伤科肿痛酊中药塌渍对前交叉韧带悬吊固定术后肿胀疼痛、疼痛-炎症介质的影响  

Effects of Shangke Zhongtong Tincture wet compress therapy on swelling,pain,and pain-inflammatory mediators after anterior cruciate ligament suspension fixation

作　　者：蒋臻 李玉福 郑伟[1] 高杨 王小菲 何晓丽 董赛 高凯 JIANG Zhen;LI Yufu;ZHENG Wei;GAO Yang;WANG Xiaofei;HE Xiaoli;DONG Sai;GAO Kai(Orthopedic Department of Chinese Medicine,The Third Hospital of Shijiazhuang,Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市第三医院中医骨科,河北石家庄050000

出　　处：《湖南中医药大学学报》2024年第10期1822-1827,共6页Journal of Hunan University of Chinese Medicine

基　　金：河北省中医药类科学研究课题计划项目(2023384,2022187)。

摘　　要：目的探究伤科肿痛酊中药塌渍缓解前交叉韧带悬吊固定术后肿胀疼痛的效果与机制。方法选取2021年4月至2023年6月石家庄市第三医院中医骨科住院部前交叉韧带悬吊固定术患者100例,采用随机数字表法分为常规组和肿痛酊组,各50例。常规组予以双氯芬酸二乙胺乳胶剂,肿痛酊组予以伤科肿痛酊中药塌渍。比较两组临床疗效,患肢手术、肿胀高峰时间、皮肤褶皱出现时间、Kolcaba的舒适状况量表评分(general comfort questionnaire,GCQ),肿胀与疼痛程度,引流液疼痛介质[神经肽Y(neuropeptide Y,NPY)、前列腺素E2(prostaglandin E2,PGE2)、P物质],引流液炎症因子[C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因(tumor necrosis factor-α,TNF-α)、淀粉样蛋白A(serum amyloid A,SAA)、白细胞介素6(interleukin-6,IL-6)]及安全性。结果肿痛酊组总有效率(94.00%)高于常规组(76.00%)(P<0.05)。肿痛酊组患肢肿胀高峰时间、皮肤褶皱出现时间早于常规组(P<0.01),总用药7 d的GCQ评分高于常规组(P<0.01)。肿痛酊组用药1 d、用药2 d、用药3 d、用药7 d双侧肢体周径差、疼痛视觉模拟评分法(visual analogue scale,VAS)评分低于常规组(P<0.05)。肿痛酊组用药1 d、用药2 d的NPY、PGE2、P物质低于常规组(P<0.01)。肿痛酊组用药2 d的CRP、TNF-α、SAA、IL-6低于常规组(P<0.01)。结论伤科肿痛酊中药塌渍能抑制疼痛介质、炎症因子合成,有效缓解前交叉韧带悬吊固定术后肿胀疼痛,加快患者恢复,提高患者舒适度,具有一定安全性。Objective To explore the effects and mechanism of Chinese medicine wet compress therapy with Shangke Zhongtong Tincture(SKZTT)in relieving swelling and pain after anterior cruciate ligament(ACL)suspension fixation.Methods A total of 100 patients who underwent ACL suspension fixation in the Orthopedic Department of Chinese medicine,the Third Hospital of Shijiazhuang from April 2021 to June 2023 were selected and randomly divided into routine treatment group and Zhongtong Tincture group,with 50 cases in each group.The routine treatment group was treated with diclofenac diethylamide emulsion,while the Zhongtong Tincture group received Chinese medicine wet compress therapy with SKZTT.The two groups were compared in terms of clinical efficacy,time to peak swelling of the affected limb,time to skin fold appearance,Kolcaba's general comfort questionnaire(GCQ)score,degree of swelling and pain,pain mediators in drainage fluid[neuropeptide Y(NPY),prostaglandin E2(PGE2),substance P],inflammatory factors in drainage fluid[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),serum amyloid A(SAA),interleukin-6(IL-6)],and safety.Results The total effective rate of the Zhongtong Tincture group(94.00%)was higher than that of the routine treatment group(76.00%)(P<0.05).The time to peak swelling and the time to skin fold appearance in the affected limb were earlier in the Zhongtong Tincture group than in the routine treatment group(P<0.01).The GCQ score at 7 d after treatment was higher in the Zhongtong Tincture group than in the routine treatment group(P<0.01).The circumference differences of bilateral limbs and the visual analogue scale(VAS)pain scores were lower in the Zhongtong Tincture group than in the routine treatment group at 1 d,2 d,3 d,and 7 d after treatment(P<0.05).The levels of NPY,PGE2,and substance P in the drainage fluid of the Zhongtong Tincture group were lower than those of the routine treatment group at 1 d and 2 d after treatment(P<0.01).The levels of CRP,TNF-α,SAA,and IL-6 in the Zhongtong Tincture group

关 键 词：疼痛介质 炎症因子 伤科肿痛酊 中药塌渍 前交叉韧带悬吊固定术 肿胀 疼痛 

分 类 号：R274[医药卫生—中医骨伤科学]