大承气汤药粉治疗胫腓骨骨折肢体肿胀的疗效观察

Clinical Efficacy of External Application of Da Chengqi Decoction Medicinal Powder for Treatment of Limb Swelling Induced by Tibia and Fibula Fracture

【目的】观察大承气汤药粉外敷联合红外线照射治疗胫腓骨骨折患者肢体肿胀的疗效。【方法】将70例胫腓骨骨折患者随机分为试验组和对照组,每组各35例。2组患者入院后均常规采用抬高患肢、保持患肢制动、跟骨骨钉牵引以及骨折急性期冰敷患肢等治疗,在此基础上,对照组患者给予红外线照射治疗,试验组给予大承气汤药粉外敷联合红外线照射治疗,疗程为5 d。观察2组患者治疗前后疼痛数字分级量表(NRS)评分、小腿周径肿胀比的变化情况,并评价2组患者的肿胀度消退疗效和安全性。【结果】(1)治疗后,2组患者的疼痛NRS评分、小腿周径肿胀比均明显降低(P<0.01),且试验组对疼痛NRS评分和小腿周径肿胀比的降低作用均明显优于对照组,差异均有统计学意义(P<0.05或P<0.01)。(2)治疗5 d后,试验组的有效率为91.4%(32/35),对照组为71.4%(25/35),组间比较,试验组的肿胀度消退疗效明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗期间,2组患者均未发生皮肤瘙痒、红肿皮疹等局部不适症状,中药外敷及红外线灯照射均未影响手术方案的施行,手术治疗前后患者的三大常规、肝肾功能、心电图等均未出现明显异常。【结论】大承气汤药粉外敷联合红外线照射治疗胫腓骨骨折患者,能够减轻患者的肢体肿胀程度和疼痛程度,其疗效优于单纯红外线照射。

Objective To observe the curative effect of external application of Da Chengqi Decoction medicinal powder combined with infrared radiation on the swelling of the affected limb after tibia and fibula fracture. Methods A total of 70 patients with tibiofibular fracture were randomized into trial group and control group,35 cases in each group. The patients in the two groups were given elevation of the affected extremity,immobilization of the affected limb,calcaneal bone screw traction,and ice compress on the affected limb in the acute state of fracture after admission. And additionally,the control group was treated with infrared radiation,and the trial group was treated with external application of Da Chengqi Decoction medicinal powder combined with infrared radiation. The course of the treatment for the two groups lasted for 5 days. Before and after treatment,the numerical rating scale(NRS)pain scores and calf circumference swelling ratio in the two groups were observed. After treatment,the clinical efficacy for relieving swelling and the clinical safety in the two groups were compared. Results(1) After treatment, the NRS pain scores and the calf circumference swelling ratio in the two groups were obviously decreased in comparison with those before treatment(P<0.01), and the trial group had stronger effect on decreasing the NRS pain scores and the calf circumference swelling ratio than the control group,the difference being statistically significant(P<0.05 or P<0.01).(2)After 5 days of treatment,the effective rate in the trial group was 91.4%(32/35),and that in the control group was 71.4%(25/35). The intergroup comparison showed that the efficacy on relieving the swelling in the trial group was superior to that in the control group, and the difference was statistically significant(P<0.05).(3)During the trial, no discomforts of skin itching, local congestion and swelling,or skin rash were found in the two groups. The external application of Chinese medicine and infrared irradiation had no influence on the performance of operation regimen. And no abnormalities were found in the routine test for blood,urine and stool,hepatic and renal function examination,or electrocardiogram of the two groups. Conclusion External application of Da Chengqi Decoction medicinal powder combined with infrared radiation is more effective on relieving the swelling and pain of the affected limb of the patients suffering tibia and fibula fracture than infrared radiation alone.