仙方活命饮治疗热毒蕴结型骨髓炎临床研究  

Clinical Study on Xianfang Huoming Decoction for Osteomyelitis of Heat Toxin Accumulation Type

作　　者：常宗伟 葛占州 孙小旭 CHANG Zongwei;GE Zhanzhou;SUN Xiaoxu(Fifth Department of Orthopedics,Chinese Medicine Hospital of Puyang,Puyang Henan 457001,China)

机构地区：[1]濮阳市中医医院骨五科,河南濮阳457001

出　　处：《新中医》2024年第21期27-32,共6页New Chinese Medicine

摘　　要：目的:观察仙方活命饮治疗热毒蕴结型骨髓炎的临床疗效。方法:选取120例热毒蕴结型骨髓炎患者为研究对象,按随机数字表法分为观察组及对照组各60例。2组均行常规手术清创,对照组术后采用负压封闭引流技术(VSD)治疗,观察组在对照组基础上采用仙方活命饮治疗。2组均治疗4周。观察2组恢复情况及不良反应发生情况,比较2组治疗前后中医证候积分、炎症因子[C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、红细胞沉降率(ESR)]、膝关节功能障碍评分(HSS)、踝关节功能量表(Baird-Jackson)评分的变化,采用双变量相关性person分析骨髓炎患者炎症因子与临床症状的相关性。结果:治疗4周后,观察组骨愈合、肉芽覆盖创面、创口愈合、肿胀消退及疼痛消失时间均短于对照组,差异均有统计学意义(P<0.05)。治疗4周后,2组患肢疼痛、患肢肿胀、皮肤颜色、皮肤温度中医证候积分及总分均较治疗前下降(P<0.05),观察组上述4项中医证候积分及总分均低于对照组(P<0.05)。治疗4周后,2组CRP、TNF-α、IL-6、IL-8、ESR血清炎症因子水平均较治疗前下降,观察组上述5项水平均低于对照组(P<0.05)。骨髓炎患者CRP、TNF-α、IL-6、IL-8、ESR水平与患肢疼痛、患肢肿胀、皮肤颜色、皮肤温度症状严重程度呈正相关(r>0,P<0.05)。治疗2周、4周,HSS评分、Baird-Jackson评分均较治疗前升高,观察组HSS评分、Baird-Jackson评分均高于对照组(P<0.05)。治疗期间,2组均未发生严重不良反应。结论:仙方活命饮能够有效抑制骨髓炎患者机体炎症反应,缓解临床症状,促进病灶愈合,改善膝关节及踝关节功能。Objective:To observe the curative effect of Xianfang Huoming Decoction on osteomyelitis of heat toxin accumulation type.Methods:A total of 120 cases of patients with osteomyelitis of heat toxin accumulation type were selected as the research subjects and divided into the observation group and the control group,with 60 cases in each group,using a random number table method.All patients underwent routine surgical debridement.The control group was treated with negative pressure vacuum sealing drainage(VSD)after surgery,and the observation group was additionally treated with Xianfang Huoming Decoction on the basis of the treatment of the control group.Both groups were treated for four weeks.Observed the recovery and occurrence of adverse reactions in two groups,compared the changes in traditional Chinese medicine syndrome scores,inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),erythrocyte sedimentation rate(ESR)],Hospital for Special Surgery(HSS)of knee scores,and ankle joint function scale(Baird-Jackson)scores before and after treatment,and used bivariate correlation person analysis to investigate the correlation between inflammatory factors and clinical symptoms in patients with osteomyelitis.Results:After four weeks of treatment,the observation group had shorter bone healing,granulation tissue covering the wound,wound healing,swelling resolution,and pain disappearance time than the control group,the difference being significant(P<0.05).After four weeks of treatment,the traditional Chinese medicine syndrome scores and total scores for limb pain,swelling,abnormal skin color,and abnormal skin temperature in both groups were decreased when compared with those before treatment(P<0.05),and the observation group had lower scores and total scores for the above four traditional Chinese medicine syndromes than the control group(P<0.05).After four weeks of treatment,the inflammatory factors levels of CRP,TNF-α,IL-6,IL-8,and ESR in serum in both groups were

关 键 词：骨髓炎 热毒蕴结型 仙方活命饮 炎症因子 膝关节功能 

分 类 号：R681.2[医药卫生—骨科学] R274.9[医药卫生—外科学]