摘要
目的探究祛瘀生新方剂型选择对四肢骨折患者术后早期肿痛及凝血指标的影响。方法选取江苏省第二中医院2019年2月—2020年4月期间收治的四肢骨折患者156例,应用简单随机化法分为观察1组52例、观察2组52例、对照组52例。3组患者均行经皮微创内固定术,术后给予常规抗感染、消肿止痛干预,在此基础上,观察1组辅助祛瘀生新配方颗粒治疗,观察2组辅助祛瘀生新汤治疗,持续5 d。比较3组患者患肢肿胀情况、疼痛情况[视觉模拟评分法(Visual analogue scale,VAS)]、凝血指标[凝血酶原时间(Prothrombin time,PT)、活化部分凝血活酶时间(Activated partial thromboplastin time,APTT)、D-二聚体(D-Dimer,DD)、纤维蛋白原(Fibrirlogerl,Fg)]、炎症因子[肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-1(Interleukin-1,IL-1)、白细胞介素-6(Interleukin-6,IL-6)]、骨折愈合时间。结果术后第3天、术后第5天,3组患肢肿胀程度优于术后第1天,且观察1组、观察2组患肢肿胀程度优于对照组,差异有统计学意义(P<0.05);术后第3天、术后第5天,观察1组、观察2组患肢肿胀程度比较,差异无统计学意义(P>0.05)。3组患者术后第3天、术后第5天VAS评分均低于术后第1天,差异有统计学意义(P<0.05);术后第3天、术后第5天,观察1组、观察2组VAS评分低于对照组,差异有统计学意义(P<0.05);术后第3天、术后第5天,观察1组、观察2组患VAS评分比较,差异无统计学意义(P>0.05)。术后第5天,3组患者PT、APTT水平高于术后第1天,DD、Fg、TNF-α、IL-1、IL-6水平低于术后第1天,差异有统计学意义(P<0.05);且观察1组、观察2组PT、APTT水平高于对照组,DD、Fg、TNF-α、IL-1、IL-6水平低于对照组,差异有统计学意义(P<0.05);术后第5天,观察1组、观察2组PT、APTT、DD、Fg、TNF-α、IL-1、IL-6水平比较,差异无统计学意义(P>0.05)。观察1组、观察2组骨折愈合时间短于对照组,差异有统计学意义(P<0.05);观察1组、观察2组骨折愈合时间比较,差异无统计学意义(P>0.05)。结论祛瘀生新配方颗粒、汤剂辅助外科手术治疗四肢骨折,均可减轻术后早期肿痛,促进骨折愈合,可能与调节凝血功能及血清炎症介质表达有关。
Objective To explore the influence of Quyu Shengxin dosage form on the early postoperative swelling and pain and blood coagulation indexes of patients with limb fractures.Methods A total of 156 patients with limb fractures treated in Jiangsu Provincial Second Traditional Chinese Medicine Hospital from February 2019 to April 2020 were selected and randomly divided into an observation group 1(n=52),an observation group 2(n=52),and a control group(n=52).The three groups underwent minimally invasive percutaneous fixation.On the basis of routine anti-infective,edema-alleviating and analgesic intervention,observation group 1 was treated with Quyu Shengxin Granules,while observation group 2 was treated with Quyu Shengxin Decoction for 5 days.Then the swelling and pain of affected limbs[visual analog scale(VAS)],coagulation indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer(DD),fibrinogen(Fg)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),interleukin-6(IL-6)],and fracture healing time of the three groups were compared.Results On the 3 rd and 5 th day after operation,the degree of limb swelling in the three groups was better and VAS score was lower than those on the 1 st day after operation(P<0.05),and the observation group 1 and observation group 2 had more significant improvement than the control group(P<0.05);there was no significant difference in the two indicators between the observation group 1 and the observation group 2(P>0.05).On the 5 th day after operation,the PT and APTT levels of patients in the three groups were higher and the DD,Fg,TNF-α,IL-1 and IL-6 levels were lower than those on the 1 st day after operation(P<0.05),and the observation group 1 and observation group 2 had increased PT and APTT and decreased DD,Fg,TNF-α,IL-1 and IL-6 compared with the conditions in the control group(P<0.05);no distinct differences were observed in the above indicators between the two observation groups(P>0.05).In terms of fracture healing time,the observation group 1 and observation group 2 was shorter than the control group(P<0.05),while there was no marked difference between the two observation groups(P>0.05).Conclusion Quyu Shengxin Granules and Quyu Shengxin Decoction played an assisting role in surgical treatment of limb fractures,which could reduce early postoperative swelling and pain and promote fracture healing.This might be related to the regulation of blood coagulation function and the expression of serum inflammatory mediators.
作者
吴鹏飞
杨权宏
WU Peng-fei;YANG Quan-hong(Department of Orthopedics,Jiangsu Provincial Second Traditional Chinese Medicine Hospital,Nanjing Jiangsu 210017)
出处
《世界中西医结合杂志》
2022年第10期1980-1984,共5页
World Journal of Integrated Traditional and Western Medicine
基金
江苏省中医药局科技项目(YB2020120)。
关键词
祛瘀生新配方颗粒
祛瘀生新汤
四肢骨折
肿痛
炎症因子
凝血指标
Quyu Shengxin Granules
Quyu Shengxin Decoction
Limb fractures
Swelling and pain
Inflammatory factors
Coagulation indicators
