• 三黄消肿汤不同贴敷方案在 Schatzker Ⅳ ~ Ⅵ型胫骨平台骨折患者中的应用效果对比
  • Comparison of Clinical Efficacy of Different Application Schemes of Sanhuang Xiaozhong Decoction in Patients with Schatzker Ⅳ-Ⅵ Tibial Plateau Fracture
  • 张 蕊,龚秋菊,杨 菲,陈 璐,杨 楠,郭 洁,唐小娟.三黄消肿汤不同贴敷方案在 Schatzker Ⅳ ~ Ⅵ型胫骨平台骨折患者中的应用效果对比[J].中国烧伤创疡杂志,2024,(5):386~390.
    DOI:
    中文关键词:  三黄消肿汤  贴敷  Schatzker分型  胫骨平台骨折  肿胀  疼痛
    英文关键词:Sanhuang Xiaozhong Decoction  Application  Schatzker classification  Tibial plateau fracture  Swelling  Pain
    基金项目:南阳市骨科医院 2023 年科研 “苗圃计划” (2023016)
    作者单位
    张 蕊 473000 河南 南阳南阳市中医院独山院区(南阳市骨科医院)创伤科 
    龚秋菊  
    杨 菲  
    陈 璐  
    杨 楠  
    郭 洁  
    唐小娟  
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    中文摘要:
          【摘要】 目的 对比分析三黄消肿汤不同贴敷方案在 Schatzker Ⅳ~ Ⅵ型胫骨平台骨折患者中的应用效果。方法 选取 2022 年 1 月至 2023 年 6 月南阳市中医院独山院区收治的 90 例 Schatzker Ⅳ~Ⅵ型胫骨平台骨折患者作为研究对象, 按照随机数表法将其随机分为试验 1 组 (30例)、 试验2组 (30例) 与对照组 (30例), 试验 1 组患者患肢骨折处采用冰袋冰敷联合三黄消肿汤贴敷序贯间断处理, 试验 2 组患者患肢骨折处采用冰袋联合三黄消肿汤持续冰敷、 湿敷处理, 对照组患者患肢骨折处采用冰袋冰敷联合红花酒涂抹按摩序贯间断处理, 对比观察 3组患者患肢肿胀评分、 肿胀率、 疼痛程度及消肿时间。结果 干预 5、 7 d 时, 试验 2 组患者患肢肿胀评分及肿胀率均明显低于试验 1 组与对照组 (干预 5 d 时肿胀评分: q = 3.418、 5.402, P= 0.046、 0.001; 干预 7 d 时肿胀评分: q = 3.912、 5.924, P= 0.019、 P<0.001; 干预 5 d 时肿胀率: q = 3.768、 8.164, P = 0.025、 P<0.001; 干预7 d 时肿胀率: q = 4.291、7.931, P= 0.009、P< 0.001), 且试验 1 组患者患肢肿胀率均明显低于对照组 ( q =4.396、3.640, P= 0.007、0.031); 干预 3、5、 7 d 时, 试验2组患者患肢视觉模拟评分法 (VAS)评分均明显低于试验 1 组与对照组 (干预 3 d 时: q = 5.293、9.490, P = 0.001、 P<0.001; 干预 5 d 时: q = 3.804、 7.886,P= 0.023、 P<0.001; 干预 7 d 时: q = 4.510、10.090, P = 0.006、P< 0.001), 且试验 1 组均明显低于对照组(q = 4.198、4.082、5.584, P= 0.011、0.014、 0.001); 试验 2 组患者患肢消肿时间明显短于试验1组与对照组(q = 6.028、11.540, P 均<0.001), 且试验 1 组明显短于对照组 (q = 5.507, P= 0.001)。结论 冰袋联合三黄消肿汤持续冰敷、湿敷更能明显缓解 Schatzker Ⅳ~Ⅵ型胫骨平台骨折患者骨折部位疼痛, 促进局部肿胀消退, 缩短肿胀时间。
    英文摘要:
          【Abstract】 Objective To compare the clinical efficacy of different application schemes of Sanhuang XiaozhongDecoction in patients with Schatzker Ⅳ-Ⅵ tibial plateau fracture. Methods 90 patients with Schatzker Ⅳ-Ⅵ tibial plateau fractures, admitted to Dushan Branch of Nanyang Traditional Chinese Medicine Hospital from January 2022 to June 2023, were enrolled as research subjects and divided, using the random number table, into the experiment group 1 ( n = 30), the experiment group 2 (n = 30) and the control group (n = 30). The fracture sites of affected limbs of patients in the experiment group 1 were given the sequential and intermittent application of cold compress with ice pack and Sanhuang Xiaozhong Decoction. The fracture sites of affected limbs of patients in the experiment group 2 were given continuous cold and wet compress with ice pack and Sanhuang Xiaozhong Decoction. The fracture sites of affected limbs of patients in the control group were given the sequential and intermittent application of cold compress with ice pack and safflower alcohol smear massage. The swelling scores, swelling rates, pain degree, and swelling subsiding time of affected limbs were compared among the three groups. Results On day 5 and 7 of interventions, the swelling score and swelling rate of affected limbs of patients in the experiment group 2 were significantly lower respectively compared with the experiment group 1 and the control group (swelling scores on day 5 of intervention: q = 3.418 and 5.402, P= 0.046 and 0.001; swelling scores on day 7 of intervention: q = 3.912 and 5.924, P = 0.019, P<0.001; swelling rate on day 5 of intervention: q = 3.768 and 8.164, P= 0.025, P<0.001; swelling rate on day 7 of intervention: q = 4.291 and 7.931, P= 0.009, P<0.001), and the swelling rate of affected limbs of patients was significantly lower in the experiment group 1 compared with the control group (q = 4.396 and 3.640, P= 0.007 and 0.031). Respectively on day 3, 5 and 7 of interventions, the visual analogue scale (VAS) score of patients in the experiment group 2 were significantly lower than those in the experiment group 1 and the control group (day 3 of intervention: q = 5.293 and 9.490, P = 0.001, P<0.001; day 5 of intervention: q = 3.804 and 7.886, P= 0.023, P<0.001; day 7 of intervention: q = 4.510 and 10.090, P= 0.006, P<0.001), and the VAS scores of patients in the experiment group 1 were significantly lower than those in the control group ( q = 4.198, 4.082 and 5.584, P= 0.011, 0.014 and 0.001). The swelling subsiding time was significantly shorter in the experiment group 2 respectively compared with the experiment group 1 and the control group ( q = 6.028 and 11.540, both P<0.001), and the swelling subsiding time in the experiment group 1 was significantly shorter than that in the control group ( q = 5.507, P = 0.001). Conclusion Continuous cold and wet compress with ice pack and Sanhuang Xiaozhong Decoction can effectively alleviate the pain at fracture sites of affected limbs of patients with Schatzker Ⅳ-Ⅵ tibial plateau fracture, promote the subsidence of local swelling, and shorten the swelling duration.