复元活血汤联合葶苈大枣泻肺汤加减辅助治疗肋骨骨折合并血胸临床研究

Clinical Study on Modified Treatment of Fuyuan Huoxue Tang Combined with Tingli Dazao Xiefei Tang for Rib Fracture Complicated with Hemothorax

目的:观察复元活血汤联合葶苈大枣泻肺汤加减治疗肋骨骨折合并血胸的临床疗效。方法:选取68例肋骨骨折合并血胸患者,按随机数字表法分为对照组和观察组,每组34例。对照组采用西医常规治疗,观察组在对照组治疗基础上给予复元活血汤联合葶苈大枣泻肺汤加减治疗。对比2组康复情况和治疗前后肺功能、血液流变学及凝血功能指标。结果:观察组疼痛消失时间、血胸消失时间、骨折愈合时间及住院时间均短于对照组,差异均有统计学意义(P <0.01)。治疗7、14天,2组D-二聚体(D-D)水平均较治疗前下降(P <0.01);观察组D-D水平均低于同期对照组(P <0.01)。治疗后,2组用力肺活量(FVC)及第1秒用力呼气量/FVC (FEV1/FVC)值均较治疗前升高(P <0.01);观察组FVC及FEV1/FVC值均高于对照组(P <0.01)。治疗后,2组全血黏度(高切、中切、低切)及血浆黏度水平均较治疗前降低(P <0.01);观察组全血黏度(高切、中切、低切)及血浆黏度水平均低于对照组(P <0.01)。结论:复元活血汤联合葶苈大枣泻肺汤加减治疗肋骨骨折合并血胸,可促进患者骨折愈合,改善肺功能、血液流变学和凝血功能。

Objective:To observe the clinical effect of the modified treatment of Fuyuan Huoxue tang combined with Tingli Dazao Xiefei tang for rib fracture complicated with hemothorax. Methods: A total of 68 cases of patients with rib fracture complicated with hemothorax were divided into the control group and the observation group according to the random number table method,34 cases in each group. The control group was treated with routine western medicine, and the observation group was additionally given the modified treatment of Fuyuan Huoxue tang and Tingli Dazao Xiefei tang based on the treatment of the control group. The rehabilitation as well as the indexes of the lung function, hemorheology and the coagulation function before and after treatment in the two groups were compared. Results:The disappearance time of pain and hemothorax,the fracture healing time and the hospitalization time in the observation group were shorter than those in the control group,differences being significant(P < 0.01). After 7 days and 14 days of treatment,the levels of D-dimer(D-D)in the two groups were decreased when compared with those before treatment(P < 0.01);the level of D-D in the observation group was lower than that in the control group in the same period(P < 0.01). After treatment,the values of forced vital capacity(FVC)and the ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC)in the two groups were increased when compared with those before treatment(P < 0.01);the above values in the observation group were higher than those in the control group(P < 0.01). After treatment,the levels of whole blood viscosity(high shear,middle shear and low shear)and plasma viscosity in the two groups were decreased when compared with those before treatment(P < 0.01);and the above levels in the observation group were lower than those in the control group(P < 0.01). Conclusion:The modified treatment of Fuyuan Huoxue tang combined with Tingli Dazao Xiefei tang in treating rib fracture complicated with hemothorax can promote fracture healing of patients as well as improve the lung function,hemorheology and the coagulation function.