双氯芬酸联合活血祛瘀汤对骨折早期软组织挫伤的疗效及对血液流变学的影响

Clinical efficiency and effect of diclofenac combined with HuoXueHuaYuTang on hemorheology in the treatmen with fracture and early soft tissue injury

目的观察双氯芬酸联合活血祛瘀汤对骨折早期软组织挫伤的疗效及对血液流变学的影响。方法将2012年8月至2014年8月收治的100例骨折合并软组织挫伤患者,按照随机数字表法分为试验组和对照组(均50例)。对照组,肌内注射双氯芬酸钠注射液50 mg,1次/天,给药2 d;口服云南白药胶囊,0.25 g/次,3次/天,用药7 d。在对照组基础上,试验组早晚服用活血祛瘀法汤200 mL,共服用7 d。比较2组患者治疗前和治疗第1,3,5,7天的疼痛程度、患肢肿胀度,并评价2组患者治疗前后血液流变学指标及组织胰岛素样生长因子-1(IGFs-1)、蛋白表达水平。结果治疗7 d后,试验组与对照组的总有效率分别为94.0%,78.0%,试验组总有效率显著高于对照组(P<0.05)。在后3个时间点,试验组的疼痛程度、患肢肿胀度显著低于对照组(P<0.05);治疗7 d后,试验组全血黏度、血浆黏度、红细胞沉降率及红细胞比容都显著低于对照组(P<0.05)。2组患者治疗后IGFs-1 mRNA、蛋白表达水平均显著升高(P<0.05);试验组在治疗后IGFs-1 mRNA、蛋白表达水平亦显著高于对照组(P<0.05)。结论双氯芬酸联合活血祛瘀汤较单用西药能够使患者病情显著改善。

Objective To explore the clinical efficiency and effect of diclofenac combined with Huo Xue Hua Yu Tang on hemorheology in the treatmen with fracture and early soft tissue injury. Methods A total of100 cases of fracture and early soft tissue injury patients treated in our hospital from August 2014 to August 2012 were randomly divided into treatment group of 50 cases and control group of 50 cases. Patients in control group injected with diclofenac 50 mg,one time per 1 day,continued 2 d; plus Yunnanbaiyao capsule 0. 25 g,three times per 1 day,continued 7 d. Basis on the control group,treatment group combined with HuoXueHuaYuTang,200 mL / doses,1 doses / day,for 7 d. The degree of pain and swelling of the patients in two groups were compared before and after 1d,3 d,5 d,7d treatment. The hemorheology index,insulin-like growth factors-1（ IGFs-1）,and expression level of mRNA in two groups were evaluated before and after treatment. Results The total effective rate in treatment group and control group after 7 d of treatment was 94%,78%,respectively. The difference in two groups was significantly（ P〈0. 05）. The degree of pain,limb swelling in treatment group as significantly less than in control group after 3,5,7 d of treatment（ P〈0. 05）. The whole blood viscosity,plasma viscosity,erythrocyte sedimentation rate,hematocrit in treatment group after 7 d of treatmen was significantly lower than in control group（ P〈0. 05）. The IGFs- 1 mRNA,protein expression levels were significantly elevated in two groups of patients after treatment（ P〈0. 05）. The mRNA,protein expression levels of IGFs-1 were significantly in treatment group higher than in control group（ P〈0. 05）. Conclusion Diclofenac combine with HuoXueHuaYuTang can promote soft tissue IGFs-1 expression level,improving the local blood flow,promoting the repair and regeneration of skeletal muscle,and improving the degree of pain and swelling of patients,can be considered as one of the early treatment of soft tissue injury.