“接骨木康方”外敷治疗伴胫距关节半脱位SER Ⅳ度踝骨折早期肿痛研究

Clinical research on early-stage swelling and pain of SER Ⅳ ankle fracture complicated with tibiotalar subluxation treated with the external application of jiegumu formula

目的观察中药"接骨木康方"外敷治疗伴踝关节骨折早期肿痛的疗效。方法将65例伴胫距关节半脱位SERⅣ度踝骨折患者随机分为两组,对照组32例给予西乐葆及七叶皂苷钠消肿止痛等常规治疗,治疗组33例在常规治疗基础上用"接骨木康方"外敷于患肢肿胀处,分别于治疗后3、5、7 d进行肢体肿胀、疼痛程度和疗效评定。结果治疗组总有效率高于对照组,并且治疗后5 d和7 d治疗组肿胀改善情况显著优于对照组,表明"接骨木康方"促进伴胫距关节半脱位SERⅣ度踝骨折肿胀消退效果确切。治疗后3 d两组患肢肿胀情况比较差异无统计学意义,考虑伤后3 d左右炎性反应强,肿胀达到高峰,且SERⅣ度踝骨折伴胫距关节半脱位受伤暴力较大,肿胀严重,往往肿胀开始消退缓慢,至达到手术条件需7～10 d,故两组治疗后7 d总有效率均低于90%。治疗组治疗后3 d和5 d VAS疼痛评分较对照组明显降低,但治疗后7 d VAS评分比较差异无统计学意义,表明"接骨木康方"缓解伴胫距关节半脱位SERⅣ度踝骨折早期(3～5 d)疼痛有一定优势。结论 "接骨木康方"外敷能有效缓解伴胫距关节半脱位SERⅣ度踝骨折早期肢体肿胀及疼痛。

Objective To observe the therapeutic effects on early-stage swelling and pain of SERⅣankle fracture complicated with tibiotalar subluxation treated with the external application of jiegumu formula.Methods A total of65patients of SER IV ankle fracture complicated with tibiotalar subluxation were randomized into two groups.In the control group,32cases were treated with the routine schemes,including celecoxib and sodium aescinate to remove swelling and pain.In the treatment group,on the base of the treatment as the control group,33cases were treated with the external application of jiegumu formula on the local swelling area.Separately,on day3,5and7after treatment,the limb swelling,pain and therapeutic effects were evaluated.Results The total effective rate in the treatment group was higher than the control group.On day5and7after treatment,the improvement in swelling in the treatment group was significantly better than the control group.It was indicated that jiegumu formula had the definite effects of removing swelling in SERⅣankle fracture complicated with tibiotalar subluxation.On day3after treatment,the swelling of the affected limb was not different significant between the two groups.It was considered that about on day3after injury,the inflammatory reaction was strong,swelling was up to the peak degree,the injured violence of SERⅣankle fracture complicated with tibiotalar subluxation was strong and swelling was serious.In generally,it takes7to10days for the starting of the slow removal of swelling when the case meets the operation criteria.It was the reason why the total effective rate on day7after treatment was less than90%in the two groups.On day3and5after treatment,VAS scores in the treatment group were reduced obviously as compared with the control group and the effects were similar between the two groups on day7.It was indicating that jiegumukang formula was.advantageous at relieving pain at the early stage(3to5days)of SERⅣankle fracture complicated with tibiotalar subluxation.Conclusion The external application of jiegumu formula effectively relieves swelling and pain of the limb at the early stage of SERⅣankle fracture complicated with tibiotalar subluxation.