve pain and swelling and reduce risk of complications.Therefore it is worth recommending.

关 键 词：桂枝茯苓汤 下肢胫骨骨折 血液粘度 下肢肿胀疼痛 并发症 

分 类 号：R687[医药卫生—骨科学]