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[1]趙春棟,周松,高開(kāi)拓.傷科消腫湯口服聯(lián)合甘露醇靜脈滴注治療脛腓骨骨折術(shù)后肢體腫脹的臨床研究[J].中醫(yī)正骨,2016,28(12):21-25.
　ZHAO Chundong,ZHOU Song,GAO Kaituo.Clinical study on oral application of Shangke Xiaozhong Tang(傷科消腫湯)combined with intravenous drip infusion of mannitol for treatment of postoperative limb swelling in patients with peroneotibial fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(12):21-25.
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傷科消腫湯口服聯(lián)合甘露醇靜脈滴注治療脛腓骨骨折術(shù)后肢體腫脹的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年12期
頁(yè)碼:
21-25
欄目:
臨床研究
出版日期:
2016-12-30

文章信息/Info

Title:
Clinical study on oral application of Shangke Xiaozhong Tang(傷科消腫湯)combined with intravenous drip infusion of mannitol for treatment of postoperative limb swelling in patients with peroneotibial fractures
作者:
趙春棟1; 周松2; 高開(kāi)拓2
1.浙江中醫(yī)藥大學(xué),浙江 杭州 310053;
2.山東省臨沂市人民醫(yī)院,山東 臨沂 276000
Author(s):
ZHAO Chundong1; ZHOU Song2; GAO Kaituo2
1.Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China 2.The People's Hospital of Linyi City in Shandong Province,Linyi 276000,Shandong,China
關(guān)鍵詞:
脛骨骨折;  腓骨;  骨折;  手術(shù)后并發(fā)癥;  腫脹;  傷科消腫湯;  中藥療法;  甘露醇;  臨床試驗(yàn)
Keywords:
tibial fractures;  fibula;  fractures; bone;  postoperative complications;  swelling;  Shangke Xiaozhong Tang;  drug therapy(TCD);  mannitol;  clinical trial
摘要:
目的:觀察傷科消腫湯口服聯(lián)合甘露醇靜脈滴注治療脛腓骨骨折術(shù)后肢體腫脹的臨床療效。方法:將48例脛腓骨骨折術(shù)后肢體腫脹的患者隨機(jī)分為2組,每組24例,分別給予傷科消腫湯口服聯(lián)合甘露醇靜脈滴注治療和單純甘露醇靜脈滴注治療。傷科消腫湯早晚各1袋溫服,每袋150 mL,連續(xù)服用7 d; 靜脈滴注20%甘露醇,每次150 mL,每8 h注射1次,連續(xù)注射7 d。分別于術(shù)后第1天、第3天、第5天、第7天測(cè)量患健側(cè)小腿周徑并比較2組患者患側(cè)小腿腫脹值(患側(cè)小腿周徑-健側(cè)小腿周徑),并于術(shù)后第7天參照《中藥新藥臨床研究指導(dǎo)原則》中軟組織損傷的療效標(biāo)準(zhǔn)評(píng)價(jià)療效。結(jié)果:2組患者小腿腫脹值在術(shù)后不同時(shí)間點(diǎn)間比較,差異有統(tǒng)計(jì)學(xué)意義,存在時(shí)間效應(yīng),治療后腫脹值逐漸降低(F=555.770,P=0.000); 2組患者術(shù)后小腿腫脹值總體上比較,組間差異無(wú)統(tǒng)計(jì)學(xué)意義,不存在分組效應(yīng)(F=0.354,P=0.555); 術(shù)后第1天、第3天2組患者小腿腫脹值比較,組間差異均無(wú)統(tǒng)計(jì)學(xué)意義[(4.42±1.30)cm,(4.20±1.15)cm,t=0.612,P=0.543;(3.74±1.21)cm,(3.53±0.99)cm,t=0.668,P=0.507]; 術(shù)后第5天、第7天傷科消腫湯聯(lián)合甘露醇組小腿腫脹值低于甘露醇組[(1.96±0.82)cm,(2.60±0.76)cm,t=-2.773,P=0.008;(1.03±0.56)cm,(1.44±0.54)cm,t=-2.496,P=0.016]; 時(shí)間因素和分組因素存在交互效應(yīng)(F=13.826,P=0.000); 傷科消腫湯聯(lián)合甘露醇組小腿腫脹值比甘露醇組降低得更快。術(shù)后第7天,傷科消腫湯聯(lián)合甘露醇組顯效20例、有效4例,甘露醇組顯效10例、有效14例,傷科消腫湯聯(lián)合甘露醇組的臨床療效優(yōu)于甘露醇組(Z=-2.950,P=0.003)。結(jié)論:采用傷科消腫湯口服聯(lián)合甘露醇靜脈滴注,可以更快地減輕脛腓骨骨折術(shù)后患肢腫脹,其療效優(yōu)于單純甘露醇治療,值得臨床推廣應(yīng)用。
Abstract:
