清热、活血、益气法对创伤组织修复的临床研究

Clinical Study on the Methods of Promoting Blood Flow,Replenishing Qi and Clearing Heat in Healing Wound Tissue

目的:探讨清热、活血、益气法对围手术期创伤组织修复的影响。方法:开放胆囊切除术的患者共64例,随机分为两组。对照组按照常规临床路径治疗;治疗组在标准临床路径的基础上加用分期中医辨证处方治疗方案:手术当日及术后第1～3天静脉滴注清开灵注射液、丹参注射液;术后第4～7天静脉滴注参麦注射液、丹参注射液。观察患者术后体温恢复正常时间、伤口愈合情况、白细胞恢复正常时间、胃肠功能恢复时间、体质量变化、伤口愈合情况、胃肠道功能恢复情况、并发症情况、住院时间、住院费用等指标。结果:治疗组在体温恢复正常时间、白细胞恢复正常时间、肛门排气时间、术后首次排便时间、拆线时间、体质量减轻等方面,均优于对照组,差异有统计学意义(P<0.05);治疗组并发症发生率低于对照组。结论:清热、活血、益气法能够促进创伤组织修复;在围手术期运用分期辨证理念有助于术后康复。

Objective ： To evaluate effects of the treatment methods of promoting blood flow, replenishing qi and clearing heat in healing wound tissue of perioperative period. Methods ：64 patients of open cystectomy were selected and divided into 2 groups in random. Patients in the control group were treated with routine treatment in clinic ; Patients in the treatment group, based on the above standard treatment,were additionally given the treatment program of syndrome differentiation and prescription of TCM by stages. The patients were given intravenous injection of Qingkailing injection and Danshen injection at the operation day and 1 -3 days after operation. The patients were given intravenous injection of Shenmai injection and Danshen injection at the 4 - 7 days after operation. The postoperative body temperature recovery time,wound healing condition, white blood ceils （WBC） recovery time, the recovery time of gastrointestinal functions, body weigh changes, complications,length of stay in hospital and costs of hospitalization of the patients were observed and in- vestigated. Results：The treatment group was better than the control groups in the following items such as body temperature recovery time, WBC recovery time, time of passage of gas by anus, first defecation time after operation, the time of taking out stitches, body weight lessening and so on and difference had statistic significance （P 〈 0. 05 ）. The incidence of complications in treatment group was lower than control group. Conclusion ： The treatment methods of promoting blood flow, replenishing qi and clearing heat could promote wound tissue healing and the use of syndrome differentiation by stages contributes to the postoperative rehabilitation in the perioperative stage.