血府逐瘀汤联合酚磺乙胺治疗肋骨骨折伴血胸临床研究

Clinical Study on Xuefu Zhuyu Tang Combined with Etamsylate for Rib Fracture Complicated with Hemothorax

目的:观察血府逐瘀汤联合酚磺乙胺治疗肋骨骨折伴血胸的临床疗效及其对患者疼痛、生活质量的影响。方法:选取108例肋骨骨折伴血胸患者,根据治疗方法的不同分为治疗组和对照组各54例。治疗组给予血府逐瘀汤联合酚磺乙胺治疗,对照组给予酚磺乙胺治疗。观察比较2组临床疗效、生活质量、疼痛视觉模拟评分法(VAS)评分、症状消失时间及凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)、D-二聚体(D-D)]变化。结果:治疗组总有效率为94.44%,对照组为77.78%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组生存质量评分均较治疗前提高(P<0.05),疼痛VAS评分均较治疗前降低(P<0.05);且治疗组生存质量评分高于对照组(P<0.05),VAS评分低于对照组(P<0.05)。治疗后,2组PT、APTT、TT水平均较治疗前升高(P<0.05),Fib、D-D水平均较治疗前降低(P<0.05);且治疗组上述各项指标改善较对照组更显著(P<0.05)。治疗后,治疗组疼痛消失时间、血胸消失时间均短于对照组(P<0.05)。结论:血府逐瘀汤联合酚磺乙胺治疗肋骨骨折伴血胸患者疗效确切,可有效减轻疼痛,提高生活质量,有利于改善凝血功能,加速病情康复。

Objective:To observe the clinical effect of the therapy of Xuefu Zhuyu tang combined with etamsylate on rib fracture complicated with hemothorax and its effect on patients’ pain and quality of life.Methods:A total of 108 patients with rib fracture complicated with hemothorax were selected and divided into the treatment group and the control group according to different treatment methods,with 54 cases in each group.The treatment group was treated with the therapy of Xuefu Zhuyu tang combined with etamsylate,and the control group was simply treated with etamsylate.The clinical effects,and the changes in quality of life,scores of Visual Analogue Scale(VAS) of pain,disappearance time of symptoms and levels of coagulation function indexes,including prothrombin time(PT),activated partial thrombin time(APTT),thrombin time(TT),fibrinogen(Fib) and D-dimer(D-D),were observed and compared between the two groups.Results:The total effective rate was 94.44% in the treatment group and 77.78% in the control group,the difference being significant(P<0.05).After treatment,the scores of quality of life in both groups were increased when compared with those before treatment(P<0.05),and the VAS scores of pain were decreased(P<0.05);the score of quality of life in the treatment group was higher than that in the control group(P<0.05),and the VAS score was lower(P<0.05).After treatment,the levels of PT,APTT and TT in the two groups were increased when compared with those before treatment(P<0.05),and the levels of Fib and D-D were decreased(P<0.05);the improvement of the above indexes in the treatment group was more significant than that in the control group(P<0.05).After treatment,the disappearance time of pain and hemothorax in the treatment group was shorter than that in the control group(P<0.05).Conclusion:The therapy of Xuefu Zhuyu tang combined with etamsylate has a definite curative effect on patients with rib fracture complicated with hemothorax,which can relieve pain,improve the quality of life,enhance the coagulation function and promote recovery.