伤科消肿Ⅱ号汤联合甘露醇对胫腓骨骨折(血瘀证)术后肢体肿痛的治疗作用  

Therapeutic effect of Shangke Xiaozhong No.2 decoction combined with mannitol on limb swelling and pain after tibiofibular fracture(blood stasis syndrome)

作　　者：郝胜坤 王轶 张志强 陈超 张伟 闫立平 田峰 石继祥[2] Hao Shengkun;Wang Yi;Zhang Zhiqiang;Chen Chao;Zhang Wei;Yan Liping;Tian Feng;Shi Jixiang

机构地区：[1]北京中医医院怀柔医院,北京101400 [2]上海中医药大学附属普陀医院,上海200062

出　　处：《中医临床研究》2020年第30期114-117,共4页Clinical Journal Of Chinese Medicine

基　　金：国家自然科学基金资助项目(81673782)。

摘　　要：目的:探究伤科消肿Ⅱ号汤联合甘露醇治疗胫腓骨骨折术后肢体肿胀与疼痛的临床疗效。方法:选自2016年11月-2018年12月,在上海中医药大学附属普陀医院骨科,行胫腓骨骨折切开复位内固定手术者76例,随机分为观察组和对照各38例。对照组术后静滴甘露醇100 mL,每日1次,观察组术后在对照组治疗基础上口服伤科消肿Ⅱ号汤,两组患者均连续治疗7天,术后均抬高患肢20 cm,同时活动远端脚趾关节。分别于术后当天、术后第1天、第3天、第5天、第7天,记录两组病例患肢肿胀度、VAS评分、中医证候积分等情况。结果:治疗1 d后,观察组与对照组在肿胀消退、疼痛缓解、中医证候积分方面均有效,组间差异无统计学意义(P>0.05);治疗3 d、5 d、7 d后,消肿疗效比较:对照组显效12例,有效26例,无效0例,显效率为31.58%(12/38);观察组显效22例,有效16例,无效0例,显效率为57.89%(22/38);差异有统计学意义(P<0.05);缓解疼痛疗效比较:对照组显效28例,有效10例,无效0例,显效率73.68%(28/38);观察组显效35例,有效3例,无效0例,显效率92.11%(35/38),差异有统计学意义(P<0.05)。中医证候积分比较:观察组(9.26±0.408),对照组(10.95±0.368),差异有统计学意义(P<0.05)。结论:伤科消肿Ⅱ号汤联合甘露醇能够明显缓解胫腓骨骨折术后患肢肿胀与疼痛,改善中医证候,其疗效优于单纯使用甘露醇。Objective:To investigate the clinical efficacy of Shangke Xiaozhong No.2 decoction(伤科消肿Ⅱ号汤)combined with mannitol in the treatment of limb swelling and pain after tibial fracture.Method:From November 2016 to December 2018,76 patients underwent open reduction and internal fixation of the humeral fracture in the Department of Orthopaedics,Putuo Hospital,Shanghai University of Traditional Chinese Medicine,were randomly divided into the observation group and the control group.In the control group,100 mL of mannitol was intravenously instilled daily.The patients in the observation group were orally treated with Shangke Xiaozhong No.2 decoction on the basis of intravenous drip mannitol.The two groups were treated continuously for 7 days,and the affected limbs were raised 20 cm after operation.At the same time,the distal toe joint was active.The swelling degree,VAS score and TCM syndrome scores of the two groups were recorded on the day after surgery and on the 1st,3rd,5th and 7th day after surgery.Results:After 1 day of treatment,the observation group and the control group were effective in swelling subsidence,pain relief,and TCM syndrome scores.There was no significant difference between the groups(P>0.05).After 3,5,and 7 days of treatment,the effect of swelling was reduced.Comparison:12 cases were significantly effective in the control group,26 cases were effective,0 case was ineffective,and the significant effective rate was 31.58%(12/38);22 cases were significantly effective in the observation group,16 cases were effective,0 case was ineffective,and the significant effective rate was 57.89%(22/38);the difference was statistically significant(P<0.05);Comparison of pain relief effects:28 cases in the control group were markedly effective,10 cases were effective,0 case was ineffective,and the significant effective rate was 73.68%(28/38);35 cases in the observation group were markedly effective,3 cases were effective,0 case was ineffective,and the significant effective rate was 92.11%(35/38);the differenc

关 键 词：胫腓骨骨折 伤科消肿Ⅱ号汤 甘露醇 消肿 止痛 

分 类 号：R274.1[医药卫生—中医骨伤科学]