自拟活血消肿方减轻高能量胫骨平台骨折术前肢体肿胀的临床研究  

Clinical Study on Self-prepared Huoxue Xiaozhong Decoction in Alleviating Preoperative Limb Swelling of High-energy Tibial Plateau Fractures

作　　者：邵加龙[1] 要少飞 钟世荣 薛锦标[1] 汤继磊 SHAO Jialong;YAO Shaofei;ZHONG Shirong;XUE Jinbiao;TANG Jilei(Qidong Hospital of Traditional Chinese Medicine,Nantong 226200,China)

机构地区：[1]启东市中医院,江苏南通226200

出　　处：《河北中医药学报》2025年第1期19-25,共7页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：南通市中医医疗联盟课题(TZYK202223)。

摘　　要：目的:探讨自拟活血消肿方在高能量胫骨平台骨折术前准备阶段的运用价值。方法:本研究纳入就诊于启东市中医院骨伤科80例高能量胫骨平台骨折患者,随机分为对照组和观察组,每组各40例,2组均接受常规消肿治疗,观察组在对照组基础上加入自拟活血消肿方。对2组患者的疼痛控制、炎症因子水平、治疗进程、肿胀消退情况、术后关节功能进行评估。结果:在治疗后3、5和7 d,观察组的疼痛视觉模拟量表(VAS)评分低于对照组(P<0.05)。在治疗后7 d,观察组的疼痛递质(SP、PGE2、NPY)、炎症因子(CRP、IL-6、TNF-α)均低于对照组(P<0.05)。观察组术前等待时间、术后住院时间、骨折愈合时间及术后6个月膝关节评分系统(HSS)评分均优于对照组(P<0.05)。治疗后3、5、7 d,观察组的肿胀值均低于对照组(P<0.05)。治疗后3、5、7 d,观察组肿胀优良率及术后6月HSS评分优良率均优于对照组(P<0.05)。操作特征(ROC)分析显示,观察组肿胀优良率和术后6个月HSS评分优良率ROC曲线下面积分别为AUC=0.613和AUC=0.600。结论:自拟活血消肿方在高能量胫骨平台骨折患者的术前准备中能够有效减少肿胀,缓解疼痛,促进术后关节功能的恢复。Objective:To explore the application value of self-prepared Huoxue Xiaozhong Decoction in the preoperative preparation stage of high-energy tibial plateau fractures.Methods:This study included 80 patients with high-energy tibial plateau fractures,who were randomly divided into a control group and an observation group,with 40 cases in each group.Both groups received routine swelling reduction treatment,and the observation group was additionally given self-prepared Huoxue Xiaozhong Decoction in addition.The pain control,inflammatory factor levels,treatment progress,swelling reduction,and postoperative joint function of the two groups of patients were evaluated.Results:At 3,5,and 7 days after treatment,the visual analogue scale(VAS)scores for pain in the observation group were lower than those in the control group(P<0.05).At 7 days after treatment,the levels of substance P(SP),prostaglandin E2(PGE2),and neuropeptide Y(NPY)were lower than those in the control group(P<0.05).At 7 days after treatment,the inflammatory indicators C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor(TNF-α)were lower than those in the control group(P<0.05).In the treatment progress,the observation group was superior to the control group in preoperative waiting time,postoperative hospital stay,and fracture healing time(P<0.05).Regarding swelling indicators,the swelling values of the observation group at 3,5,and 7 days after treatment were better than those of the control group(P<0.05),and the swelling grades at 5 days and 7 days after treatment were also better than those of the control group(P<0.05).At 6 months after surgery,the Hospital for Special Surgery(HSS)knee score of the observation group was higher than that of the control group(P<0.05).The excellent rates of swelling at 3,5,and 7 days after treatment and the excellent rate of HSS at 6 months after surgery in the observation group were all better than those in the control group(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the excellent

关 键 词：高能量损伤 胫骨平台骨折 自拟活血消肿方 消肿 疼痛控制 关节功能康复 

分 类 号：R274.9[医药卫生—中西医结合]