[1]赵春栋,周松,高开拓.伤科消肿汤口服联合甘露醇静脉滴注治疗胫腓骨骨折术后肢体肿胀的临床研究[J].中医正骨,2016,28(12):21-25.
　ZHAO Chundong,ZHOU Song,GAO Kaituo.Clinical study on oral application of Shangke Xiaozhong Tang(伤科消肿汤)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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伤科消肿汤口服联合甘露醇静脉滴注治疗胫腓骨骨折术后肢体肿胀的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年12期
页码:
21-25
栏目:
临床研究
出版日期:
2016-12-30

文章信息/Info

Title:
Clinical study on oral application of Shangke Xiaozhong Tang(伤科消肿汤)combined with intravenous drip infusion of mannitol for treatment of postoperative limb swelling in patients with peroneotibial fractures
作者:
赵春栋1; 周松2; 高开拓2
1.浙江中医药大学,浙江 杭州 310053;
2.山东省临沂市人民医院,山东 临沂 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
关键词:
胫骨骨折;  腓骨;  骨折;  手术后并发症;  肿胀;  伤科消肿汤;  中药疗法;  甘露醇;  临床试验
Keywords:
tibial fractures;  fibula;  fractures; bone;  postoperative complications;  swelling;  Shangke Xiaozhong Tang;  drug therapy(TCD);  mannitol;  clinical trial
摘要:
目的:观察伤科消肿汤口服联合甘露醇静脉滴注治疗胫腓骨骨折术后肢体肿胀的临床疗效。方法:将48例胫腓骨骨折术后肢体肿胀的患者随机分为2组,每组24例,分别给予伤科消肿汤口服联合甘露醇静脉滴注治疗和单纯甘露醇静脉滴注治疗。伤科消肿汤早晚各1袋温服,每袋150 mL,连续服用7 d; 静脉滴注20%甘露醇,每次150 mL,每8 h注射1次,连续注射7 d。分别于术后第1天、第3天、第5天、第7天测量患健侧小腿周径并比较2组患者患侧小腿肿胀值(患侧小腿周径-健侧小腿周径),并于术后第7天参照《中药新药临床研究指导原则》中软组织损伤的疗效标准评价疗效。结果:2组患者小腿肿胀值在术后不同时间点间比较,差异有统计学意义,存在时间效应,治疗后肿胀值逐渐降低(F=555.770,P=0.000); 2组患者术后小腿肿胀值总体上比较,组间差异无统计学意义,不存在分组效应(F=0.354,P=0.555); 术后第1天、第3天2组患者小腿肿胀值比较,组间差异均无统计学意义[(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]; 术后第5天、第7天伤科消肿汤联合甘露醇组小腿肿胀值低于甘露醇组[(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]; 时间因素和分组因素存在交互效应(F=13.826,P=0.000); 伤科消肿汤联合甘露醇组小腿肿胀值比甘露醇组降低得更快。术后第7天,伤科消肿汤联合甘露醇组显效20例、有效4例,甘露醇组显效10例、有效14例,伤科消肿汤联合甘露醇组的临床疗效优于甘露醇组(Z=-2.950,P=0.003)。结论:采用伤科消肿汤口服联合甘露醇静脉滴注,可以更快地减轻胫腓骨骨折术后患肢肿胀,其疗效优于单纯甘露醇治疗,值得临床推广应用。
Abstract:
Objective:To observe the clinical curative effects of oral application of Shangke Xiaozhong Tang(伤科消肿汤,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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备注/Memo

备注/Memo:
基金项目:山东省中医药科技发展计划项目(2013ZDZK-153)
通讯作者:周松 E-mail:zhousong186@163.com
更新日期/Last Update: 2016-12-30