安神解郁汤联合活血洗剂对自残性断指再植术后恢复情况及血管危象的影响

Effects of Anshen Jieyu decoction combined with huoxue lotion on the recovery and vascular crisis after replantation of self-mutilating amputated fingers

目的:探讨安神解郁汤联合活血洗剂对自残性断指再植术后恢复情况及血管危象的影响。方法:选择于我院就诊的自残性断指再植术后患者114例,根据随机数字表法分为对照组与治疗组各57例,对照组给予抗感染、抗凝、抗血管痉挛治疗。治疗组在对照组基础上给予安神解郁汤联合活血洗剂。观察两组患者治疗前后心理负面情绪评分、患指功能恢复情况、血液流变学指标及术后发生血管危象的情况。结果:治疗后,两组DASS-21评分、HAMA评分、PANAS评分,以及PV、LS、MS、HS水平均较治疗前降低,且治疗组[(23.09±2.03)分vs(30.28±2.47)分、(20.65±1.44)分vs(23.71±1.68)分、(14.62±2.03)分vs(18.87±2.36)分、(1.14±0.61)mPa·s vs(1.52±0.75)mPa·s、(6.53±1.22)mPa·s vs(9.17±1.41)mPa·s、(4.13±0.95)mPa·s vs(6.08±1.16)mPa·s、(3.74±1.13)mPa·s vs(5.53±1.46)mPa·s]低于对照组(P<0.05)。两组治疗后手指运动功能、日常生活活动、感觉恢复情况、血液循环状态、外观及恢复工作情况评分均较治疗前升高,且治疗组[(13.42±2.52)分vs(10.94±1.74)分、(13.04±2.12)分vs(11.86±1.95)分、(15.63±3.08)分vs(12.47±2.91)分、(6.32±1.16)分vs(4.61±1.04)分、(14.52±2.47)分vs(11.08±1.61)分、(6.06±1.12)分vs(4.15±0.95)分]高于对照组(P<0.05)。治疗组血管危象发生率(12.28%)显著低于对照组(28.07%),差异有统计学意义(P<0.05)。结论:安神解郁汤联合活血洗剂可缓解自残性断指再植术后患者的负面情绪,恢复手指功能,改善血液流变学,降低血管危象发生率。

Objective To investigate the effect of Anshen Jieyu Decoction combined with Huoxue Lotion on the recovery and vascular crisis after replantation of self-mutilated amputated fingers.Methods A total of 114 patients with self-mutilating amputated fingers after replantation in our hospital were selected.According to the random number table method,they were divided into a control group and a treatment group with 57 cases in each group.The control group was given anti-infection,anticoagulation and anti-vasospasm treatment.The treatment group was given Anshen Jieyu Decoction combined with Huoxue Lotion on the basis of the control group.Before and after treatment,the two groups of patients were observed with psychological negative emotion scores,and the recovery of affected finger function,hemorheological indicators,postoperative vascular crisis and its influencing factors.Results After treatment,DASS-21 score,HAMA score,PANAS score negative emotion score,PV,LS,MS,HS levels in the two groups were lower than those before treatment,and the treatment group was lower[(23.09±2.03)vs(30.28±2.47),(20.65±1.44)vs(23.71±1.68),(14.62±2.03),(18.87±2.36),(1.14±0.61)mPa·s vs(1.52±0.75)mPa·s,(6.53±1.22)mPa·s vs(9.17±1.41)mPa·s,(4.13±0.95)mPa·s vs(6.08±1.16)mPa·s,(3.74±1.13)mPa·s vs(5.53±1.46)mPa·s]than the control group(P<0.05).After treatment,the scores of finger motor function,activities of daily living,sensory recovery,blood circulation,appearance and return to work in the two groups were all lower than those before treatment,and the treatment group was lower[(13.42±2.52)vs(10.94±1.74),(13.04±2.12)vs(11.86±1.95),(15.63±3.08)vs(12.47±2.91),(6.32±1.16)vs(4.61±1.04),(14.52±2.47)vs(11.08±1.61),(6.06±1.12)vs(4.15±0.95)]than those of the control group(P<0.05).The incidence of vascular crisis in the treatment group was 12.28%,which was significantly lower than that in the control group(28.07%,P<0.05).Conclusion Anshen Jieyu Decoction combined with Huoxue Lotion can reduce the negative emotions of patients after replantation of self-mutilating amputated fingers,restore finger function,improve blood rheology and reduce the occurrence of vascular crisis.