新伤湿敷液外敷在胫骨平台骨折术前治疗中的应用  

External application of Xinshang Shifu(新伤湿敷)solution to preoperative treatment of tibial plateau fractures

作　　者：常峥 符朝程 刘文龙[2] 刘志军 CHANG Zheng;FU Zhaocheng;LIU Wenlong;LIU Zhijun(The First Hospital of Traditional Chinese Medicine of Changde,Changde 415000,Hunan,China;Hunan University of Chinese Medicine,Changsha 410208,Hunan,China)

机构地区：[1]常德市第一中医医院,湖南常德415000 [2]湖南中医药大学,湖南长沙410208

出　　处：《中医正骨》2020年第6期18-21,26,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：湖南省中医药管理局项目(2019104)。

摘　　要：目的:观察新伤湿敷液外敷在胫骨平台骨折术前治疗中的应用价值。方法:将60例接受手术治疗的胫骨平台骨折患者随机分为2组,每组30例。常规治疗组术前给予甘露醇脱水消肿、低分子肝素钙抗凝治疗,并指导患者行股四头肌等长收缩、足踝关节功能锻炼;外敷组在常规治疗基础上采用新伤湿敷液外敷患处治疗,每日2次,待肢体肿胀消除后停用。记录并比较2组患者患肢肿胀率、患肢疼痛视觉模拟量表(visual analogue scale,VAS)评分及手术等待时间。结果:外敷组退出1例,常规治疗组退出2例。①患肢肿胀率。时间因素和分组因素存在交互效应(F=35.234,P=0.000);2组患者患肢肿胀率总体比较,组间差异有统计学意义,即存在分组效应(F=-1.986,P=0.012);治疗前后不同时间点患肢肿胀率的差异有统计学意义,即存在时间效应(F=619.710,P=0.000);2组患者患肢肿胀率随时间呈先升高后降低趋势,但变化趋势不完全一致[(7.83±1.52)%,(9.73±1.90)%,(10.84±2.00)%,(5.63±1.23)%,F=387.336,P=0.000;(7.67±1.65)%,(9.49±1.70)%,(10.79±1.66)%,(6.68±1.63)%,F=459.514,P=0.000];治疗前及治疗1 d、3 d后,2组患者患肢肿胀率的组间差异均无统计学意义(t=0.381,P=0.705;t=0.497,P=0.621;t=0.097,P=0.923);治疗7 d后外敷组患肢肿胀率低于常规治疗组(t=-2.775,P=0.008)。②患肢疼痛VAS评分。时间因素和分组因素存在交互效应(F=12.362,P=0.000);2组患者患肢疼痛VAS评分比较,组间差异有统计学意义,即存在分组效应(F=-6.974,P=0.000);治疗前后不同时间点患肢疼痛VAS评分的差异有统计学意义,即存在时间效应(F=251.136,P=0.000);2组患者患肢疼痛VAS评分随时间呈降低趋势,但变化趋势不完全一致[(7.50±0.36)分,(7.15±0.31)分,(6.89±0.19)分,(4.92±0.46)分,F=322.490,P=0.000;(7.55±0.36)分,(7.36±0.28)分,(7.34±0.32)分,(6.13±0.41)分,F=94.309,P=0.000];治疗前,2组患者患肢疼痛VAS评分的差异无统计学意义(t=-0.937,Objective:To observe the applied values of external application of Xinshang Shifu(新伤湿敷,XSSF)solution to preoperative treatment of tibial plateau fractures.Methods:Sixty patients who would receive surgery for tibial plateau fractures were selected and randomly divided into conventional therapy group and external application group,30 cases in each group.All patients were treatd with dehydration and detumescence therapy using mannitol and anticoagulant therapy using low-molecular-weight heparins calcium(LMWHC),and were instructed to perform quadriceps femoris isometric contraction and ankle functional exercises before the surgery;moreover,the patients in external application group were treatd with external application of XSSF solution at the fractured parts,twice a day,till the limb swelling was eliminated.The affected limb swelling rate,visual analogue scale(VAS)scores and operating-room waiting time were recorded and compared between the 2 groups.Results:One patient in external application group and 2 patients in conventional therapy group dropped out of the study.There was interaction between time factor and group factor in affected limb swelling rate(F=35.234,P=0.000).There was statistical difference in affected limb swelling rate between the 2 groups in general,in other words,there was group effect(F=-1.986,P=0.012).There was statistical difference in affected limb swelling rate between different timepoints before and after the treatment,in other words,there was time effect(F=619.710,P=0.000).The affected limb swelling rate presented a time-dependent trend of increasing firstly and decreasing subsequently in the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency(7.83+/-1.52,9.73+/-1.90,10.84+/-2.00,5.63+/-1.23%,F=387.336,P=0.000;7.67+/-1.65,9.49+/-1.70,10.79+/-1.66,6.68+/-1.63%,F=459.514,P=0.000).There was no statistical difference in affected limb swelling rate between the 2 groups before treatment and after 1-and 3-day treatment(t=0.381,P=0.705;t=0.497,P=0.621;t=0.

关 键 词：胫骨骨折 胫骨平台 新伤湿敷液 中药外敷 临床试验 

分 类 号：R687.3[医药卫生—骨科学]