活血消肿方对骨筋膜室综合征患者筋膜室压力影响及肌肉神经组织坏死的预防作用研究

Study on the effect of Huoxue Xiaozhong Decoction on the pressure of fascia compartment in patients with osteofascial compartment syndrome and the preventive effect on necrosis of muscle and nerve tissue

目的探讨活血消肿方对骨筋膜室综合征患者筋膜室压力的影响及对肌肉神经组织坏死的预防作用。方法将2019年4月—2020年3月上海中医药大学附属曙光医院收治的80例骨筋膜室综合征患者随机分成对照组和观察组,对照组40例给予常规西医治疗,观察组40例在此基础上给予活血消肿方治疗,2组均治疗2周。观察2组治疗后筋膜室内压力、血氧饱和度[S p(O_(2))]及血清肌酸激酶(CK)、乳酸脱氢酶(LDH)、天冬氨酸氨基转移酶(AST)水平变化,比较2组临床疗效,记录2组治疗期间肢体肿胀缓解时间、疼痛缓解时间、肿胀消失时间及不良事件。结果治疗后,2组舒张压与筋膜室内压差△P和S p(O_(2))均明显升高(P均<0.05),血清CK、LDH、AST水平均明显降低(P均<0.05),且观察组以上指标改善程度更为明显(P均<0.05);观察组肢体肿胀缓解时间、疼痛缓解时间及肿胀消失时间均明显短于对照组(P均<0.05);观察组总有效率为85.0%(34/40),对照组为65.0%(26/40),观察组明显高于对照组(P<0.05);2组治疗期间均未出现严重的不良事件。结论活血消肿方能够缓解骨筋膜室综合征患者组织缺氧,降低筋膜室压力,对预防肌肉神经组织坏死具有积极作用。

Objective It is to investigate the effect of Huoxue Xiaozhong Decoction on the pressure of fascia compartment in patients with osteofascial compartment syndrome and the preventive effect on necrosis of muscle and nerve tissue.Methods Eighty cases of compartment syndrome patients admitted to Shuguang Hospital of Shanghai University of Traditional Chinese Medicine from April 2019 to March 2020 were randomly divided into a control group and an observation group,40 cases in the control group were given conventional western medicine treatment,and 40 cases in the observation group were treated with Huoxue Xiaozhong Decoction based on the control group,both groups were treated for 2 weeks.The changes of intrafascial compartment pressure,blood oxygen saturation[S p(O_(2))],the levels of serum creatine kinase(CK),lactate dehydrogenase(LDH),and aspartate aminotransferase(AST)after treatment were observed in the two groups,and the clinical efficacy was compared,the relief time of limb swelling,pain relief time,swelling disappearing time and adverse events during treatment were recorded in the two groups.Results After treatment,the diastolic blood pressure and intra-fascial pressure difference△P and S p(O_(2))of the two groups were significantly increased(all P<0.05),the levels of serum CK,LDH,and AST were significantly reduced(all P<0.05),and the improvements of the above indicators were more obvious in the observation group(all P<0.05);the relief time of limb swelling,pain relief time and swelling disappearing time of the observation group were significantly shorter than those of the control group(all P<0.05);the total effective rate of the observation group was 85.0%(34/40),that of the control group was 65.0%(26/40),the observation group was significantly higher than the control group(P<0.05);there was no serious adverse events during the treatment period in the two groups.Conclusion Huoxue Xiaozhong Decoction can relieve tissue hypoxia in patients with compartment syndrome,reduce compartment pressure,and have a positive effect on preventing necrosis of muscle and nerve tissue.