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[1]常崢,符朝程,劉文龍,等.新傷濕敷液外敷在脛骨平臺(tái)骨折術(shù)前治療中的應(yīng)用[J].中醫(yī)正骨,2020,32(06):18-21,26.
　CHANG Zheng,FU Zhaocheng,LIU Wenlong,et al.External application of Xinshang Shifu(新傷濕敷)solution to preoperative treatment of tibial plateau fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(06):18-21,26.
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新傷濕敷液外敷在脛骨平臺(tái)骨折術(shù)前治療中的應(yīng)用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年06期
頁碼:
18-21,26
欄目:
臨床研究
出版日期:
2020-06-20

文章信息/Info

Title:
External application of Xinshang Shifu(新傷濕敷)solution to preoperative treatment of tibial plateau fractures
作者:
常崢1; 符朝程1; 劉文龍2; 劉志軍1
(1.常德市第一中醫(yī)醫(yī)院,湖南常德415000; 2.湖南中醫(yī)藥大學(xué),湖南長(zhǎng)沙410208)
Author(s):
CHANG Zheng1; FU Zhaocheng1; LIU Wenlong2; LIU Zhijun1
1.The First Hospital of Traditional Chinese Medicine of Changde,Changde 415000,Hunan,China 2.Hunan University of Chinese Medicine,Changsha 410208,Hunan,China
關(guān)鍵詞:
脛骨骨折;  脛骨平臺(tái);  新傷濕敷液;  中藥外敷;  臨床試驗(yàn)
Keywords:
tibial fractures;  tibial plateau;  Xinshang Shifu solutions;  external applications(TCD);  clinical trial
摘要:
目的:觀察新傷濕敷液外敷在脛骨平臺(tái)骨折術(shù)前治療中的應(yīng)用價(jià)值。方法:將60例接受手術(shù)治療的脛骨平臺(tái)骨折患者隨機(jī)分為2組,每組30例。常規(guī)治療組術(shù)前給予甘露醇脫水消腫、低分子肝素鈣抗凝治療,并指導(dǎo)患者行股四頭肌等長(zhǎng)收縮、足踝關(guān)節(jié)功能鍛煉; 外敷組在常規(guī)治療基礎(chǔ)上采用新傷濕敷液外敷患處治療,每日2次,待肢體腫脹消除后停用。記錄并比較2組患者患肢腫脹率、患肢疼痛視覺模擬量表(visual analogue scale,VAS)評(píng)分及手術(shù)等待時(shí)間。結(jié)果:外敷組退出1例,常規(guī)治療組退出2例。①患肢腫脹率。時(shí)間因素和分組因素存在交互效應(yīng)(F=35.234,P=0.000); 2組患者患肢腫脹率總體比較,組間差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=-1.986,P=0.012); 治療前后不同時(shí)間點(diǎn)患肢腫脹率的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=619.710,P=0.000); 2組患者患肢腫脹率隨時(shí)間呈先升高后降低趨勢(shì),但變化趨勢(shì)不完全一致[(7.83±1.52)%,(9.73±1.90)%,(10.84±2.00)%,(5.63±1.23)%,F=387.336,P=0.000;(7.67±1.65)%,(9.49±1.70)%,(10.79±1.66)%,(6.68±1.63)%,F=459.514,P=0.000]; 治療前及治療1 d、3 d后,2組患者患肢腫脹率的組間差異均無統(tǒng)計(jì)學(xué)意義(t=0.381,P=0.705; t=0.497,P=0.621; t=0.097,P=0.923); 治療7 d后外敷組患肢腫脹率低于常規(guī)治療組(t=-2.775,P=0.008)。②患肢疼痛VAS評(píng)分。時(shí)間因素和分組因素存在交互效應(yīng)(F=12.362,P=0.000); 2組患者患肢疼痛VAS評(píng)分比較,組間差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=-6.974,P=0.000); 治療前后不同時(shí)間點(diǎn)患肢疼痛VAS評(píng)分的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=251.136,P=0.000); 2組患者患肢疼痛VAS評(píng)分隨時(shí)間呈降低趨勢(shì),但變化趨勢(shì)不完全一致[(7.50±0.36)分,(7.15±0.31)分,(6.89±0.19)分,(4.92±0.46)分,F=322.490,P=0.000;(7.55±0.36)分,(7.36±0.28)分,(7.34±0.32)分,(6.13±0.41)分,F=94.309,P=0.000]; 治療前,2組患者患肢疼痛VAS評(píng)分的差異無統(tǒng)計(jì)學(xué)意義(t=-0.937,P=0.353); 治療1 d、3 d、7 d后外敷組患肢疼痛VAS評(píng)分均低于常規(guī)治療組(t=-2.720,P=0.009; t=-6.414,P=0.000; t=-10.520,P=0.000)。③手術(shù)等待時(shí)間。外敷組手術(shù)等待時(shí)間短于常規(guī)治療組手術(shù)等待時(shí)間[(8.31±3.15)d,(10.21±3.51)d,t=-4.219,P=0.000]。結(jié)論:對(duì)于接受手術(shù)治療的脛骨平臺(tái)骨折患者,術(shù)前在常規(guī)治療的基礎(chǔ)上采用新傷濕敷液外敷,可以消除腫脹、緩解疼痛、縮短手術(shù)等待時(shí)間。
Abstract:
