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药对黄芪-金银花治疗骨折术后切口愈合不良疗效观察

Clinical Effect of Drug Pair "Astragalus-Honeysuckle" on the Treatment of Poor Wound Healing after Fracture Operation
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摘要 目的:基于“脾肾相关”探讨药对黄芪-金银花治疗骨折术后切口愈合不良的临床疗效。方法:采用回顾性观察性研究,选取2019年1月—2022年6月江西中医药大学附属医院骨科收治的43例骨折术后切口愈合不良患者,将其分为2组。其中对照组20例,采用基础治疗(抗菌药物结合常规换药或充分引流);观察组23例,在对照组基础上服用含黄芪-金银花药对的中药颗粒剂。比较2组患者的切口愈合时间、切口愈合等级、疼痛视觉模拟(VAS)评分、不良反应发生率及血清C-反应蛋白(CRP)、白细胞(WBC)、降钙素原(PCT)的变化,评价2组患者的临床疗效。结果:观察组患者手术切口愈合时间显著短于对照组,差异有统计学意义(P<0.05);观察组切口愈合等级(乙级15例、丙级8例)显著优于对照组(乙级5例、丙级15例),差异有统计学意义(P<0.05);2组患者治疗后VAS评分均低于治疗前(P<0.05),且观察组低于对照组(P<0.05);2组患者治疗后3 d、7 d血清CRP、WBC、PCT表达水平均低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。2组患者治疗期间均未出现不良反应。结论:药对黄芪-金银花治疗骨折术后切口愈合不良的临床疗效确切,可缩短切口愈合时间,改善患者炎症反应、疼痛及切口愈合质量,值得临床推广。 Objective:To explore the clinical effect of"Astragalus-Honeysuckle"in the treatment of poor wound healing after fracture surgery based on the theory of"spleen kidney correlation".Methods:A retrospective observational study was conducted to select 43 patients with poor wound healing after fracture surgery who were admitted to the orthopaedic department of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2019 to June 2022.Among them,20 cases in the control group were treated with basic treatment(antibiotic treatment combined with routine dressing change or adequate drainage);the observation group(23 cases)was treated with traditional Chinese medicine granules containing"Astragalus Honeysuckle"drug pair on the basis of basic treatment.The wound healing time,wound healing grade,visual analog pain(VAS)score,adverse reaction rate and the changes of white blood cel l(WBC),C-reactive protein(CRP)and procalcitonin(PCT)in se rum were compared between the two groups to evaluate the clinical efficacy of the two groups.Results:The healing time of the incision in the study group significantly shorter than that in the control group,the difference was statistically significant(P<0.05);the wound healing grade of the study group(15 cases of grade B and 8 cases of grade C)was significantly better than that of the control group(5 cases of grade B and 15 cases of grade C),and the difference was statistically significant(P<0.05);the VAS scores of the two groups after treatment were lower than those before treatment(P<0.05),and that of the study group was lower than that of the control group(P<0.05);the expression of serum WBC,CRP and PCT in the two groups was lower than that before treatment(P<0.05)and that in the study group was lower than that in the control group(P<0.05);no adverse reactions occurred in both groups during treatment.Conclusion:The medicine"Astragalus-Honeysuckle"has a definite clinical effect on the treatment of poor wound healing after fracture surgery. It can shorten the healing time of short incision, improve the inflammatory reaction, pain and wound healing quality of patients, and is worthy of clinical applicat ion.
作者 夏自成 郭德华 张国福 曾志奎 雷海燕 XIA Zicheng;GUO Dehua;ZHANG Guofu;ZENG Zhikui;LEI Haiyan(The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China;Jiangxi University of Chinese Medicine,Nanchang 330004,China.)
出处 《江西中医药大学学报》 2024年第1期38-40,44,共4页 Journal of Jiangxi University of Chinese Medicine
基金 国家自然科学基金地区项目(81860856) 国家自然科学基金地区项目(81960880) 江西省科学技术厅省临床研究中心项目(20212BCG 74004) 江西中医药大学校级研究生创新专项(JZYC21S23) 江西省研究生创新专项(YC2021-S524) 江西省卫生健康委科技计划项目(202210744)。
关键词 切口愈合不良 脾肾相关 黄芪-金银花 药对 骨折术后并发症 Poor Wound Healing Astragalus-Honeysuckle Spleen and Kidney Correlation Postoperative Complications of Fracture
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