接骨膏对肋骨骨折合并肺挫伤患者致痛因子和炎症因子的影响

Effect of Jiegu Ointment on Rib Fracture Combined with Pulmonary Contusion and Its Impact on Pain Factors and Inflammatory Factors

目的观察应用接骨膏治疗肋骨骨折合并肺挫伤的临床效果。方法肋骨骨折合并肺挫伤患者98例随机分为两组,对照组给予常规治疗,观察组在对照组基础上采用接骨膏治疗。进行疼痛视觉模拟量表(VAS)评分、肺挫伤简易评分和气滞血瘀证评分;记录血气指标、胸管留置时间、首次下床活动时间、住院时间及并发症发生情况;检测炎症因子和致痛因子;比较两组的临床疗效。结果治疗后3、5、7天两组VAS评分均显著下降(P<0.05),且观察组均低于同期对照组(P<0.05);治疗后,两组的肺挫伤简易评分和气滞血瘀证积分均下降(P<0.05),且观察组低于对照组(P<0.05);治疗后,两组患者氧分压(PaO_(2))和氧合指数上升(P<0.05),二氧化碳分压(PaCO_(2))下降(P<0.05),观察组PaO_(2)和氧合指数高于对照组(P<0.05),PaCO_(2)水平低于对照组(P<0.05);治疗后,观察组胸管留置时间、首次下床活动时间及住院时间均短于对照组(P<0.05);治疗后,两组患者炎症因子C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)显著下降(P<0.05),且观察组低于对照组(P<0.05);治疗后,两组患者致痛因子前列腺素E2(PGE2)、5-羟色胺(5-HT)和P物质(SP)水平显著下降(P<0.05),且观察组低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05);观察组总有效率高于对照组(P<0.05)。结论接骨膏治疗肋骨骨折合并肺挫伤早期患者临床疗效显著,在早期可最大限度减轻患者痛苦,缩短病程,减少并发症,改善肺功能及促进骨折和肺挫伤的康复。

Objective:To explore the clinical effect of using Jiegu Ointment in treatment of rib fractures combined with pulmonary contusion,and its impact on pain factors and inflammatory factors.Methods:A total of 98 patients with rib fractures and pulmonary contusions were randomly divided into control group and observation group,and 49 cases were in each group.The control group was given routine treatment,while the observation group received external application of Jiegu Ointment on the basis of the control group.The pain VAS scores,simple scores of lung contusion,scores qi stagnation and blood stasis syndrome were recorded;the blood gas analysis indicators,chest tube retention time,first time out of bed activity time,hospitalization time,the occurrence of complications and the clinical efficacy of two groups were compared;the inflammatory and pain factors were detected.Results:After 3,5,and 7 days of treatment,the VAS scores of both groups significantly decreased(P<0.05),and the VAS scores at each time point were lower than those of the control group during the same period(P<0.05);after treatment,the simplified score of lung contusion and the integral of qi stagnation and blood stasis syndrome decreased in both groups(P<0.05),and the observation group was lower than the control group(P<0.05);after treatment,PaO_(2)and oxygenation index increased(P<0.05)and PaCO_(2)decreased(P<0.05)in both groups.The observation group had higher PaO_(2)and oxygenation index than the control group(P<0.05),and the PaCO_(2)level was lower than the control group(P<0.05);after treatment,the observation group had shorter chest tube retention time,first time out of bed activity time,and hospitalization time than the control group(P<0.05);after treatment,the inflammatory factors CRP,TNF-αand IL-6 in both groups significantly decreased(P<0.05),and the observation group was lower than the control group(P<0.05);after treatment,the levels of pain inducing factors PGE2,5-HT,and SP in both groups significantly decreased(P<0.05),and the index in the observation group was lower than the control group(P<0.05);the incidence of complications in the observation group was lower than the control group(P<0.05);the total effective rate of the observation group was higher than the control group(P<0.05).Conclusion:The clinical efficacy of Jiegu Ointment in the treatment of early patients with rib fractures and pulmonary contusions is significant.In the early stage,it can minimize patient pain,shorten the course of the disease,reduce complications,improve lung function,and promote the recovery of fractures and pulmonary contusions.