Objective:To observe the applied values of external application of Xinshang Shifu(新傷濕敷,XSSF)solution to preoperative treatment of tibial plateau fractures.Methods:Sixty patients who would receive surgery for tibial plateau fractures were selected and randomly divided into conventional therapy group and external application group,30 cases in each group.All patients were treatd with dehydration and detumescence therapy using mannitol and anticoagulant therapy using low-molecular-weight heparins calcium(LMWHC),and were instructed to perform quadriceps femoris isometric contraction and ankle functional exercises before the surgery; moreover,the patients in external application group were treatd with external application of XSSF solution at the fractured parts,twice a day,till the limb swelling was eliminated.The affected limb swelling rate,visual analogue scale(VAS)scores and operating-room waiting time were recorded and compared between the 2 groups.Results:One patient in external application group and 2 patients in conventional therapy group dropped out of the study.There was interaction between time factor and group factor in affected limb swelling rate(F=35.234,P=0.000).There was statistical difference in affected limb swelling rate between the 2 groups in general,in other words,there was group effect(F=-1.986,P=0.012).There was statistical difference in affected limb swelling rate between different timepoints before and words,there was time effect(F=619.710,P=0.000).The affected limb swelling rate presented a time-dependent trend of increasing firstly and decreasing subsequently in the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency(7.83+-1.52,9.73+-1.90,10.84+-2.00,5.63+-1.23%,F=387.336,P=0.000; 7.67+-1.65,9.49+-1.70,10.79+-1.66,6.68+-1.63%,F=459.514,P=0.000).There was no statistical difference in affected limb swelling rate between the 2 groups before treatment and after 1- and 3-day treatment(t=0.381,P=0.705; t=0.497,P=0.621; t=0.097,P=0.923).The affected limb swelling rate was lower in external application group compared to conventional therapy group after 7-day treatment(t=-2.775,P=0.008).There was interaction between time factor and group factor in affected limb pain VAS scores(F=12.362,P=0.000).There was statistical difference in affected limb pain VAS scores between the 2 groups,in other words,there was group effect(F=-6.974,P=0.000).There was statistical difference in affected limb pain VAS scores between different timepoints before and after the treatment,in other words,there was time effect(F=251.136,P=0.000).The affected limb pain VAS scores presented a time-dependent decreasing trend in the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency(7.50+-0.36,7.15+-0.31,6.89+-0.19,4.92+-0.46 points,F=322.490,P=0.000; 7.55+-0.36,7.36+-0.28,7.34+-0.32,6.13+-0.41 points,F=94.309,P=0.000).There was no statistical difference in affected limb pain VAS scores between the 2 groups before the treatment(t=-0.937,P=0.353).The affected limb pain VAS scores were lower in external application group compared to conventional therapy group after 1-,3- and 7-day treatment(t=-2.720,P=0.009; t=-6.414,P=0.000; t=-10.520,P=0.000).The operating-room waiting time was shorter in external application group compared to conventional therapy group(8.31+-3.15 vs 10.21+-3.51 days,t=-4.219,P=0.000).Conclusion:For patients with tibial plateau fractures who will receive surgery,the combination therapy of conventional treatment and external application of XSSF solution can eliminate swelling,relieve pain and shorten operating-room waiting time before surgery.

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備注/Memo

備注/Memo:
(收稿日期:2020-03-17本文編輯:時(shí)紅磊)基金項(xiàng)目:湖南省中醫(yī)藥管理局項(xiàng)目(2019104)通訊作者:劉志軍E-mail:[email protected]
更新日期/Last Update: 2020-10-10