解郁化瘀中药应用于自残性断指再植术后临床观察

Clinical Observation on the Application of Relieving Depression and Removing Blood Stasis Chinese Medicine in Post Replantation of Self-mutilate Severed Finger

目的观察解郁化瘀中药对自残性断指再植术后患者情绪及再植指体血运的影响,为临床合理应用中药提供一定的理论依据。方法60例自残性断指患者随机分为观察组(30例)及对照组(30例),2组患者均采用相同的手术方法及术后常规治疗,观察组在对照组治疗基础上予以加味逍遥散治疗。2组均治疗1周。并于术后1、3、5、7 d,应用抑郁自评量表(SDS)、焦虑自评量表(SAS)和患指血供指标对2组患者进行测评,计算2组患者的血管危象发生率;比较2组患者的不良情绪变化和血供指标差异。结果观察组SDS、SAS评分低于对照组(P<0.05)。再植指监测指标优于对照组(P<0.05)。观察组30例中28例断指再植成活,2例手指坏死,成活率93.3%(28/30),对照组30例,20例成活,10例手指坏死,总成活率66.7%(20/30),观察组成活率明显优于对照组。经χ^(2)检验,观察组与对照组血管危象发生率比较,差异有统计学意义(P<0.05)。结论自残性断指再植术后,应用加味逍遥散参与治疗,可以有效缓解自残性断指再植患者术后不良情绪,减少血管危象发生率,提高再植成活率。

Objective To observe the effects of Chinese medicine for relieving depression and removing blood stasis on the mood and blood circulation on post replantation of self-mutilate severed finger,so as to provide a theoretical basis for the rational application of traditional Chinese medicine in clinic.Methods 60 patients with self-mutilate severed fingers were randomly divided into observation group(30 cases)and control group(30 cases).Both groups were treated with the same surgical method and postoperative routine treatment.The observation group was treated with modified Xiaoyao powder in addition to routine treatment.Both groups were treated for 1 week.Self rating Depression Scale(SDS),self rating Anxiety Scale(SAS)and blood supply index of patient finger were used to evaluate the two groups on the 1st,3rd,5th and 7th day after operation,and the incidence of vascular crisis was calculated.The changes of bad mood and blood supply indexes between the two groups were compared.Results The scores of SDS and SAS in the observation group were lower than those in the control group(P<0.05).The monitoring index of replantation finger was better than that of control group(P<0.05).In the observation group,28 cases of severed finger replantation survived,2 cases of finger necrosis,the survival rate of 93.3%(28/30),30 cases of control group,20 cases of survival,10 cases of finger necrosis,the total survival rate of 66.7%(20/30),the survival rate of the observation group was significantly better than the control group.Byχ^(2) test,the incidence of vascular crisis was compared between the observation group and the control group,and the difference was statistically significant(P<0.05).Conclusion After replantation of self-mutilated severed fingers,the application of modified Xiaoyao powder can effectively alleviate the bad mood of patients with replantation,reduce the incidence of vascular crisis,and improve the survival rate of replantation.