复元活血汤联合清创术后置管对脊柱侧凸后路矫形融合术后感染患者血清炎性因子表达的影响  

Effect of Fuyuan Huoxue Decoction(复元活血汤)Combined with Catheter after Debridement on Expressions of Serum Inflammatory Factors in Patients with Infection After Scoliosis

作　　者：范珂 高强 张留巧[2] 焦文娟 支慧 FAN Ke;GAO Qiang;ZHANG Liuqiao;JIAO Wenjuan;ZHI Hui(Henan People's Hospital,People's Hospital of Zhengzhou University,Zhengzhou 450003,Henan,China;Henan Traditional Chinese Medicine Hospital,Zhengzhou 450002,Henan,China)

机构地区：[1]河南省人民医院,郑州大学人民医院,河南郑州450003 [2]河南省中医院,河南郑州450002

出　　处：《中华中医药学刊》2021年第7期46-49,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：中华医学会临床医学科研专项(18010086523);河南省医学科技攻关计划省部共建项目(SBGJ2018076)。

摘　　要：目的探讨复元活血汤联合清创术后置管对脊柱侧凸后路矫形融合术后感染疗效及对炎症因子影响性。方法回顾性分析2016年1月—2019年12月在医院脊柱科住院的48例脊柱侧凸后路矫形融合术后感染患者,根据治疗方案不同分成两组,对照组24例,予清创术后置管引流并应用抗菌药物,研究组24例,在对照组基础上加用复元活血汤口服治疗,治疗3周。观察治疗前、治疗3周后炎症因子、凝血功能、血液流变学变化并比较。比较不同时期疼痛视觉模拟(VAS)评分。结果 (1)治疗3周后C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、高迁移率族蛋白-1(HMGB-1)、白细胞介素-6(IL-6)和治疗前比较两组均显著下降;且治疗3周后研究组下降程度显著高于对照组,均有统计学意义(P<0.05)。(2)治疗3周后酶原时间(PT)、活化部分凝血酶原时间(APTT)、血小板计数(PLT)和治疗前比较显著升高,纤维蛋白原(FIB)、D-二聚体(D-D)显著下降;治疗3周后研究组PT、APTT、PLT显著高于对照组,FIB、D-D显著低于对照组,均有统计学意义(P<0.05)。(3)对照组治疗前、治疗3周后血液流变学指标比较差异无统计学意义(P>0.05),治疗3周后较治疗前研究组全血黏度、全血还原黏度高切、中切、低切水平均显著下降,有统计学意义(P<0.05),且治疗3周后研究组以上指标均显著低于对照组,差异有统计学意义(P<0.05)。(4)两组治疗后第1周、2周、3周VAS评分较治疗前比较均显著下降,且研究组显著低于对照组,均有统计学意义(P<0.05)。结论复元活血汤联合清创术后置管能抑制脊柱侧凸后路矫形融合术后感染炎症反应,促进血液循环,改善疼痛,提高疗效。Objective To investigate the effect of Fuyuan Huoxue Decoction(复元活血汤) combined with catheter placement after debridement on infection and inflammatory factors after posterior spinal fusion. Methods A retrospective analysis was made on 48 cases of infection after posterior approach orthopedic fusion of scoliosis hospitalized in the spine department of our hospital from January 2016 to December 2019. According to the different treatment schemes, they were divided into two groups. The control group(24 cases) was treated with catheter drainage after debridement and antibiotics. The study group(24 cases) was treated with Fuyuan Huoxue Decoction on the basis of the control group(3 weeks). The changes of inflammatory factors, coagulation function and hemorheology before and after treatment were observed and compared. The visual analogue of pain(VAS) scores in different periods were compared. Results(1)After 3 weeks of treatment, C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), procalcitonin(PCT), high mobility group protein-1(HMGB-1) and interleukin-6(IL-6) were decreased significantly in the study group compared with those of the control group(P<0.05).(2)After 3 weeks of treatment, Pt, APTT, PLT, FIB and D-D were significantly higher than those of the control group, and FIB and D-D were significantly lower than those of the control group(P<0.05).(3)There was no significant difference in hemorheological indexes between the control group before treatment and after 3 weeks of treatment(P>0.05). After 3 weeks of treatment, the levels of whole blood viscosity, high shear, medium shear and low shear of whole blood reduced viscosity in the study group were significantly lower than those in the control group(P<0.05). After 3 weeks of treatment, the above indexes in the study group were significantly lower than those in the control group, and the difference was statistically significant(P<0.05).(4)The VAS scores of the two groups at the first, second and third weeks after treatment were significantly lower t

关 键 词：复元活血汤 清创术后置管 脊柱侧凸后路矫形融合术后感染 炎症因子 凝血功能 血液流变学 

分 类 号：R274.981.5[医药卫生—中西医结合]