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[1]鄭玉石.中藥外敷和薰洗治療第五跖骨基底部骨折[J].中醫(yī)正骨,2019,31(11):26-30.
　ZHENG Yushi.External applications of traditional Chinese drugs and Chinese herbal steaming washing therapy for treatment of the fifth metatarsal base fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(11):26-30.
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中藥外敷和薰洗治療第五跖骨基底部骨折()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年11期
頁碼:
26-30
欄目:
臨床研究
出版日期:
2019-11-20

文章信息/Info

Title:
External applications of traditional Chinese drugs and Chinese herbal steaming washing therapy for treatment of the fifth metatarsal base fractures
作者:
鄭玉石
(廈門市中醫(yī)院,福建 廈門 361009)
Author(s):
ZHENG Yushi
Xiamen Hospital of Traditional Chinese Medicine,Xiamen 361009,Fujian,China
關(guān)鍵詞:
骨折;  跖骨;  中藥外敷;  薰洗
Keywords:
fractures; bone;  metatarsal bones;  external applications(TCD);  steaming washing therapy
摘要:
目的:探討中藥外敷和薰洗治療第五跖骨基底部骨折的臨床療效。方法:49例第五跖骨基底部骨折患者,隨機分為中藥外治組(25例)和石膏固定組(24例)。中藥外治組分2期治療,早中期(第1周至第5周)中藥外敷后繃帶“8”字包扎固定,每日1次; 后期(第6周至第7周)中藥薰洗,每日早晚各1次。石膏固定組采用石膏后托外固定5周。治療開始后,前5周患者拄雙拐,患足不負重; 第6周改用單拐,患足足跟部著地; 第7周去除拐杖雙足行走。分別于治療前和治療3周、5周、7周后,采用疼痛數(shù)字評定量表(numerical rating scale,NRS)評分評價患足疼痛情況,測量患足腫脹度; 治療7周后,參照《中醫(yī)病證診斷療效標準》中跖骨骨折療效評價標準對骨折愈合情況進行評分,并采用“起立–行走”計時測試從行走時間和步態(tài)兩方面對患者步行能力進行評價。結(jié)果:①治療和隨訪完成情況。治療開始后第2周,中藥外治組1例患者因出現(xiàn)皮膚發(fā)紅、瘙癢而終止治療退出試驗,其余48例患者均完成治療和隨訪。②患足疼痛NRS評分。時間因素和分組因素不存在交互效應(F=0.537,P=0.586); 2組患者患足疼痛NRS評分總體比較,差異有統(tǒng)計學意義,即存在分組效應(F=23.858,P=0.000); 治療前后不同時間點之間患足疼痛NRS評分的差異有統(tǒng)計學意義,即存在時間效應(F=89.863,P=0.000); 2組患者患足疼痛NRS評分隨時間變化總體上均呈下降趨勢,但兩組的下降趨勢不完全一致; 治療前,2組患者患足疼痛NRS評分比較,差異無統(tǒng)計學意義[(76.17±12.16)分,(75.13±12.86)分,t=0.287,P=0.775]; 治療3周、5周和7周后,中藥外治組患足疼痛NRS評分均低于石膏固定組[(19.33±11.43)分,(27.42±10.97)分,t=-2.500,P=0.016;(2.58±3.81)分,(8.25±5.48)分,t=-4.160,P=0.000;(3.83±4.30)分,(12.29±6.15)分,t=-5.448,P=0.000]。③患足腫脹度。時間因素和分組因素存在交互效應(F=43.818,P=0.000); 2組患者患足腫脹度總體比較,差異有統(tǒng)計學意義,即存在分組效應(F=8.582,P=0.000); 治療前后不同時間點之間患足腫脹度的差異有統(tǒng)計學意義,即存在時間效應(F=156.319,P=0.000); 2組患者患足腫脹度隨時間變化總體上均呈下降趨勢,但兩組的下降趨勢不完全一致; 治療前,2組患者患足腫脹度比較,差異無統(tǒng)計學意義[(1.21±0.27)cm,(1.22±0.26)cm,t=-0.047,P=0.963]; 治療3周、5周和7周后,中藥外治組患足腫脹度均低于石膏固定組[(0.59±0.21)cm,(0.75±0.26)cm,t=-2.501,P=0.016;(0.06±0.09)cm,(0.42±0.22)cm,t=-6.559,P=0.000;(0.08±0.09)cm,(0.42±0.16)cm,t=-8.877,P=0.000]。④骨折愈合評分和患者步行能力。治療7周后,中藥外治組骨折愈合評分和步態(tài)評分均低于石膏固定組,起立行走時間較石膏固定組短[(1.5±0.5)分,(2.2±0.5)分,t=-4.615,P=0.000;(1.6±0.8)分,(2.6±0.6)分,t=-4.679,P=0.000;(8.5±0.3)s,(9.1±0.4)s,t=-6.124,P=0.000]。結(jié)論:對于第五跖骨基底部骨折,采用中藥外敷和薰洗治療,在緩解患足疼痛、消除患足腫脹、促進骨折愈合、改善患者行走能力方面均優(yōu)于石膏后托外固定。
Abstract:
Objective:To explore the clinical curative effects of external applications of traditional Chinese drugs(TCD)and Chinese herbal steaming washing therapy for treatment of the fifth metatarsal base fractures.Methods:Forty-nine patients with fifth metatarsal base fractures were randomly divided into TCD external treatment group(25)and plaster fixation group(24).The patients in TCD external treatment group received two-stage treatment.In the early-middle period(from the 1st week to the 5th week),the patients were treated with external application of TCD followed by fixation with figure-of-eight bandages,once a day.In the later period(from the 6th week to the 7th week),the patients were treated with Chinese herbal steaming washing therapy,twice a day in the morning and evening respectively.The patients in plaster fixation group were treated with plaster slab external fixation for 5 weeks.Assisted by double crutches,the patient can walk on the uninjured foot in the first 5 weeks after the begining of