加味桃红四物汤降低骨折伤肢骨筋膜室内压的临床研究

摘要

Objective To observe the effect of Modified Too Hong Siwu Decoction (MTHSD) in decreasing osteofascial intra-compartment pressure of injured extremity induced by bone fracture, and to supply an effective method for the prevention and treatment of osteofascial compartment syndrome. Methods Seventy patients confirmed as fracture of tibiofibula and fracture of radioulna were randomized into treatment group (N = 38 ) and control group ( N = 32 ). In the two groups, patients with fracture of tibiofibula were given calcaneal traction and splint fixation, and patients with fracture of radioulna were given manipulative reduction and splint fixation. The patients in the treatment group were given MTHSD additionally. After splint fixation, the osteofascial intra-compartment pressure of injured extremity was detected, and then the data were processed and analyzed. Results The osteofascial intra-compartment pressure of injured forearm was similar to that of the injured shank in the treatment group: the pressure on the first and second day of treatment differed from that before treatment ( P < 0. 05) , and then decreased to the level before treatment on the fourth day. From the first day to the fourth day of treatment, the osteofascial intra-compartment pressure differed from that before treatment ( P < 0. 05 ) in the control group, and the difference of the pressure between the two groups was also significant ( P < 0. 05). Conclusion Modified Too Hong Siwu Decoction shows preventive and therapeutic effect for osteofascial compartment syndrome by decreasing osteofascial intra-compartment pressure of injured extremity induced by bone fracture.%[目的]探讨加味桃红四物汤对骨折伤肢骨筋膜室内压的作用,为临床防治骨筋膜室综合征提供有效疗法.[方法]临床确诊为胫腓骨骨折和桡尺骨骨折患者共70例,随机分为治疗组38例和对照组32例,2组患者胫腓骨骨折均采用跟骨骨牵引、夹板固定,桡尺骨骨折均采用手法复位、夹板固定,治疗组加服加味桃红四物汤,夹板固定后开始检测伤侧相关骨筋膜室内压,对2组数据进行比较分析.[结果]2组治疗前前臂和小腿骨筋膜室内压情况基本一致.治疗第1、2天,治疗组前臂、小腿的筋膜室内压较治疗前上升,差异有显著性意义(P＜0.05),治疗第4天,筋膜室内压均下降到治疗前水平(P＞0.05);对照组治疗后第1、2、3、4天的小腿、前臂筋膜室内压均较治疗前上升,差异均有显著性意义(P＜0.05).2组间比较,治疗组第1、2、3、4天的小腿、前臂筋膜室内压均低于同期对照组,差异均有显著性意义(P＜0.05).[结论]加味桃红四物汤能降低骨折伤肢骨筋膜室内压,对骨筋膜室综合征有一定防治作用.