[1]周峰,泮利锋,钱建军.海桐皮汤薰洗联合常规消肿疗法治疗跟骨骨折后早期足踝部肿胀的疗效观察[J].中医正骨,2020,32(10):31-34.
　ZHOU Feng,PAN Lifeng,QIAN Jianjun.Observation on the curative effects of steaming and washing therapy with Haitongpi Tang(海桐皮汤)combined with conventional decongestive therapy for treatment of early ankle swelling after calcaneal fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(10):31-34.
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海桐皮汤薰洗联合常规消肿疗法治疗跟骨骨折后早期足踝部肿胀的疗效观察()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年10期
页码:
31-34
栏目:
临床研究
出版日期:
2020-10-20

文章信息/Info

Title:
Observation on the curative effects of steaming and washing therapy with Haitongpi Tang(海桐皮汤)combined with conventional decongestive therapy for treatment of early ankle swelling after calcaneal fractures
作者:
周峰; 泮利锋; 钱建军
(杭州市第九人民医院,浙江 杭州 311225)
Author(s):
ZHOU Feng; PAN Lifeng; QIAN Jianjun
The Ninth People’s Hospital of Hangzhou City,Hangzhou 311225,Zhejiang,China
关键词:
跟骨;  骨折; 闭合性;  肿胀;  海桐皮汤;  薰洗;  消肿;  临床试验
Keywords:
calcaneus;  fractures; closed;  swelling;  Haitongpi Tang;  steaming washing therapy;  subsiding swelling;  clinical trial
摘要:
目的:观察海桐皮汤薰洗联合常规消肿疗法治疗跟骨骨折后早期足踝部肿胀的临床疗效。方法:将符合要求的80例跟骨骨折后早期足踝部肿胀患者随机分为常规消肿组和海桐皮汤薰洗组,每组40例。常规消肿组给予冰敷、抬高患肢、石膏托外固定、足趾被动功能锻炼等治疗,连续治疗7 d; 海桐皮汤薰洗组在常规消肿组治疗方案的基础上采用海桐皮汤薰洗患处,每次薰洗约30 min,每日2次,连续薰洗7 d。结果:①足踝部皮肤褶皱出现时间。海桐皮汤薰洗组足踝部皮肤褶皱出现时间早于常规消肿组[(5.93±0.92)d,(7.88±0.79)d,t=-10.188,P=0.000]。②张力性水疱发生情况。海桐皮汤薰洗组2例出现张力性水疱,常规消肿组8例出现张力性水疱; 海桐皮汤薰洗组张力性水疱发生率低于常规消肿组(χ2=4.114,P=0.043)。③患侧与健侧足踝部周径差。海桐皮汤薰洗组2例患者和常规消肿组8例患者均因足踝部出现张力性水疱而未完成患侧与健侧足踝部周径差的测量。其他患者测量结果显示,时间因素和分组因素存在交互效应(F=9.519,P=0.000)。2组患者的患侧与健侧足踝部周径差总体比较,组间差异有统计学意义,即存在分组效应(F=8.854,P=0.004)。治疗前后不同时间点患侧与健侧足踝部周径差的差异有统计学意义,即存在时间效应(F=407.980,P=0.000); 2组患者治疗前后的患侧与健侧足踝部周径差均呈先升高后降低的趋势[海桐皮汤薰洗组:(2.52±0.73)cm,(4.09±0.57)cm,(2.26±0.71)cm,(1.20±0.46)cm,F=138.563,P=0.000; 常规消肿组:(2.53±0.78)cm,(4.02±0.44)cm,(2.63±0.64)cm,(1.82±0.35)cm,F=81.032,P=0.000],但2组的变化趋势不完全一致; 治疗前、治疗后第2天2组患者患侧与健侧足踝部周径差的差异均无统计学意义[t=-0.042,P=0.967; t=0.620,P=0.537]; 治疗后第4天、第7天海桐皮汤薰洗组患侧与健侧足踝部周径差均小于常规消肿组[t=-2.285,P=0.025; t=-6.269,P=0.000]。结论:海桐皮汤薰洗联合常规消肿疗法治疗跟骨骨折后早期足踝部肿胀,与常规消肿疗法相比,能尽早消除足踝部肿胀,降低张力性水疱的发生率。
Abstract:
To observe the clinical curative effects of steaming and washing therapy with Haitongpi Tang(海桐皮汤,HTPT)combined with conventional detumescence therapy for treatment of early ankle swelling after calcaneal fractures.Methods:Eighty patients with early ankle swelling secondary to calcaneal fracture were enrolled in the study and were randomly divided into conventional detumescence group and HTPT steaming-washing group,40 cases in each group.All patients in the 2 groups were treated with ice compress,raising the injured limbs,plaster slab external fixation and passive toes functional exercises for consecutive 7 days.Moreover,the patients in HTPT steaming-washing group were treated with HTPT steaming and washing therapy at the afflicted parts twice a day,30 minutes at a time for consecutive 7 days.Results:The skin folds of foot and ankle appeared earlier in HTPT steaming-washing group compared to conventional detumescence group(5.93+/-0.92 vs 7.88+/-0.79 days,t=-10.188,P=0.000).The tension blisters were found in 2 patients in HTPT steaming-washing group and 8 patients in conventional detumescence group.The incidence rate of tension blister was lower in HTPT steaming-washing group compared to conventional detumescence group(χ2=4.114,P=0.043).The measurements of difference of ankle circumference between affected side and healthy side was unfinished in 2 patients in HTPT steaming-washing group and 8 patients in conventional detumescence group for appearing tension blisters at foot and ankle.The measurement results of the other patients showed that there was interaction between time factor and group factor(F=9.519,P=0.000).There was statistical difference in the difference of ankle circumference between affected side and healthy side between the 2 groups in general,in other words,there was group effect(F=8.854,P=0.004).There was statistical difference in the difference of ankle circumference between affected side and healthy side between different timepoints before and after the treatment,in other words,there was time effect(F=407.980,P=0.000).The difference of ankle circumference between affected side and healthy side presented a time-dependent trend of increasing firstly and decreasing subsequently in the 2 groups(HTPT steaming-washing group:2.52+/-0.73,4.09+/-0.57,2.26+/-0.71,1.20+/-0.46 cm,F=138.563,P=0.000; conventional detumescence group:2.53+/-0.78,4.02+/-0.44,2.63+/-0.64,1.82+/-0.35 cm,F=81.032,P=0.000),while the 2 groups were inconsistent with each other in the variation tendency.There was no statistical difference in the difference of ankle circumference between affected side and healthy side between the 2 groups before the treatment and at posttreatment day 2(t=-0.042,P=0.967; t=0.620,P=0.537).The difference of ankle circumference between affected side and healthy side was smaller in HTPT steaming-washing group compared to conventional detumescence group at posttreatment day 4 and 7(t=-2.285,P=0.025; t=-6.269,P=0.000].Conclusion:The HTPT steaming and washing therapy combined with conventional detumescence therapy can eliminate ankle swelling early and reduce incidence rate of tension blisters compared to the monotherapy of conventional detumescence therapy in treatment of early ankle swelling after calcaneal fractures.

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备注/Memo:
通讯作者:周峰 E-mail:feng492057053@sina.com
更新日期/Last Update: 2020-10-20