肢体关节中药熏蒸与中药熏洗治疗的实验研究与临床疗效比较

摘要

[目的]比较在肢体关节实施中药熏蒸与熏洗治疗的安全性与临床疗效。[方法]熏洗按照中医护理操作程序完成，熏蒸使用自行研制的骨伤科床边多功能肢体关节中药汽疗仪进行。首先模拟肘关节熏蒸与熏洗(医用人形塑胶模特)，测量治疗温度、时间及中药蒸汽产生量。然后选取外伤骨折固定治疗后引发的肘关节僵硬32例病人，分熏蒸组与熏洗组，两组病人均进行患肘持续被动活动(CPM)与功能锻炼，比较治疗前后肘关节主动屈伸活动度(ROM)及治疗后 Mayo 肘关节功能评分(MEPS)，并评价疗效。[结果]实验研究显示：应用中药熏洗时肘关节下侧测温40 min超过44℃(皮肤安全阈值)，易致低温烫伤；临床观察显示：熏蒸组病人肘关节主动屈伸活动度改善、MEPS评分与疗效均优于熏洗组。[结论]实验及临床观察均显示使用自行研制的骨伤科床边多功能肢体关节中药汽疗仪进行中药熏蒸治疗更安全，疗效更佳。%Objective:To compare the safety and clinical efficacy of traditional Chinese medicine (TCM)fumiga-tion and TCM fumigation and washing in the treatment of limb and j oints.Methods:TCM fumigation and wash-ing was carried out according to TCM nursing procedure.TCM fumigation was carried out by self developed bedside multi functional limb and joints TCM steam therapy instrument.With simulated elbow fumigation and fumigation and washing on the medical humanoid plastic model,the treatment temperature,period and TCM steam production were measured.A total of 32 elbow stiffness patients were selected and divided into TCM fu-migation group and TCM fumigation and washing group,with a treatment of continuous passive motion (CPM) and functional exercise.The treatment effects were evaluated by comparing the positive range of motion (ROM) and Mayo elbow performance score (MEPS)between the two groups before and after treatment.Results:After 40 mins treatment of TCM fumigation and washing,the temperature of the lower elbow joint was over 44 ℃(the skin safety threshold)which could easily cause low temperature scald.The clinical observation showed that the improvement of positive ROM,MEPS score,and effect of TCM fumigation group were better than TCM fu-migation and washing group.Conclusions:Both experiments and clinical observation showed that the TCM fumi-gation treatment is more safe and effective with self developed beaside multi functional limb and joints TCM steam therapy instrument.