镇痛方内服外敷治疗四肢闭合性骨折早期软组织损伤临床疗效及对患者愈合过程中C反应蛋白、肿瘤坏死因子α的影响

The clinical effect of Zhentong recipe for internal and external use on early soft tissue injury of closed fracture of extremities and the effect on C-reactive protein and tumor necrosis factorαduring the healing process

目的观察镇痛方内服外敷治疗四肢闭合性骨折早期软组织损伤临床疗效及对患者愈合过程中炎症因子C反应蛋白(CRP)和肿瘤坏死因子α(TNF-α)的影响。方法将130例四肢闭合性骨折患者按照随机数字表法分为2组。2组均接受骨折复位治疗后,对照组65例予盐酸曲马多片治疗;观察组65例予镇痛方内服外敷治疗。2组均治疗8周后统计临床疗效,并观察2组治疗前后中医证候积分及血清炎症因子CRP、TNF-α水平,以及不良反应情况。结果观察组总有效率89.23%(58/65),对照组总有效率72.31%(47/65),观察组临床疗效优于对照组(P<0.05)。治疗后2组中医证候(骨折、肿胀、疼痛、肢体功能受限、局部斑块、尿赤、口渴、便秘、舌脉)积分及总分均较本组治疗前降低(P<0.05),且观察组均低于对照组(P<0.05)。治疗后2组血清CRP、TNF-α水平均较本组治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。观察组不良反应发生率27.69%(18/65),对照组不良反应发生率20.0%(13/65),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论镇痛方内服外敷治疗四肢闭合性骨折早期软组织损伤安全有效,能够显著减轻患者痛苦,抑制炎性反应发生,有效促进骨折愈合。

Objective To observe the effect of Zhentong recipe for internal and external use on early soft tissue injury of closed fracture of extremities and the effect on C-reactive protein(CRP)and tumor necrosis factorα(TNF-α)during the healing process.Methods 130 patients with closed fractures of extremities were divided into two groups according to the random number table method.After fracture reduction treatment,65 cases in the control group were treated by tramadol hydrochloride tablets.65 cases in the observation group were treated by Zhentong recipe for internal and external use.After 8 weeks of treatment,the clinical effect of the two groups were statistically analyzed,and the TCM syndrome score,serum inflammatory factor CRP,TNF-αlevels and adverse reactions were observed before and after treatment between two groups.Results The total effective rate was 89.23%(58/65)in the observation group and 72.31%(47/65)in the control group.The clinical effect of the observation group was better than that of the control group(P<0.05).After treatment,the scores and total scores of TCM syndromes(fracture,swelling,pain,limited limb function,local plaque,red urine,thirst,constipation,tongue vein)in the two groups were lower than those in the group before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,the levels of serum CRP and TNF-αin the two groups were lower than those in the group before treatment(P<0.05),and the observation group were lower than the control group(P<0.05).The incidence of adverse reactions was 27.69%(18/65)in the observation group and 20.0%(13/65)in the control group.There was no significant difference between the two groups(P>0.05).Conclusion It is safe and effective to treat early soft tissue injury of closed fracture of extremities with internal and external application of Zhentong recipe,which can significantly reduce the pain of patients,inhibit the occurrence of inflammatory reaction,and effectively promote fracture healing.