the treatment.Assisted by single crutch,the patient can walk and strike the ground with the heel of the injured foot in the 6th week.The patient can walk on double feet without the crutchs in the 7th week.The injured foot pain was evaluated by using numerical rating scale(NRS)scores and the injured foot swelling degree was measured before the treatment and after 3-,5- and 7-week treatment respectively.The fracture healing was scored after 7-week treatment according to the therapeutic effect evaluation standard of metatarsal fracture which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes,and the patient's walking ability,including walking time and gait,was evaluated by using timed up and go test.Results:At the 2nd week after the begining of the treatment,one patient in TCD external treatment group dropped out of the trial for redness and itching in skin,and the treatment and follow-up were finished successfully in the other 48 patients.There was no interaction between time factor and group factor in injured foot pain NRS scores(F=0.537,P=0.586).There was statistical difference in injured foot pain NRS scores between the 2 groups in general,in other words,there was group effect(F=23.858,P=0.000).There was statistical difference in injured foot pain NRS scores between different timepoints before and after the treatment,in other words,there was time effect(F=89.863,P=0.000).The injured foot pain NRS scores presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency.There was no statistical difference in injured foot pain NRS scores between the 2 groups before the treatment(76.17+/-12.16 vs 75.13+/-12.86 points,t=0.287,P=0.775).The injured foot pain NRS scores were lower in TCD external treatment group compared to plaster fixation group after 3-,5- and 7-week treatment(19.33+/-11.43 vs 27.42+/-10.97 points,t=-2.500,P=0.016; 2.58+/-3.81 vs 8.25+/-5.48 points,t=-4.160,P=0.000; 3.83+/-4.30 vs 12.29+/-6.15 points,t=-5.448,P=0.000).There was interaction between time factor and group factor in the injured foot swelling degree(F=43.818,P=0.000).There was statistical difference in injured foot swelling degree between the 2 groups in general,in other words,there was group effect(F=8.582,P=0.000).There was statistical difference in injured foot swelling degree between different timepoints before and after the treatment,in other words,there was time effect(F=156.319,P=0.000).The injured foot swelling degree presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency.There was no statistical difference in injured foot swelling degree between the 2 groups before the treatment(1.21+/-0.27 vs 1.22+/-0.26 cm,t=-0.047,P=0.963).The injured foot swelling degree was lower in TCD external treatment group compared to plaster fixation group after 3-,5- and 7-week treatment(0.59+/-0.21 vs 0.75+/-0.26 cm,t=-2.501,P=0.016; 0.06+/-0.09 vs 0.42+/-0.22 cm,t=-6.559,P=0.000; 0.08+/-0.09 vs 0.42+/-0.16 cm,t=-8.877,P=0.000).The fracture healing scores and gait scores were lower and the up-and-go time was shorter in TCD external treatment group compared to plaster fixation group after 7-week treatment(1.5+/-0.5 vs 2.2+/-0.5 points,t=-4.615,P=0.000; 1.6+/-0.8 vs 2.6+/-0.6 points,t=-4.679,P=0.000; 8.5+/-0.3 vs 9.1+/-0.4 seconds,t=-6.124,P=0.000).Conclusion:For patients with the fifth metatarsal base fractures,the combination of external applications of TCD and Chinese herbal steaming washing therapy surpass plasterslab external fixation therapy in relieving foot pain,eliminating foot swelling,promoting fracture healing and improving walking ability.

