改良桃红四物汤辅助治疗对创伤性四肢骨折术后患肢末梢循环及血栓素B_(2)、前列腺素I_(2)水平的影响  

Effects of modified Taohong Siwu Decoction on postoperative affected limb peripheral circulation and serum levels of TXB_(2) and PGI_(2) in patients with traumatic limb fractures

作　　者：白志林 周熙 撒忠秋 Bai Zhilin;Zhou Xi;Sa Zhongqiu(Department of Orthopedics,Kunshan Integrated Traditional Chinese and Western Medicine Hospital,Kunshan215300,China)

机构地区：[1]昆山市中西医结合医院骨科,昆山215300

出　　处：《国际中医中药杂志》2024年第8期993-998,共6页International Journal of Traditional Chinese Medicine

基　　金：昆山市科技局科技计划项目(KSZ2117)。

摘　　要：目的评价改良桃红四物汤辅助治疗对创伤性四肢骨折患者术后患肢末梢循环及血栓素B_(2)(TXB_(2))、前列腺素I_(2)(PGI_(2))水平的影响。方法随机对照试验研究。选择2020年2月-2023年2月本院70例行切开复位内固定术的创伤性四肢骨折患者作为观察对象, 按住院顺序分对照组34例、观察组36例。对照组行常规治疗, 观察组在对照组基础上予改良桃红四物汤辅助治疗。2组均治疗2周。分别于治疗前后进行中医证候评分;采用多普勒血流探测仪测量踝肱指数(ABI), 彩色多普勒超声仪检测血管内径、血流量及患肢深静脉;采用ELISA法检测TXB2、PGI2水平, 评价临床疗效。结果观察组总有效率为91.67%(33/36)、对照组为73.53%(25/34), 2组比较差异有统计学意义(χ^(2)=4.05, P=0.044)。观察组治疗后气血凝滞[(2.13±0.43)分比(3.61±0.96)分, t=5.85]、筋骨损伤[(1.62±0.41)分比(2.74±0.58)分, t=9.37]、肿胀瘀斑[(1.15±0.31)分比(2.28±0.52)分, t=11.12]、肝肾不足[(1.52±0.24)分比(2.15±0.36)分, t=8.66]积分低于对照组(P<0.001);观察组治疗后ABI[(0.83±0.03)比(0.74±0.02), t=14.68]、血管内径[(0.48±0.13)mm比(0.42±0.11)mm, t=2.08]、血流速度[(60.24±15.46)cm/s比(52.15±12.11)cm/s, t=2.41]高于对照组(P<0.01或P<0.05)。观察组治疗后血清TXB_(2)水平[(140.76±16.64)ng/L比(168.39±25.28)ng/L, t=5.37]及TXB_(2)/PGI_(2)比值[(6.67±1.24)比(9.33±1.69), t=7.54]低于对照组(P<0.01);PGI_(2)水平[(21.27±2.24)ng/L比(18.71±1.79)ng/L, t=5.26]高于对照组(P<0.01)。观察组治疗后深静脉血栓发生率为19.44%(7/36)、对照组为44.12%(15/34), 2组比较差异有统计学意义(χ^(2)=4.94, P=0.026)。结论改良桃红四物汤辅助治疗可提高创伤性四肢骨折患者切开复位内固定术后临床疗效、减轻临床症状、改善患肢末梢循环状态、减轻术后高凝状态并预防深静脉血栓形成。Objective:To observe the effects of modified Taohong Siwu Decoction on peripheral circulation status of affected limbs and serum thromboxane B_(2)(TXB_(2))and prostacyclin(PGI_(2))levels in patients with traumatic limb fractures after open reduction and internal fixation.Methods:Randomized controlled trial study was conducted.70 patients with traumatic limb fractures who underwent open reduction and internal fixation in the hospital from February 2020 to February 2023 were set as observation subjects and divided into control group(34 cases)and observation group(36 cases)according to the order of hospitalization.The control group was given conventional method for treatment,and the observation group was given modified Taohong Siwu Decoction adjuvant therapy on the basis of the control group.The treatment for both groups lasted for 2 weeks.TCM symptoms scores were evaluated before and after treatment.Ankle brachial index(ABI)was detected using a Doppler blood flow detector.Color Doppler ultrasound was used to detect the inner diameter,blood flow,and deep veins of the affected limb;serum levels of TXB 2 and PGI 2 were detected by ELISA.Results:After treatment,the total effective rate of clinical efficacy was 91.67%(33/36)in observation group and 73.53%(25/34)in control group,with statistical significance(P<0.05).After treatment,the observation group had lower scores for qi and blood stasis(2.13±0.43 vs.3.61±0.96,t=5.85),tendon and bone injury(1.62±0.41 vs.2.74±0.58,t=9.37),swelling and ecchymosis(1.15±0.31 vs.2.28±0.52,t=1.12),and liver and kidney deficiency(1.52±0.24 vs.2.15±0.36,t=8.66)compared to the control group(P<0.001);after treatment,the ABI(0.83±0.03 vs.0.74±0.02,t=14.68),vascular diameter[(0.48±0.13)mm vs.(0.42±0.11)mm,t=2.08],and blood flow velocity[(60.24±15.46)cm/s vs.(52.15±12.11)cm/s,t=2.41]in the observation group were higher than those in the control group(P<0.01 or P<0.05).After treatment,the serum TXB_(2) levels[(140.76±16.64)ng/L vs.(168.39±25.28)ng/L,t=5.37]and TXB_(2)/PGI_(2)(6.6

关 键 词：骨折 桃红四物汤 末梢循环 血栓素B2 前列腺素I_(2) 

分 类 号：R274.1[医药卫生—中医骨伤科学]