加味复元活血汤在腰椎骨折病人围手术期的临床应用研究

Research of clinical application about concocted decoction for activating blood circulation on patients suffering fracture of dorsal vertebra or lumbar vertebra.

目的观察加味复元活血汤对胸腰椎骨折围手术期患者腹胀、血钾浓度及周围神经损伤症状的影响,探讨加味复元活血汤用于胸腰椎骨折患者围手术期的临床价值。方法39例胸腰椎骨折患者随机分为对照组、西药组、中药组,围手术期分别给予不同的干预措施,观察术后7 d患者腹胀、血钾离子浓度以及术后1个月、3个月周围神经损伤症状的变化。结果围手术期给予加味复元活血汤组术后7 d腹胀改善程度明显高于对照组;对照组和西药组在术后7 d血钾离子浓度显著降低,加味复元活血汤组血钾离子浓度较术前明显升高;术后1个月、3个月中药组患者周围神经损伤症状与另外两个组相比差异不显著。结论加味复元活血汤用于胸腰椎骨折围手术期可明显改善患者腹胀症状,缓解患者围手术期麻痹性肠梗阻引起的低血钾,改善消化道功能,促进食欲,从而促进体力恢复,有利于康复,但未观察到对周围神经损伤症状有明显改善。

Objective Observe how the concocted decoction for activating blood circulation influences abdominal distention, serum potassium concentration and peripheral nerve injury of the patients who suffering fracture of dorsal vertebra or lumbar vertebra before and after operation. Discuss the clinical value of concocted decoction for activating blood circulation. Methods 39 patients suffering fracture of dorsal vertebra or lumbar vertebra were selected at random and separated into Chinese ＆Western Comparative Group, Chinese Medicine Group and Western Medicine Group. Then they were given different interfering measures respectively. Look into the changes of abdominal distention and serum potassium concentration after seven - day operation and peripheral nerve injury after one - month and three - month operation. Results： After seven - day operation, the improvement of abdominal distention of patients who taking concocted decoction for aetivating blood eirculation hefore and after operation was much better that the patients in Chinese - Western Comparative Group. At the same time the concentration of serum potassium of patients in Western Medicine Group and Chinese - Western Group was obviously decreased, but the concentration of patients in Chinese Medicine Group was greatly increased. The symptom of peripheral nerve injury changed little for all three - group patients after one - month and three - month opera- tion, Conclusion Concocted decoction for activating blood circulation can obviously improve abdominal distention and relieve low serum potassium caused by adynamie ileus before and after operation. The decoction can also improve patients＇alimentary canal function and get their appetites up, then restore physical strength. But great improvement of peripheral nerve injmy was not found.