Objective:To observe the clinical curative effects of oral application of Shangke Xiaozhong Tang(傷科消腫湯,SKXZT)combined with intravenous drip infusion of mannitol for treatment of postoperative limb swelling in patients with peroneotibial fractures.Methods:Forty-eight patients with limb swelling after surgery for treatment of peroneotibial fractures were randomly divided into 2 groups,24 cases in each group,and were treated with oral application of SKXZT combined with intravenous drip infusion of mannitol(group A)and monotherapy of intravenous drip infusion of mannitol(group B)respectively.The warm SKXZT were taken at a dose of 150 mL,twice a day in the morning and evening for consecutive 7 days.The 20% mannitol was injected intravenously at a dose of 150 mL,once every 8 hours for consecutive 7 days.The perimeters of legs of affected and unaffected side were measured and the swelling values of legs of affected side(perimeter difference of legs between affected side and unaffected side)were compared between the 2 groups on postoperative day 1,3,5 and 7 respectively.Furthermore,the curative effects were evaluated on postoperative day 7 according to therapeutic effect evaluation standard of soft tissue injury which was extracted from guiding principles for clinical research on new Chinese medicine.Results:There was statistical difference in the leg swelling values between different time points,in other words,there was time effect.The leg swelling values decreased gradually after treatment(F=555.770,P=0.000).There was no statistical difference in the postoperative leg swelling values between the 2 groups in general,in other words,there was no group effect(F=0.354,P=0.555).There was no statistical difference in the leg swelling values between the 2 groups on postoperative day 1 and 3(4.42+/-1.30 vs 4.20+/-1.15 cm,t=0.612,P=0.543; 3.74+/-1.21 vs 3.53+/-0.99 cm,t=0.668,P=0.507).The leg swelling values were lower in group A compared to group B on postoperative day 5 and 7(1.96+/-0.82 vs 2.60+/-0.76 cm,t=-2.773,P=0.008; 1.03+/-0.56 vs 1.44+/-0.54 cm,t=-2.496,P=0.016).There was interaction between time factor and group factor(F=13.826,P=0.000).The leg swelling values decreased more rapidly in group A compared to group B.On postoperative day 7,20 patients got good result and 4 fair in group A,while 10 patients got good result and 14 fair in group B.The group A surpassed the group B in the clinical curative effect(Z=-2.950,P=0.003).Conclusion:Oral application of SKXZT combined with intravenous drip infusion of mannitol can reduce postoperative limb swelling in patients with peroneotibial fractures more quickly,and it surpasses the monotherapy of intravenous drip infusion of mannitol in the clinical curative effect,so it is worthy of popularizing in clinic.

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備注/Memo

備注/Memo:
基金項(xiàng)目:山東省中醫(yī)藥科技發(fā)展計(jì)劃項(xiàng)目(2013ZDZK-153)
通訊作者:周松 E-mail:[email protected]
更新日期/Last Update: 2016-12-30