消肿止痛方外敷用于全髋关节置换术后肢体肿胀的活血通络效果研究

摘要

Objective To explore the effect of external application of Xiaozhong Zhitong decoction on limb swelling after total hip arthroplasty. Methods 86 patients with limb swelling after total hip arthroplasty were randomly divided into observation group and control group (n=43). The rats in the control group were treated with magnesium sulfate topical, and the observation group was treated with Xiaozhong Zhitong decoction. TCM syndrome integral (main symptoms: skin ecchymosis, rubefaction, swelling; minor symptoms: local erythema, local pyrexia) before and after treatment were analyzed according to TCM syndrome scoring criteria. The hemarheology level of venous blood was determined, swelling degree and pain score were evaluated, and the adverse reaction was observed. Results After treatment, TCM syndrome score of the two groups decreased, the skin stasis, redness and swelling of the skin were lower than the control group, and the difference was statistically significant (P<0.05). After treatment, the total blood viscosity of the observation group was significantly lower than that in the control group, with a significant difference between the groups (P<0.05). After treatment, the swelling height and pain score were lower than the control group, and the comparison between the two groups was statistically significant (P<0.05). The incidence of adverse reactions was 2.33％ in the observation group, and 4.65％ in the control group, which were not statistically significant(P>0.05). Conclusion Xiaozhong Zhitong decoction shows obvious effect in treatment of patients with limb swelling after total hip arthroplasty, compared with the conventional Western medicine. The hemorheology, swelling degree, and pain score of patients are improved. No serious side effects were observed, it is worth popularizing in clinic.%目的 探讨消肿止痛方外敷在全髋关节置换术后肢体肿胀中的活血通络效果.方法 纳入我院收治的全髋关节置换术后肢体肿胀患者86例,随机将其分成观察组、对照组各43例.对照组予以硫酸镁外敷治疗,观察组采用消肿止痛方外敷治疗.根据中医证候评分标准分析治疗前、后的中医证候(主证:皮肤瘀斑、皮肤发红、肿胀;次证:局部红疹、局部发热)积分,并于治疗前、后采集空腹静脉血,测定血液流变学(全血黏度高切、中切、低切及血浆黏度)水平,评估肿胀程度与疼痛评分,观察用药后不良反应发生情况.结果 治疗后两组中医证候积分均下降,观察组治疗后的皮肤瘀斑、皮肤发红、肿胀积分低于对照组,差异有统计学意义(P<0.05);经治疗后,两组血液流变学水平均下降,且观察组的全血黏度高切、中切、低切水平较对照组明显降低,差异有统计学意义(P<0.05);治疗后两组肢体肿胀程度、疼痛评分均低于治疗前,且观察组治疗后的肿胀程度、疼痛评分均小于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为2.33％,与对照组的4.65％比较差异无统计学意义(P>0.05).结论 与常规西药治疗相比,全髋关节置换术后肢体肿胀患者采用消肿止痛方治疗的血液流变学、肿胀程度、疼痛评分改善更显著,且未见严重不良反应,值得临床推广.