苓桂活血化瘀除湿汤加减治疗骨折术后肿胀的效果及对凝血指标、疼痛程度的影响

Effects of Modified Linggui Huoxue Huayu Chushi Decoction in the Treatment of Swelling after Fracture and its Influence on Coagulation Indicators and Pain Degree

目的:探究苓桂活血化瘀除湿汤加减治疗骨折术后肿胀的效果及对凝血指标、疼痛程度的影响。方法:选取我院2019年1月-2021年12月行骨折手术的患者96例,采用简单随机化法分为2组,每组各48例。对照组予以骨折术后常规治疗,观察组(中药组)在此基础上予以苓桂活血化瘀除湿汤加减治疗,2组均持续治疗14天。对比治疗后2组的临床疗效,治疗前后2组肢体肿胀程度、疼痛程度视觉模拟评分量表(VAS)评分、临近关节活动度评分、凝血指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-Dimer)]以及治疗后骨痂线评分、患者满意度的变化。结果:治疗后观察组临床总有效率高于对照组(P<0.05);2组治疗后肢体肿胀程度、VAS评分、临近关节活动度评分、FIB及D-Dimer水平较治疗前均明显降低(P均<0.05),且观察组均低于对照组(P均<0.05);2组治疗后PT、APTT水平较治疗前均明显升高(P均<0.05),且观察组水平均高于对照组(P均<0.05);治疗后观察组骨痂线评分、患者满意度均高于对照组(P均<0.05)。结论:骨折术后的患者在常规治疗的基础上使用苓桂活血化瘀除湿汤加减能有效缓解患者肢体肿胀及疼痛,提升关节活动度,改善凝血功能,促进骨折愈合,提高患者满意度,对预后康复有积极意义。

To explore the effects of modified Linggui Huoxue Huayu Chushi decoction in the treatment of swelling after fracture and its influence on coagulation indicators and pain degree.Methods:A total of 96 patients who underwent fracture surgery in the hospital from January 2019 to December 2021 were selected and divided into two groups with 48 cases in each group by simple ran-domization method.The routine group was given routine treatment after fracture surgery,and the traditional Chinese medicine group was given modified Linggui Huoxue Huayu Chushi decoction on this basis,and both groups were treated continuously for 14 days.The clinical efficacy after treatment and limb swelling degree,pain degree[Visual Analogue Scale(VAS)],range of motion score of adjacent joint,coagulation indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-Dimer]before and after treatment and callus line score and patient satisfaction after treatment were compared between the two groups.Results:After treatment,the total clinical effective rate in the traditional Chinese medicine group was higher than that in the routine group(P<0.05).The degree of limb swelling,VAS score,score of adjacent joint range of motion and levels of FIB and D-Dimer in both groups after treatment were significantly reduced compared with those before treatment(all P<0.05),and the above indicators were milder or lower in the traditional Chinese medicine group than those in the routine group(all P<0.05).The PT and APTT in both groups were signifi-cantly prolonged after treatment compared to before treatment(all P<0.05),and the two indicators in the traditional Chinese medicine group were longer than those in the routine group(all P<0.05).After treatment,the callus line score and patient satisfaction in the tra-ditional Chinese medicine group were higher than those in the routine group(all P<0.05).Conclusion:In patients after fracture sur-gery,modified Linggui Huoxue Huayu Chushi decoction on the basis of routine treatment can effectively relieve limb swelling and pain.,enhance the joint range of motion,improve coagulation function,promote the fracture healing and improve the patient satisfaction,and has positive significance for prognosis and recovery.