[1]李俊,陈勇,刘明,等.冰酥肿痛酊外用治疗踝关节闭合性骨折早期肿痛的临床研究[J].中医正骨,2022,34(05):13-16.
 LI Jun,CHEN Yong,LIU Ming,et al.A clinical study of external application of Bingsu Zhongtong(冰酥肿痛)tincture for treatment of early swelling and pain resulting from closed ankle fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(05):13-16.
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冰酥肿痛酊外用治疗踝关节闭合性骨折早期肿痛的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年05期
页码:
13-16
栏目:
临床研究
出版日期:
2022-05-20

文章信息/Info

Title:
A clinical study of external application of Bingsu Zhongtong(冰酥肿痛)tincture for treatment of early swelling and pain resulting from closed ankle fractures
作者:
李俊1陈勇1刘明1黄路玺1段超1邓超1车国良1马强2周细江1
(1.长沙市中医医院/长沙市第八医院,湖南 长沙 410002; 2.湖南中医药大学,湖南 长沙 410208)
Author(s):
LI Jun1CHEN Yong1LIU Ming1HUANG Luxi1DUAN Chao1DENG Chao1CHE Guoliang1MA Qiang2ZHOU Xijiang1
1.Changsha Hospital of TCM(The Eighth Hospital of Changsha),Changsha 410002,Hunan,China2.Hunan University of Chinese Medicine,Changsha 410208,Hunan,China
关键词:
踝部骨折 骨折闭合性 肿胀 疼痛 冰酥肿痛酊 临床试验
Keywords:
ankle fractures fracturesclosed swelling pain Bingsu Zhongtong tincture clinical trial
摘要:
目的:观察冰酥肿痛酊外用治疗踝关节闭合性骨折早期肿痛的临床疗效。方法:将90例符合要求的闭合性踝关节骨折患者随机分为3组,每组30例。冰敷组予以肿胀处冰敷、患肢石膏固定制动、患肢抬高、功能锻炼等处理; 雪上花搽剂组在冰敷组处理的基础上,在肿胀处外敷雪上花搽剂,每次5 mL,每天3次; 冰酥肿痛酊组在冰敷组处理的基础上,在肿胀处外敷冰酥肿痛酊,每次3~5 mL,每天3次。3组均治疗至肿胀消退。比较3组患者的肿胀持续时间、消肿速度、踝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分。结果:①肿胀持续时间。3组患者的肿胀持续时间比较,差异有统计学意义[(10.13±0.96)d,(8.03±0.91)d,(9.70±0.66)d,F=61.967,P=0.000]; 冰敷组的肿胀持续时间比雪上花搽剂组和冰酥肿痛酊组长(P=0.000; P=0.000); 雪上花搽剂组和冰酥肿痛酊组的肿胀持续时间比较,差异无统计学意义(P=0.067)。②消肿速度。3组患者的消肿速度比较,差异有统计学意义[(0.35±0.09)cm·d-1,(0.44±0.08)cm·d-1,(0.50±0.10)cm·d-1,F=17.816,P=0.000]; 冰敷组的消肿速度比雪上花搽剂组和冰酥肿痛酊组慢(P=0.000; P=0.000); 雪上花搽剂组和冰酥肿痛酊组的消肿速度比较,差异无统计学意义(P=0.625)。③踝关节疼痛VAS评分。治疗前3组患者的踝关节疼痛VAS评分比较,差异无统计学意义[(8.07±0.57)分,(8.10±0.54)分,(8.17±0.58)分,F=7.630,P=0.120]。治疗结束后3组患者的踝关节疼痛VAS评分均较治疗前减小(t=1.256,P=0.000; t=2.575,P=0.000; t=1.360,P=0.000)。治疗结束后3组患者的踝关节疼痛VAS评分比较,差异有统计学意义[(1.93±0.63)分,(1.90±0.47)分,(1.80±0.48)分,F=18.714,P=0.045]; 冰敷组与雪上花搽剂组比较,差异无统计学意义(P=0.240); 冰敷组和雪上花搽剂组的踝关节疼痛VAS评分均高于冰酥肿痛酊组(P=0.001; P=0.000)。结论:在冰敷的基础上采用冰酥肿痛酊外用治疗踝关节闭合性骨折早期肿痛,疗效确切,其疗效优于单纯冰敷和冰敷联合雪上花搽剂外用。
Abstract:
Objective:To observe the clinical outcome of external application of Bingsu Zhongtong(冰酥肿痛,BSZT)tincture in treatment of early swelling and pain resulting from closed ankle fractures.Methods:Ninety patients with closed ankle fractures were enrolled in the study and were randomly divided into ice compress group,Xueshanghua(雪上花,XSH)liniment group and BSZT tincture group,30 cases in each group.All patients in the 3 groups were treated with the conventional treatments such as ice compress at the swelling parts,plaster fixing,braking and raising the injured limbs and functional exercises.Moreover,the patients in XSH liniment group were further treated with external application of XSH liniment at the swelling parts,3 times a day,5 mL at a time; and the ones in BSZT tincture group with external application of BSZT tincture at the swelling parts,3 times a day,3-5 mL at a time.All patients in the 3 groups were treated till the swelling was subsided and skin folds appeared in ankle.The ankle swelling duration,detumescence speed and ankle pain visual analogue scale(VAS)score were compared between the 3 groups.Results:①There was statistical difference in ankle swelling duration between the 3 groups(10.13±0.96,8.03±0.91,9.70±0.66 days,F=61.967,P=0.000).The ankle swelling duration was longer in ice compress group compared to XSH liniment group and BSZT tincture group(P=0.000,P=0.000),while there was no statistical difference between XSH liniment group and BSZT tincture group(P=0.067).②There was statistical difference in detumescence speed between the 3 groups(0.35±0.09,0.44±0.08,0.50±0.10 cm/d,F=17.816,P=0.000).The detumescence speed was slower in ice compress group compared to XSH liniment group and BSZT tincture group(P=0.000; P=0.000),while there was no statistical difference between XSH liniment group and BSZT tincture group(P=0.625).③There was no statistical difference in ankle pain VAS score between the 3 groups before the treatment(8.07±0.57,8.10±0.54,8.17±0.58 points,F=7.630,P=0.120).The ankle pain VAS scores decreased in the 3 groups after the end of the treatment compared to pre-treatment(t=1.256,P=0.000; t=2.575,P=0.000; t=1.360,P=0.000).There was statistical difference in ankle pain VAS score between the 3 groups after the end of the treatment(1.93±0.63,1.90±0.47,1.80±0.48 points,F=18.714,P=0.045).The ankle pain VAS scores were not significantly different from each other between ice compress group and XSH liniment group(P=0.240),whereas it was lower in BSZT tincture group compared to compress group and XSH liniment group(P=0.001; P=0.000).Conclusion:Combination of ice compress with external application of BSZT tincture has reliable curative effects in treatment of early swelling and pain resulting from closed ankle fractures,and it surpasses the monotherapy of ice compress and the combination therapy of ice compress and external application of XSH liniment in curative effects.

