自拟通脉活血汤于老年股骨骨折患者术后的应用  

Application of self-designed Tongmai Huoxue Decoction in elderly patients with femoral fracture after operation

作　　者：李煜 唐洪涛 张振东 Li Yu;Tang Hongtao;Zhang Zhendong(The second TCM hospital of Kaifeng city,Kaifeng,H enan,475004,China;Luoyang bonesetting hospital of Henan province(Henan provincial orthopaedichospital),Zhengzhou,Henan,471002,China)

机构地区：[1]开封市第二中医院,河南开封475004 [2]河南省洛阳正骨医院(河南省骨科医院),河南郑州471002

出　　处：《齐齐哈尔医学院学报》2022年第4期361-364,共4页Journal of Qiqihar Medical University

基　　金：河南省中医药科学研究专项课题(2016ZY2078)。

摘　　要：目的 探讨自拟通脉活血汤在老年股骨骨折患者术后的应用效果。方法 选择2018年6月—2020年3月本院收治的132例老年股骨骨折患者作为研究对象,按随机数表法分为对照组与研究组两组,每组各66例。对照组患者使用常规治疗,研究组患者在对照组基础上使用自拟通脉活血汤治疗。对比两组术后中医证候评分、疼痛程度[疼痛数字评分法(NRS)]、血浆致痛因子[前列腺素E2(PGE2)、缓激肽(BME)、5-羟色胺(5-HT)]。结果 治疗1周后,两组各项指标均明显低于治疗前,且两组相比较,研究组患者中医证候评分[肿胀(3.36±0.87)分、疼痛(1.35±0.26)分、活动障碍(2.15±0.66)分]、NRS评分[静息时(1.01±0.36)分、活动时(2.96±0.52)分、按压时(3.15±1.03)分]、血浆致痛因子水平[PGE2(145.95±15.26)pg/mL、BME(21.46±2.25)pg/ml、5-HT(245.36±26.58)pg/ml]均低于对照组患者中医症候评分[肿胀(4.18±1.01)分、疼痛(2.65±0.59)分、活动障碍(2.88±0.93)分]、NRS评分[静息时(1.83±0.51)分、活动时(3.52±1.11)分、按压时(4.04±1.31)分]、血浆致痛因子水平[PGE2(213.56±18.39)pg/ml、BME(27.94±2.59)pg/ml、5-HT(306.67±37.89)pg/ml],t值分别为(t=4.997、t=16.380、t=5.200)、(t=11.355、t=3.712、t=4.259)、(t=22.985、t=15.34、t=8.513),差异均具有统计学意义(均P<0.05)。结论 对于老年股骨骨折患者,术后采用自拟通脉活血汤辅助治疗效果较好,可有效改善临床症状并缓解疼痛,具有较高临床应用价值。Objective To explore the application effect of self-designed Tongmai Huoxue Decoction in elderly patients with femur fracture after surgery.Methods 132 elderly patients suffered with femur fracture, those were admitted to our hospital from June 2018 to March 2020, were selected as the research object, and they were divided into control group and research group according to random number table method, with 66 cases in each group.Patients in the control group were treated with conventional treatment, and patients in the research group were given self-designed Tongmai Huoxue Decoction on the basis of the control group. The results of postoperative TCM syndrome score, pain degree(numerical pain rating scale, NRS), plasma pain factor(prostaglandin E2, PGE2;bradykinin, BME;5-hydroxytryptamine, 5-HT) were compared between two groups.Results After 1 week of treatment, all indexes of the two groups were significantly lower than before. The TCM syndrome score of patients in the study group [swelling(3.36±0.87), pain(1.35±0.26), activity disorder(2.15±0.66)] NRS score [resting(1.01±0.36), activity(2.96±0.52), press(3.15±1.03)], and plasma pain factor levels [PGE2(145.95 ±15.26)pg/mL, BME(21.46±2.25)pg/mL, 5-HT(245.36±26.58)pg/mL] were lower than syndrome score [swelling(4.18±1.01), pain(2.65±0.59), activity disorder(2.88±0.93)], NRS score [resting(1.83±0.51), activity(3.52±1.11), press(4.04±1.31)], and plasma pain factor [PGE2(213.56±18.39)pg/mL, BME(27.94±2.59)pg/mL, 5-HT(306.67±37.89) pg/mL] in control group, all the differences were statistically significant(t=4.997, t=16.380, t=5.200;t=11.355, t=3.712, t=4.259;t=22.985, t=15.34, t=8.513;P<0.05).Conclusions For elderly patients with femur fracture, postoperative adjuvant treatment with self-designed Tongmai Huoxue Decoction has a good effect, which could effectively improve the clinical symptoms and relieve pain, and has high clinical application value.

关 键 词：股骨骨折 老年 自拟通脉活血汤 术后疼痛 致痛因子 

分 类 号：R683.4[医药卫生—骨科学]