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[1]張曉芳,項杰.大黃芒硝散超聲透入在閉合性脛腓骨骨折術前治療中的應用[J].中醫(yī)正骨,2022,34(05):1-5.
　ZHANG Xiaofang,XIANG Jie.Application of phonophoresis with rhubarb-mirabilite powders in preoperative treatment of closed tibiofibular fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(05):1-5.
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大黃芒硝散超聲透入在閉合性脛腓骨骨折術前治療中的應用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年05期
頁碼:
1-5
欄目:
臨床研究
出版日期:
2022-05-20

文章信息/Info

Title:
Application of phonophoresis with rhubarb-mirabilite powders in preoperative treatment of closed tibiofibular fractures
作者:
張曉芳; 項杰
(杭州市富陽中醫(yī)骨傷醫(yī)院,浙江 杭州 311400)
Author(s):
ZHANG Xiaofang; XIANG Jie
Fuyang TCM Orthopedic-Traumatological Hospital,Hangzhou 311400,Zhejiang,China
關鍵詞:
脛骨骨折;  腓骨;  骨折; 閉合性;  大黃;  芒硝;  超聲透入療法;  腫脹;  疼痛;  臨床試驗
Keywords:
tibial fractures;  fibula;  fractures; closed;  rhei radix et rhizoma;  natrii sulfas;  phonophoresis;  swelling;  pain;  clinical trial
摘要:
目的:探討大黃芒硝散超聲透入在閉合性脛腓骨骨折術前治療中的應用價值。方法:將符合要求的105例閉合性脛腓骨骨折患者隨機分為3組,每組35例。常規(guī)治療組術前采用口服地奧司明片和靜脈滴注甘露醇注射液治療,大黃芒硝散外敷組在常規(guī)治療(同常規(guī)治療組)的基礎上給予外敷大黃芒硝散治療,超聲透入組在常規(guī)治療(同常規(guī)治療組)的基礎上給予大黃芒硝散超聲透入治療。地奧司明片,每日2次,每次2片,連續(xù)服用1周; 甘露醇注射液,每次125 mL,每日2次,連續(xù)靜脈滴注3 d; 大黃芒硝散外敷于腫脹部位,每日1次,連續(xù)外敷1周; 大黃芒硝散超聲透入,每次30 min,每日1次,連續(xù)治療1周。分別于治療前和治療開始后1 d、3 d、7 d,比較3組患者的術前下肢疼痛視覺模擬量表(visual analogue scale,VAS)評分和下肢腫脹評分。結果:①術前下肢疼痛VAS評分。時間因素和分組因素存在交互效應(F=51.571,P=0.000)。3組患者術前下肢疼痛VAS評分總體比較,差異有統(tǒng)計學意義,即存在分組效應(F=594.449,P=0.000)。治療前后不同時間點之間術前下肢疼痛VAS評分的差異有統(tǒng)計學意義,即存在時間效應(F=32.243,P=0.000); 3組患者的術前下肢疼痛VAS評分隨時間延長均呈下降趨勢,但3組的下降趨勢不完全一致[(6.03±0.95)分,(5.00±0.71)分,(1.77±0.73)分,(1.02±0.71)分,F=285.490,P=0.000;(6.11±0.96)分,(5.34±0.63)分,(3.28±0.62)分,(2.08±0.65)分,F=356.243,P=0.000;(6.40±1.03)分,(5.31±0.67)分,(3.88±0.67)分,(2.37±0.68)分,F=119.090,P=0.000]; 治療前及治療開始后1 d,3組患者的術前下肢疼痛VAS評分比較,差異均無統(tǒng)計學意義(F=1.365,P=0.260; F=2.614,P=0.078); 治療開始后3 d、7 d,超聲透入組患者的術前下肢疼痛VAS評分均低于大黃芒硝散外敷組和常規(guī)治療組(P=0.000,P=0.000; P=0.000,P=0.000),大黃芒硝散外敷組患者的術前下肢疼痛VAS評分均低于常規(guī)治療組(P=0.000,P=0.000)。②術前下肢腫脹評分。時間因素和分組因素存在交互效應(F=5.979,P=0.000)。3組患者術前下肢腫脹評分總體比較,差異有統(tǒng)計學意義,即存在分組效應(F=203.423,P=0.000)。治療前后不同時間點之間術前下肢腫脹評分的差異有統(tǒng)計學意義,即存在時間效應(F=6.636,P=0.000); 3組患者的術前下肢腫脹評分隨時間延長均呈下降趨勢,但3組的下降趨勢不完全一致[(2.65±0.48)分,(2.37±0.49)分,(1.40±0.49)分,(0.77±0.54)分,F=130.845,P=0.000;(2.57±0.50)分,(2.45±0.50)分,(1.62±0.54)分,(1.11±0.58)分,F=62.884,P=0.000;(2.62±0.49)分,(2.48±0.51)分,(1.85±0.55)分,(1.37±0.59)分,F=47.654,P=0.000]; 治療前及治療開始后1 d,3組患者的術前下肢腫脹評分比較,差異均無統(tǒng)計學意義(F=0.276,P=0.759; F=0.493,P=0.612); 治療開始后3 d,超聲透入組與大黃芒硝散外敷組患者的術前下肢腫脹評分的差異無統(tǒng)計學意義(P=0.079),超聲透入組患者的術前下肢腫脹評分低于常規(guī)治療組(P=0.000),大黃芒硝散外敷組與常規(guī)治療組患者的術前下肢腫脹評分的差異無統(tǒng)計學意義(P=0.082); 治療開始后7 d,超聲透入組患者的術前下肢腫脹評分低于大黃芒硝散外敷組和常規(guī)治療組(P=0.013,P=0.000),大黃芒硝散外敷組與常規(guī)治療組患者的術前下肢腫脹評分的差異無統(tǒng)計學意義(P=0.067)。結論:對于閉合性脛腓骨骨折患者,術前在常規(guī)治療的基礎上采用大黃芒硝散超聲透入治療,能有效緩解患肢疼痛和消除患肢腫脹。
Abstract:
Objective:To explore the applied values of phonophoresis with rhubarb-mirabilite powders(RMP)in preoperative treatment of closed tibiofibular fractures.Methods:One hundred and five patients with closed tibiofibular fractures were enrolled in the study and were randomly divided into conventional treatment group,RMP external application group and RMP phonophoresis group,35 cases in each group.All patients in the 3 groups were treated with oral application of diosmin tablets(twice a day,2 tablets at a time for consecutive 7 days)and intravenous drip infusion of mannitol injection(twice a day,125 mL at a time for consecutive 3 days)before the surgery.Moreover,the patients in RMP external application group were further treated with external application of RMP(once a day for consecutive 7 days)at the swelling parts,and the ones in RMP phonophoresis group with phonophoresis of RMP(once a day,30 minutes at a time for consecutive 7 days).The preoperative lower limb pain visual