中药熏洗联合针刺在胫骨骨折术后康复中的应用效果分析

Clinical Efficacy of TCM Fumigation & Washing Combined with Acupuncture in the Rehabilitation of Patients Underwent Tibial Fracture Surgery

目的探讨中药熏洗联合针刺在胫骨骨折术后康复中的应用效果。方法选取2017年10月至2020年7月河南省直第三人民医院收治的92例胫骨骨折患者作为研究对象,并按照随机数表法将其随机分为观察组(46例)和对照组(46例),所有患者术后均进行康复训练,与此同时观察组患者采用中药熏洗联合针刺治疗,对照组患者单纯采用中药熏洗治疗,对比观察两组患者疼痛程度、膝关节功能恢复情况、生活质量、临床疗效以及并发症发生情况。结果治疗1个疗程后,观察组患者视觉模拟评分法(VAS)评分明显低于对照组(t=11.214,P<0.001);治疗3个疗程后,观察组患者美国特种外科医院(HSS)评分及Barthel指数均明显高于对照组(t=10.827、12.881,P均<0.001);治疗3个疗程后,观察组患者中治愈35例、有效10例、无效1例,明显优于对照组患者的治愈23例、有效19例、无效4例(Z=-2.640,P=0.008)。其间,观察组患者出现关节僵硬1例,并发症发生率为2.17%,明显低于对照组患者出现的关节僵硬4例、下肢静脉血栓2例,并发症发生率13.04%(χ^(2)=3.867,P=0.049)。结论与单纯中药熏洗治疗相比,中药熏洗联合针刺治疗可明显减轻胫骨骨折患者术后疼痛程度,改善患者肢体功能恢复效果,提高患者生活质量,且不良反应发生率更低,疗效更显著,临床应用价值更高。

Objective To study the clinical efficacy of TCM fumigation & washing combined with acupuncture in the rehabilitation of patients after tibial fracture surgery.Methods 92 patients with tibial fracture, admitted to Henan No. 3Provincial People’s Hospital from October 2017 to July 2020, were enrolled as research subjects and divided, using the ran?dom number table, into observation group (n = 46) and control group ( n = 46). After surgery, all patients in the two groups received rehabilitation exercise. In the meanwhile, patients in observation group were treated with TCM fumigation &washing combined with acupuncture, whereas patients in control group were treated with TCM fumigation & washing alone.Pain degree, recovery of knee function, quality of life, clinical efficacy and occurrence of adverse reactions were compared between the two groups.Results After one course of treatment, the visual analogue scale (VAS) score was significantly lower in observation group than control group (t= 11. 214,P< 0. 001). After three courses of treatment, the hospital for special surgery (HSS) score and Barthel index were significantly higher in observation group than control group (t= 10. 827and 12. 881, bothP< 0. 001);after three courses of treatment, 35 cases were cured, 10 cases were effective and 1 case was ineffective in observation group, much better than in control group with 23 cases cured, 19 cases effective and 4 cases ineffective (Z= - 2. 640,P= 0. 008). During the course of treatment, one patient developed joint stiffness in observation group, and the incidence of complications was 2. 17% , much lower than 13. 04% in control group with 4 cases of joint stiff?ness and 2 cases of thrombus of lower extremity veins (χ^(2)= 3. 867,P= 0. 049).Conclusion Compared with TCM fumiga?tion & washing alone, the combined application of TCM fumigation & washing and acupuncture can substantially reduce the postoperative pain of patients after tibial fracture surgery, and improve the recovery of their limb function and quality of life.Moreover, the combined therapy has a lower incidence of adverse reactions and more definite curative effect, presenting a high value of clinical application.