参考文献/References:

[1] 李旭,李国良,贾乐生,等.加速康复外科理念下多模式规范化镇痛在踝关节骨折治疗中的价值[J].中国临床医生杂志,2020,48(7):840-843.
[2] 王萌,程勇杰,李龙云.踝关节骨折手术时机选择的临床研究[J].中华关节外科杂志(电子版),2013,7(2):254-256.
[3] 车彪,王凯,邹凯,等.影响踝关节骨折手术疗效的因素分析[J].中国临床研究,2014,27(7):782-784.
[4] 向旭.冰酥肿痛酊外用治疗老年Colles骨折早期肿痛的临床疗效观察[D].长沙:湖南中医药大学,2021.
[5] 赵玉沛.外科学[M].3版.北京:人民卫生出版社,2015:901.
[6] 郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:340.
[7] 郭锦丽,程宏,高朝娜.骨科专科护士实操手册[M].长春:吉林大学出版社,2018:358-359.
[8] 庞坚.膝骨关节炎疼痛强度评价方法[J].中医正骨,2018,30(11):36-38.
[9] 冯建,朱晗晓,李青,等.踝关节骨折的手术治疗[J].医学信息(上旬刊),2011,24(9):6128-6129.
[10] 裴代平.中药汤剂治疗肢体骨折肿胀的临床研究[J].现代中西医结合杂志,2011,20(1):33-34.
[11] 张密,金贵根.中药外敷治疗四肢骨折肿胀研究进展[J].实用中医药杂志,2021,37(3):516-518.
[12] 杨辉,张艳金.冰敷在四肢骨折早期应用的疗效观察[J].深圳中西医结合杂志,2015,25(1):127-128.
[13] 孙晓伟,刘健燕,邓银燕.冰袋冷敷时机选择在闭合性肘节骨折并软组织损伤患者的作用分析[J].黑龙江医药,2021,34(1):242-244.
[14] 王真,刘绍凡,郭欢,等.改良型冰袋用于足踝部闭合性骨折术前消肿临床观察[J].实用中医药杂志,2018,34(12):1528-1530.
[15] 高莹,张治然,鲁晶,等.跌打七厘片联合雪上花搽剂治疗急性软组织损伤的疗效观察[J].临床军医杂志,2013,41(8):845-846.
[16] 李永华.中药涂擦对四肢骨折早期肿胀病人的疗效观察[J].河南外科学杂志,2010,16(6):82-83.
[17] 张辉,冯国英,徐聪,等.自制“筋原散”治疗踝部骨折早期软组织肿胀40例疗效观察[J].世界中西医结合杂志,2013,8(z1):39-40.
[18] 符朝程.新伤湿敷液治疗踝关节骨折术前肿痛的疗效观察及对血清炎症因子的影响[D].长沙:湖南中医药大学,2020.
(收稿日期:2021-08-12 本文编辑:李晓乐)

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备注/Memo

备注/Memo:
基金项目:湖南省中医药科研计划项目(2019136) 通讯作者:周细江 E-mail:578121061@qq.com
更新日期/Last Update: 1900-01-01