补阳还五汤治疗脉络瘀阻型断指再植术患者的效果观察

The observation on the effect of Buyang Huanwu Decoction in the treatment of patients with digital replantation of severed fingers with arteries and veins stasis

目的观察补阳还五汤内服、外洗治疗脉络瘀阻型断指再植患者术后手指功能恢复的效果。方法收集2018年7月至2021年5月行断指再植术的患者80例,随机分为对照组和观察组,各40例。对照组术后按常规功能锻炼方式进行康复,观察组在对照组基础上增加补阳还五汤内服、外洗。比较两组患者术后3个月、6个月皮肤感觉功能及手指功能的恢复情况。结果失访1例,指体坏死2例,2例在服用中药过程中出现消化道不适症状停止治疗,2例在治疗过程中服用其他药物治疗,最终73例患者获得完整数据,对照组38例,观察组35例。术后3个月,对照组指尖静止两点辨别觉(s2-PD)距离为(14.74±1.77)mm,高于观察组(11.11±1.80)mm,差异有统计学意义(P<0.05);术后6个月,对照组指尖s2-PD距离(12.95±1.79)mm,高于观察组(8.80±2.14)mm,差异有统计学意义(P<0.05)。术后3个月,观察组运动功能、日常生活活动、感觉恢复、血液循环状态、恢复工作情况评分及总分均高于对照组,差异有统计学意义(P<0.05);术后6个月,观察组运动功能、感觉恢复、血液循环状态评分及总分均高于对照组,差异有统计学意义(P<0.05)。结论补阳还五汤内服、外洗治疗方式能够有效促进脉络瘀阻型断指再植患者术后手指神经感觉和功能的恢复。

Objective To explore the curative effect of Buyang Huanwu Decoction for oral administration and external washing on finger function recovery after digital replantation with arteries and veins stasis.Methods Patients who underwent digital replantation in Jinhua Traditional Chinese Medicine Hospital from July 2018 to May 2021 were collected.The patients were randomly divided into the control group and the treatment group with 40 cases in each group.The control group underwent rehabilitation according to routine functional exercise after operation,while the treatment group received Buyang Huanwu Decoction for oral administration and external washing on the basis of the control group.The recovery of skin sensory function and finger function were compared between the two groups at 3 months and 6 months after operation.Results In this study,1 patient lost follow-up,2 patients occurred finger necrosis,2 patients had digestive tract discomfort during the process of taking traditional Chinese medicine and could not continue the treatment,2 patients took other drugs during the treatment process,and finally 73 patients completed follow-up data,38 patients in the control group and 35 patients in the treatment group.Three months after operation,the average fingertip s2-PD distance in the control group was 14.74 mm,which was higher than 11.11 mm in the treatment group(P<0.05).Six months after operation,the average fingertip s2-PD distance in the control group was 12.95 mm,which was higher than 8.80 mm in the treatment group(P<0.05).Three months after the operation,the motor function,activities of daily living,sensory recovery,blood circulation status,return to work and the total score in the treatment group were higher than those in the control group(P<0.05).Six months after operation,the motor function,sensory recovery,blood circulation status and total score in the treatment group were higher than those in the control group(P<0.05).Conclusion Buyang Huanwu Decoction can effectively promote the recovery of finger nerve sensation and function after digital replantation with arteries and veins stasis.