analogue scale(VAS)score and lower limb swelling score were compared between the 3 groups before the treatment and at 1,3 and 7 days after the beginning of the treatment respectively.Results:①There was interaction between time factor and group factor in preoperative lower limb pain VAS score(F=51.571,P=0.000).There was statistical difference in preoperative lower limb pain VAS scores between the 3 groups in general,in other words,there was group effect(F=594.449,P=0.000).There was statistical difference in preoperative lower limb pain VAS scores between different timepoints before and after the treatment,in other words,there was time effect(F=32.243,P=0.000).The preoperative lower limb pain VAS scores presented a time-dependent decreasing trend in the 3 groups,while the 3 groups were inconsistent with each other in the variation tendency(6.03±0.95,5.00±0.71,1.77±0.73,1.02±0.71 points,F=285.490,P=0.000;6.11±0.96,5.34±0.63,3.28±0.62,2.08±0.65 points,F=356.243,P=0.000;6.40±1.03,5.31±0.67,3.88±0.67,2.37±0.68 points,F=119.090,P=0.000).There was no statistical difference in the preoperative lower limb pain VAS scores between the 3 groups before the treatment and at 1 day after the beginning of the treatment(F=1.365,P=0.260; F=2.614,P=0.078),howerer,at 3 and 7 days after the beginning of the treatment,the preoperative lower limb pain VAS scores were lower in RMP phonophoresis group compared to RMP external application group and conventional treatment group(P=0.000,P=0.000; P=0.000,P=0.000),and were lower in RMP external application group compared to conventional treatment group(P=0.000,P=0.000).②There was interaction between time factor and group factor in preoperative lower limb swelling score(F=5.979,P=0.000).There was statistical difference in preoperative lower limb swelling scores between the 3 groups in general,in other words,there was group effect(F=203.423,P=0.000).There was statistical difference in preoperative lower limb swelling scores between different timepoints before and after the treatment,in other words,there was time effect(F=6.636,P=0.000).The preoperative lower limb swelling scores presented a time-dependent decreasing trend in the 3 groups,while the 3 groups were inconsistent with each other in the variation tendency(2.65±0.48,2.37±0.49,1.40±0.49,0.77±0.54 points,F=130.845,P=0.000; 2.57±0.50,2.45±0.50,1.62±0.54,1.11±0.58 points,F=62.884,P=0.000; 2.62±0.49,2.48±0.51,1.85±0.55,1.37±0.59 points,F=47.654,P=0.000).There was no statistical difference in the preoperative lower limb swelling scores between the 3 groups before the treatment and at 1 day after the beginning of the treatment(F=0.276,P=0.759; F=0.493,P=0.612).At 3 days after the beginning of the treatment,the preoperative lower limb swelling scores were not significantly different from each other between RMP phonophoresis group and RMP external application group(P=0.079)as well as between RMP external application group and conventional treatment group(P=0.082),whereas it was lower in RMP phonophoresis group compared to conventional treatment group(P=0.000).At 7 days after the beginning of the treatment,the preoperative lower limb swelling scores were lower in RMP phonophoresis group comapred to RMP external application group and conventional treatment group(P=0.013,P=0.000),whereas there was no statistical difference between RMP external application group and conventional treatment group(P=0.067).Conclusion:Combination of conventional therapies with RMP phonophoresis can effectively relieve pain and eliminate swelling of the affected limbs in patients who will receive surgery for closed tibiofibular fractures.

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(收稿日期:2021-05-30 本文編輯:時紅磊)

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備注/Memo

備注/Memo:
基金項目:杭州市富陽區(qū)科技計劃項目(2019SK002) 通訊作者:項杰 E-mail:[email protected]
更新日期/Last Update: 1900-01-01