參考文獻/References:

[1] 王正義.足踝外科學[M].北京:人民衛(wèi)生出版社,2014:703-704. [2] 張俐.中醫(yī)正骨學[M].北京:中國中醫(yī)藥出版社,2016:139. [3] 胥少汀,葛寶豐,徐印坎.實用骨科學[M].2版.北京:人民軍醫(yī)出版社,2004:349. [4] 潘元珍,劉超群,周國林.閉合性骨折早期應用中藥熏洗、外敷的療效觀察[J].中國實驗方劑學雜志,2013,19(13):333-335. [5] 尹建文,王旭,馬昕.Jones骨折治療進展[J].國際骨科學雜志,2016,37(3):149-152. [6] 戴慎,薛建國,岳沛平.中醫(yī)病證診療標準與方劑選用[M].北京:人民衛(wèi)生出版社,2001:929. [7] 國家中醫(yī)藥管理局.中醫(yī)臨床診療術(shù)語證候部分[M].北京:中國標準出版社,1997:156. [8] 孫樹椿.中醫(yī)骨傷學高級教程[M].北京:中華醫(yī)學電子出版社,2016:192. [9] 龐堅.膝骨關(guān)節(jié)炎疼痛強度評價方法[J].中醫(yī)正骨,2018,30(11):36-38. [10] 國家中醫(yī)藥管理局.中醫(yī)病證診斷療效標準[M].南京:南京大學出版社,1994:174. [11] 燕鐵斌.“起立-行走”計時測試簡介—功能性步行能力快速定量評定法[J].中國康復理論與實踐,2000,6(3):115-117. [12] 劉震,于訓意,曹長征,等.接骨續(xù)筋丸促進大鼠骨折愈合的作用機制研究[J].中醫(yī)正骨,2017,29(10):1-12. [13] 郭天旻,李浩鋼,吳軍豪,等.石氏三色敷藥外敷治療早中期膝骨關(guān)節(jié)炎瘀血阻滯證的臨床研究[J].中醫(yī)正骨,2018,30(11):21-27. [14] 章曉云,陳躍平,龍飛攀,等.手法復位小夾板固定結(jié)合中醫(yī)三期辨證用藥治療伸直型橈骨遠端骨折367例[J].中醫(yī)正骨,2014,26(12):37-39. [15] 張曉芳,劉波,劉輝,等.以中醫(yī)療法為主的綜合康復方案治療踝關(guān)節(jié)僵硬[J].中醫(yī)正骨,2018,30(12):47-49. [16] 丁谷淵,史申宇,江顯俊,等.中藥薰蒸聯(lián)合小針刀療法治療髂脛束綜合征[J].中醫(yī)正骨,2018,30(9):62-63. [17] 林越,張寧,劉世巍,等.補腎活血方對hPTH(1-34)干預下小鼠成骨細胞MC3T3-E1增殖及分化的影響[J].中華臨床醫(yī)師雜志(電子版),2012,6(11):3065-3068. [18] 朱建富,鄭海榮,曾煥友.骨折術(shù)后患者應用活血化瘀類藥物促進骨折愈合的近期與遠期療效[J].遼寧中醫(yī)雜志,2015,42(3):509-511.

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(收稿日期:2019-08-15 本文編輯:楊雅)
更新日期/Last Update: 2019-11-10