紫荆皮散治疗跟骨骨折早期软组织肿胀的临床研究
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摘要
目的：
本研究通过临床紫荆皮散结合常规七叶皂苷钠消肿治疗,消除跟骨骨折局部软组织肿胀,评价加用紫荆皮散外敷的疗效及其应用价值,为临床推广应用提供科学依据。
方法：
本试验共51例,病人均为2009-2011年莆田学院附属医院骨科住院的病人,最终符合试验研究标准的为44例,其中男性30例、女性14例,年龄17-52岁,平均33.20岁。试验对像均为明确诊断为跟骨骨折并选择保守治疗的病人。随机分成两组：加药组26例、对照组18例。加药组：七叶皂苷钠20mg加入NS 100ml qd静滴,外加紫荆皮散局部外敷,一天一次；对照组：七叶皂苷钠20mg加入NS 100ml qd静滴。10天为一疗程,一般治疗一个疗程。每12小时观察记录患肢肿胀程度,对比上一次观察情况,记录肿胀高峰时间及皮肤出现皱褶的时间。测量健患两侧的踝-跟-踝周长(用皮尺经过内、外踝下缘及跟骨结节绕足跟部一周,测其长度,如图3所示。)记录两组患者用药前及用药后每天患侧的踝-跟-踝周长。了解患肢出现皮肤瘀斑及疼痛情况,并予评分。
结果：
跟骨骨折病人分组用药,仅有一例患者出现药物过敏。对于患肢肿胀高峰时间,皮肤出现皱褶时间,用药后第3、6、10天健患两侧的踝-跟-踝周长差,用药后第6、10天疼痛程度及皮肤瘀斑程度,两组均有显著的统计学差异(P<0.05)。
结论：
紫荆皮散外敷对加快消除跟骨骨折早期软组织肿痛具有积极意义。紫荆皮散能在最短时间内最大限度地消除局部肿胀,减轻患者的疼痛。
Object:
Through the clinical research that Zijinpi San combining Sodium Aescinate on the treatment of the swelling resulting from the calcareous fracture, this study evaluates the curative effect of Zijinpi San for external application and the value for it.And it provides science basis for its clinical application.
Methods:
There were 51 patients of 2009～2011 from 17～52 years old. Finally, there were 44 patients up to the standard which for clinical testing, and 33.20 in average, who were collected from the orthopedic department of Affiliated Hospitals of Putian Institute in this group, in which 30 patients were male and 14 were female. These patients were clearly diagnosed as calcaneal fractures and they selected the conservative treatment. All the patients took participated in the test on the basis of the random result; the patients were divided into two groups, the experimental group 26 cases and the control group 18 cases. The experimental group:20mg Sodium Aescinate joining 100ml NS for intravenous infusion treated the swelling once a day. At the same time, Zijinpi San was applied externally at local swollen skin. The control group:20mg Sodium Aescinate joining 100ml NS for intravenous infusion treated the swelling once a day. A course of treatment was 10 days, and the general treatment period was one course of treatment. And observe and record the degree of the limb swelling every 12 hours. Through comparing the new observation with last one, record the time when swelling in the most severe case and the time when the swollen skin appeared wrinkly. Measure and record the circumference of both the affected and the contralateral side everyday after treatment. (The circumference method is shown in Figure 3.)
Result:
Only one patient had drugreaction and all patients had no other adverse reactions in the two groups. To the time when swelling in the most severe case, the time when the swollen skin appear wrinkly and the degree of pain and skin ecchymosis, there were significant statistical differences (P<0.05) between the two groups. The degree of the limb swelling on day 3,6 and 10 after treatment was significant statistical differences too.
Conclusion:
The research showed that Zijinpi San for external application is highly positive for relieving the swelling resulting from the calcareous fracture in the early stage. It can relieve the pain and swelling in the shortest time.
