骨折病人围手术期的中医证候规律初探

Study on the Characteristics of TCM Syndrome on Patients with Fracture During Perioperative Period

目的:了解骨折病人围手术期临床基本证候分布情况,探讨其发展规律。方法:收集我院收治的需要手术的符合纳入标准的骨折病人181例进行临床观察,并且按病例纳入标准观察患者的症状、舌脉象、体温、脉搏等生命体征及性别、年龄等基本情况,填入证型调查表,并根据诊断标准进行证型的归纳和确定,进而将调查表所得数据进行统计学分析。结果:证型评分手术前后比较:实证组、虚证组、热证组证型评分前后比较,差别有统计学意义,实证组积分明显减低,虚证组、热证组评分明显升高。其他组差别无统计学意义。证型手术前后分布变化分析,术前不同证型组间比较差别有统计学意义,气滞血瘀证患者最多,证型表现较为单一,术后组间比较差别无统计学意义,证型表现呈现多元化趋势。结论:骨折病人在围手术期的证型演变上存在着由实转虚、由实化热的变化趋势。

Objective To find out the elementary syndrome of patients with fracture during preoperative period,probe into the possible tendency in the regularity of the evolvement.Methods According to standard diagnosis,181 patients were collected in our hospital.The symptom,tongue and pulse presentations,temperature,pulse and other vital signs,and gender,age,other fundamental state was detected in all patients.All the information was filled into the form and was analyzed statistically.Results The operation related factors had the obvious intervention effect on all kind of the TCM syndrome.There were statistical differences in the Sthenia syndrome,Asthenia syndrome and Heat syndrome groups between post-operation and pre-operation.The score of post-operation of the Sthenia syndrome group was significantly lower than that of pre-operation,and the score of post-operation of the Asthenia syndrome and Heat syndrome groups were significantly higher than that of pre-operation.There were no statistical differences in the other syndrome groups between post-operation and pre-operation.The main pathogens was the syndrome of qi stagnation and blood stasis during preoperative period,and there were many different pathogens during postperative period.Conclusion The Characteristics of TCM Syndrome of patients with fracture during preoperative period usually transform from Sthenia syndrome to Asthenia syndrome or Heat syndrome.