改良桃红四物汤对使用止血带后肢体缺血再灌注损伤保护作用的临床研究  

Clinical Study on the Protective Effect of Modified Taohong Siwu Decoction on Limb Ischemia-Reperfusion Injury After Applying Tourniquet

作　　者：撒忠秋 周熙 白志林 徐达成 蔡旭东 SA Zhong-qiu;ZHOU Xi;BAI Zhi-lin;XU Da-cheng;CAI Xu-dong(Kunshan Integrated Traditional Chinese and Western Medicine Hospital,Jiangsu Kunshan 215332)

机构地区：[1]昆山市中西医结合医院,江苏昆山215332

出　　处：《深圳中西医结合杂志》2023年第10期4-8,共5页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：昆山市级科技项目(KSZ2117)。

摘　　要：目的:探究改良桃红四物汤对使用止血带后肢体缺血再灌注损伤的保护作用。方法:选取昆山市中西医结合医院2020年7月至2021年12月期间收治的四肢创伤性闭合性骨折患者80例为研究对象,采用随机数字表法分为观察组和对照组,各40例。对照组患者术后采用20%甘露醇注射液静脉滴注。观察组患者术后采用改良桃红四物汤口服治疗。比较观察两组患者治疗前后肿胀、疼痛、关节活动、末梢循环度等情况;分析两组患者治疗前后血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、血栓素B2(TXB2)、前列环素(PGI2)水平变化,全面评估临床疗效。结果:治疗后两组患者的患肢肿胀程度、疼痛程度、关节活动度评分均有不同程度下降,末梢循环评分均有不同程度上升,且治疗后观察组患者的患肢肿胀程度、疼痛程度、关节活动度评分均低于对照组,末梢循环评分高于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者的血清TNF-α、IL-6水平均有不同程度降低,TXB2、PGI2水平有不同程度升高,且治疗后观察组患者的TNF-α、IL-6水平均低于对照组,TXB2、PGI2水平均高于对照组,差异具有统计学意义(P<0.05)。观察组患者治疗总有效率为97.50%,高于对照组的82.50%,差异具有统计学意义(P<0.05)。结论:改良桃红四物汤用于肢体缺血再灌注损伤患者的疗效优异,可通过降低患者血清TNF-α、IL-6水平及升高TXB2、PGI2水平以改善患者机体炎症反应和血液高凝状态,从而有效缓解患者肢体肿胀、疼痛等临床症状并改善患者关节活动度及末梢循环状态。Objective To investigate the protective effect of modified Taohong Siwu decoction on limb ischemia-reperfusion injury after tourniquet application.Methods A total of 80 patients with traumatic closed fracture of limbs admitted to Kunshan Integrated Traditional Chinese and Western Medicine Hospital from July 2020 to December 2021 were selected as the study objects,and were divided into an observation group and a control group by random number table method,with 40 cases in each group.The control group received 20%mannitol injection intravenously after operation,the observation group was treated with modified Taohong Siwu decoction orally after operation.The swelling,pain,joint movement and peripheral circulation of the two groups were compared before and after treatment.The serum concentrations of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),thromboxane B2(TXB2),and prostacyclin I2(PGI2)in the two groups were analyzed before and after treatment,and the clinical efficacy was evaluated comprehensively.Results After treatment,the swelling degree,pain degree and joint motion score of the two groups decreased to varying degrees,and the peripheral circulation score increased to varying degrees.After treatment,the swelling degree,pain degree and joint motion score of the observation group were lower than in the control group,and the peripheral circulation score was higher than in the control group,the differences were statistically significant(P<0.05).After treatment,serum TNF-αand IL-6 were decreased to varying degrees,while TXB2 and PGI2 were increased to varying degrees,and the levels of TNF-αand IL-6 in the observation group were lower than those in the control group,while the levels of TXB2 and PGI2 were higher than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of the observation group was 97.50%,which was higher than that in the control group(82.50%),and the difference was statistically significant(P<0.05).Conclusion Modified Taohong Siwu decocti

关 键 词：缺血再灌注损伤 肢体缺血 改良桃红四物汤 

分 类 号：R658[医药卫生—外科学]