本研究通过临床紫荆皮散结合常规七叶皂苷钠消肿治疗,消除跟骨骨折局部软组织肿胀,评价加用紫荆皮散外敷的疗效及其应用价值,为临床推广应用提供科学依据。
方法：
本试验共51例,病人均为2009-2011年莆田学院附属医院骨科住院的病人,最终符合试验研究标准的为44例,其中男性30例、女性14例,年龄17-52岁,平均33.20岁。试验对像均为明确诊断为跟骨骨折并选择保守治疗的病人。随机分成两组：加药组26例、对照组18例。加药组：七叶皂苷钠20mg加入NS 100ml qd静滴,外加紫荆皮散局部外敷,一天一次；对照组：七叶皂苷钠20mg加入NS 100ml qd静滴。10天为一疗程,一般治疗一个疗程。每12小时观察记录患肢肿胀程度,对比上一次观察情况,记录肿胀高峰时间及皮肤出现皱褶的时间。测量健患两侧的踝-跟-踝周长(用皮尺经过内、外踝下缘及跟骨结节绕足跟部一周,测其长度,如图3所示。)记录两组患者用药前及用药后每天患侧的踝-跟-踝周长。了解患肢出现皮肤瘀斑及疼痛情况,并予评分。
结果：
跟骨骨折病人分组用药,仅有一例患者出现药物过敏。对于患肢肿胀高峰时间,皮肤出现皱褶时间,用药后第3、6、10天健患两侧的踝-跟-踝周长差,用药后第6、10天疼痛程度及皮肤瘀斑程度,两组均有显著的统计学差异(P<0.05)。
结论：
紫荆皮散外敷对加快消除跟骨骨折早期软组织肿痛具有积极意义。紫荆皮散能在最短时间内最大限度地消除局部肿胀,减轻患者的疼痛。
Object:
Through the clinical research that Zijinpi San combining Sodium Aescinate on the treatment of the swelling resulting from the calcareous fracture, this study evaluates the curative effect of Zijinpi San for external application and the value for it.And it provides science basis for its clinical application.
Methods:
There were 51 patients of 2009～2011 from 17～52 years old. Finally, there were 44 patients up to the standard which for clinical testing, and 33.20 in average, who were collected from the orthopedic department of Affiliated Hospitals of Putian Institute in this group, in which 30 patients were male and 14 were female. These patients were clearly diagnosed as calcaneal fractures and they selected the conservative treatment. All the patients took participated in the test on the basis of the random result; the patients were divided into two groups, the experimental group 26 cases and the control group 18 cases. The experimental group:20mg Sodium Aescinate joining 100ml NS for intravenous infusion treated the swelling once a day. At the same time, Zijinpi San was applied externally at local swollen skin. The control group:20mg Sodium Aescinate joining 100ml NS for intravenous infusion treated the swelling once a day. A course of treatment was 10 days, and the general treatment period was one course of treatment. And observe and record the degree of the limb swelling every 12 hours. Through comparing the new observation with last one, record the time when swelling in the most severe case and the time when the swollen skin appeared wrinkly. Measure and record the circumference of both the affected and the contralateral side everyday after treatment. (The circumference method is shown in Figure 3.)
Result:
Only one patient had drugreaction and all patients had no other adverse reactions in the two groups. To the time when swelling in the most severe case, the time when the swollen skin appear wrinkly and the degree of pain and skin ecchymosis, there were significant statistical differences (P<0.05) between the two groups. The degree of the limb swelling on day 3,6 and 10 after treatment was significant statistical differences too.
Conclusion:
The research showed that Zijinpi San for external application is highly positive for relieving the swelling resulting from the calcareous fracture in the early stage. It can relieve the pain and swelling in the shortest time.
引文
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[2]范江荣,蔡林,郑勇.跟骨骨折的分型和治疗进展.中国矫形外科杂志.2010,18(02)：124
[3]梁绍雄.跟骨骨折的治疗及进展.中国现代医生.2008,46(30)：54
[4]董晓俊,覃剑,张汉庆,等.跟骨骨折研究进展.中国中医骨伤科杂志.2008,16(10)：65
[5]余新颜.骨科创伤及术后下肢肿胀防治研究进展.安徽医药预防杂志.2008,14(6),435
[6]王毅,张秀兰.创伤及术后下肢肿胀的研究进展全国第七届骨科护理学术交流暨专题讲座会议论文汇编.2005：10
[7]王予彬,贺忱.创伤及手术后肢体肿胀的机制.继续教育.2003,18(7)：21
[8]王凯波,邱荣标,陈细明,等.防己黄芪汤加味治疗四肢骨折初期肿胀疗效观察[J].实用中医药杂志.2007,23(7)：423
[9]赵建根.化瘀利水方治疗创伤后肢体肿胀184例[J].浙江中医杂志.2004,(02)：78
[10]刘斌,杨军,肖四旺.中医药对骨折早期软组织肿胀研究的新进展.中医药导报.2008,14(8)：126
[11]佃仁森,王和鸣,练克俭,等.中药促进软组织损伤修复的临床研究进展.中国中医骨伤科杂志.2008,16(3)：68
[12]周胜建,祝庆明.紫荆皮的本草学考辨.时珍国医国药.2005,16(3)：265
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