柴胡三七愈骨汤对跟骨骨折空心钉内固定术后患者肿胀疼痛程度、微循环及生活质量的影响  

Effects of Chaihu Sanqi decoction on the degree of swelling and pain,microcirculation and quality of life of patients after hollow nail internal fixation of heel fracture

作　　者：武学文 徐娜 WU Xue-wen;XU Na(Department of Orthopaedics and Traumatology,Chengde Hospital of Traditional Chinese Medicine,Chengde 067000,China)

机构地区：[1]承德市中医院骨伤科,河北承德067000 [2]承德市中心医院儿科,河北承德067000

出　　处：《中国中西医结合外科杂志》2025年第2期197-201,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：承德市科技计划项目(202204A023)。

摘　　要：目的:观察柴胡三七愈骨汤对跟骨骨折空心钉内固定术后患者肿胀疼痛程度、微循环及生活质量的影响。方法:选取2022年12月—2024年4月我院骨科收治的98例跟骨骨折患者,采用随机数字表法随机分为康复组和中药组,每组49例。两组均给予空心钉内固定治疗,康复组术后给予常规康复治疗,中药组术后在常规康复方案基础上联合柴胡三七愈骨汤治疗,连续用药2个疗程。记录两组临床疗效、首次出现皮肤皱褶时间、中医证候评分、生活质量综合评定问卷(GQOL-74)评分及并发症情况。结果:中药组的治疗总有效率(95.92%)高于康复组(81.63%),差异有统计学意义(P<0.05)。两组治疗前局部微循环差异无统计学意义(P>0.05)。两组治疗2周后流态、管襻及襻周评分均较治疗前降低,中药组治疗2周后低于康复组,差异有统计学意义(P<0.05)。两组治疗2周后襻顶血管直径较治疗前升高,中药组治疗2周后高于康复组,差异有统计学意义(P<0.05)。两组治疗前GQOL-74评分、中医证候评分差异无统计学意义(P>0.05)。两组治疗2周后GQOL-74评分较康复组更高,中药组治疗2周后高于康复组,差异有统计学意义(P<0.05)。两组治疗2周后中医证候评分较康复组更低,中药组治疗2周后低于康复组,差异有统计学意义(P<0.05)。中药组首次出现皮肤皱褶时间短于康复组,张力性水泡发生率低于康复组,差异有统计学意义(P<0.05),中药组肌腱腱鞘炎发生率与康复组比较,差异无统计学意义(P>0.05)。结论:柴胡三七愈骨汤可改善跟骨骨折空心钉内固定术后患者的局部微循环,促进肢体肿胀消除,降低术后张力性水泡发生率。Objective To observe the effects of Chaihu Sanqi decoction on the degree of swelling and pain,microcirculation and quality of life of patients after internal fixation of heel fracture with hollow nails.Methods Ninety-eight patients with calcaneal fractures admitted to the Department of Orthopaedics of our hospital were selected from December 2022 to April 2024,and were divided into 49 cases in the rehabilitation group and 49 cases in the traditional Chinese medicine group using the random number table method.49 cases were treated with hollow nails for internal fixation in the two groups,and the rehabilitation group was given conventional rehabilitation therapy after surgery,while the traditional Chinese medicine group was treated with Chaihu Sanqi decoction in conjunction with the conventional rehabilitation programme,and the medicine was administered for two consecutive courses of therapy after surgery.The clinical efficacy,the time of the first appearance of skin folds,the scores of TCM symptoms,the scores of GQOL-74,and the complications were recorded in the two groups.Results The total effective rate of the traditional Chinese medicine group was 95.92%higher than that of the rehabilitation group,which was 81.63%,with a difference(P<0.05).Comparison of local microcirculation before treatment between the two groups showed no difference(P>0.05).The flow pattern,tubular loop and loop circumference scores of both groups were lower than before treatment after 2 weeks of treatment,and the Chinese medicine group was lower than the rehabilitation group after 2 weeks of treatment,and there was a difference(P<0.05).The diameter of the loop apex vessel was elevated after 2 weeks of treatment in both groups compared with that before treatment,and it was higher in the traditional Chinese medicine group than that in the rehabilitation group after 2 weeks of treatment,and there was a difference(P<0.05).There was no difference in GQOL-74 score and TCM evidence score before treatment between the two groups(P>0.05).The GQOL-74

关 键 词：柴胡三七愈骨汤 跟骨骨折 空心钉内固定术 局部微循环 

分 类 号：R683[医药卫生—骨科学] R289.5[医药卫生—外科学]