自残性断指再植术后应用枣仁逍遥汤的疗效及预后影响因素  

Efficacy and prognostic factors of Zaoren Xiaoyao Decoction After Replantation of Self-Mutilation Severed Finger

作　　者：孙中平[1] 丁明斌 张宁 宿晓雷[1] 耿景超 张远林[1] SUN Zhong-ping;DING Ming-bin;ZHANG Ning;SU Xiao-lei;GENG Jing-chao;ZHANG Yuan-lin(Hand Microsurgery,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou Hebei 061001)

机构地区：[1]河北省沧州市中西医结合医院手显微外科,河北沧州061001

出　　处：《世界中西医结合杂志》2021年第1期113-118,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2020479)。

摘　　要：目的探究自残性断指再植术后应用枣仁逍遥汤的疗效,分析影响术后断指存活的相关因素。方法选取2017年3月—2020年3月期间在河北省沧州市中西医结合医院手显微外科就诊的行自残性断指再植术的住院患者118例。按照随机数字表法分为治疗组59例,对照组59例。对照组予以断肢再植术后常规治疗。治疗组在对照组基础上,予以枣仁逍遥汤煎服。治疗前后,观察患者疼痛程度,焦虑、抑郁程度。治疗7 d后,观察血管危象发生率、断指存活率。运用单因素分析与多因素Logistic回归分析影响自残性断指再植术后断指存活的相关因素。结果两组患者治疗3 d、7 d后VAS评分均低于治疗前(P<0.05),治疗7 d后VAS评分低于治疗3 d后(P<0.05),且治疗组治疗3 d、7 d后VAS评分均低于对照组,差异均有统计学意义(P<0.05)。两组患者治疗7 d后SDS、SAS评分均低于治疗前(P<0.05),且治疗组SDS、SAS评分均低于对照组,差异有统计学意义(P<0.05)。两组患者治疗3 d、7 d后中医证候评分均低于治疗前(P<0.05),治疗7 d后中医证候评分均低于治疗3 d后(P<0.05),且治疗组治疗3 d、7 d后中医证候评分均低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组血管危象发生率5.08%(3/59)低于对照组15.25%(9/59),且治疗组有效率96.61%(57/59)高于对照组89.83%(53/59),两组比较差异有统计学意义(P<0.05)。断指存活与患者年龄、吸烟史、是否合并糖尿病、离断指别、断指平面、热缺血时间、VAS评分、SDS评分和SAS评分均有关,差异均有统计学意义(P<0.05)。断指存活与患者性别、饮酒史、是否合并高血压、是否合并高血脂、术中是否输血、手术时间、术后是否感染无关(P>0.05)。患者吸烟史、合并糖尿病、离断指别、断指平面、热缺血时间、SDS评分和SAS评分均是影响断指存活的独立危险因素,差异均有统计学意义(P<0.05)。结论在自残性断指再Objective To explore the effect of Zaoren Xiaoyao Decoction on self-mutilation severed finger replantation,and analyze the factors influencing the survival of severed fingers.Methods From March 2017 to March 2020,118 inpatients who underwent self-injury amputated finger replantation were selected in the hand microsurgery of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Hebei Province.According to the random number table,they were divided into 59 cases in the treatment group and 59 cases in the control group.The control group received routine treatment after replantation of severed limbs.The treatment group was given Zaoren Xiaoyao Decoction on the basis of the control group.Before and after treatment,observe the patient’s pain,anxiety and depression.After 7 days of treatment,the incidence of vascular crisis and the survival rate of amputated fingers were observed,and the curative effect of Zaoren Xiaoyao Decoction after replantation of self-harm amputated fingers was analyzed.Single factor analysis and multivariate logistic regression analysis were used to analyze the related factors affecting the survival of severed finger after self-harmful finger replantation.Results The VAS scores of the two groups of patients were lower than before treatment for 3 and 7 days(P<0.05),and the VAS scores after 7 days of treatment were lower than 3 days after treatment(P<0.05),and the treatment group was treated for 3 days,After 7 days,the VAS scores were lower than those of the control group,and the differences were statistically significant(P<0.05).After 7 days of treatment,the SDS and SAS scores of the two groups of patients were lower than before treatment(P<0.05),and the SDS and SAS scores of the treatment group were lower than those of the control group,the difference was statistically significant(P<0.05).The scores of TCM syndromes of the two groups of patients were lower than those before treatment for 3 and 7 days(P<0.05),and the scores of TCM syndromes after 7 days of treatment were lower than

关 键 词：自残性断指再植术 枣仁逍遥汤 影响因素 

分 类 号：R658.1[医药卫生—外科学]