消肿止痛膏治疗股骨转子间骨折术后肿痛临床疗效观察

发布时间：2018-04-03 15:38

  本文选题：消肿止痛膏　切入点：股骨转子间骨折　出处：《广州中医药大学》2017年硕士论文

【摘要】：目的:研究消肿止痛膏对老年转子间骨折术后局部软组织疼痛、肿胀的影响,通过分析临床观察结果评价消肿止痛膏的临床疗效及安全性,为中医外治法在骨折术后肿痛的应用提供客观的临床依据。方法:选取2016年4月至2017年1月期间在广东省中医院骨二科行手术治疗的老年股骨转子间骨折患者为研究对象,将纳入研究的患者按照随机分配的方法分为治疗组(常规治疗+消肿止痛膏组)和对照组(常规治疗组)。治疗组在常规治疗的基础上于术后第1天给予消肿止痛膏外敷,对照组仅常规治疗而不给予任何药物外敷,疗程1周。观察并记录治疗前及治疗后7天的肢体周径差,疼痛评分,疼痛、肿胀及瘀斑程度;检测并记录治疗前后的白细胞计数及hs-CRP水平,并观察有无药物不良反应,然后进行数据分析并评价消肿止痛膏对老年转子间骨折术后肿痛的临床疗效。结果:本研究共纳入60例老年转子间骨折患者(治疗组30例,对照组30例),其中男性患者18例(治疗组8例,对照组10例),女性患者42例(治疗组22例,对照组20例),平均年龄为83.97 ± 5.09,最小年龄为68岁,最大年龄为94岁。通过统计对比两组患者年龄、性别比例、骨折部位、AO分型、手术耗时、麻醉方法等基本资料,两组基线均衡(P0.05)。经组间比较独立样本t检验,组内比较配对样本t检验统计分析,治疗前两组患者VAS评分及周径差组间比较无明显差异(P0.05);治疗后7天,治疗前后的VAS评分差值及周径差差值均有明显差异(P0.05);组内比较两组患者VAS评分及周径差在治疗前后均有显著差异(P0.05)。经秩和检验统计分析,两组患者疼痛程度、肿胀及瘀斑程度方面在治疗前无明显差异(P0.05),而在治疗后7天均有显著差异(P0.05)。对于炎症指标的监测情况,经t检验对比分析,治疗前及治疗后7天两组组内差异均有统计学意义(P0.05),而组间对比WBC与CRP水平在治疗前后均无统计学意义(P0.05)。全部治疗组患者均没有出现红疹、皮肤疹痒等过敏反应。结论:消肿止痛膏在老年转子间骨折术后的消肿镇痛方面有着良好的疗效,可显著改善局部软组织的肿痛程度,且无不良反应,充分发挥了中医药在骨折术后康复治疗中的优势,值得在临床上大力推广。
[Abstract]:Objective: to study the effect of Xiaozhongzhitong ointment on local soft tissue pain and swelling after intertrochanteric fracture in elderly patients, and to evaluate the clinical efficacy and safety of Xiaozhongzhitong ointment by analyzing the clinical observation results.To provide objective clinical basis for external therapy of traditional Chinese medicine in the application of swelling and pain after fracture.Methods: elderly patients with intertrochanteric fracture of femur were selected from April 2016 to January 2017, who were operated in the second Department of Bone of Guangdong Provincial Hospital of traditional Chinese Medicine.Patients included in the study were randomly divided into treatment group (routine treatment group) and control group (routine treatment group).Treatment group on the basis of routine treatment on the first day after the treatment of detumescence analgesic ointment external application, the control group only routine treatment without any drug external application, the course of one week.The peripheral diameter difference, pain score, pain, swelling and ecchymosis were observed and recorded before and after treatment, the white blood cell count and hs-CRP level before and after treatment were measured and recorded, and any adverse drug reactions were observed.Then the data were analyzed and the clinical effect of Xiaozhong Zhitong ointment on postoperative swelling and pain of senile intertrochanteric fracture was evaluated.Results: a total of 60 elderly patients with intertrochanteric fracture (30 cases in the treatment group, 30 cases in the control group, 18 cases in the male group (8 cases in the treatment group, 10 cases in the control group and 42 cases in the female group) were included in this study.In the control group, the average age was 83.97 卤5.09, the minimum age was 68 years, and the maximum age was 94 years.The basic data of age, sex ratio, AO classification of fracture site, operation time and anesthesia method were compared statistically. The baseline balance between the two groups was P0.05.There was no significant difference in VAS score and circumference difference between the two groups before treatment, and there was no significant difference between the two groups after 7 days of treatment.There were significant differences in VAS score and circumference difference between the two groups before and after treatment (P 0.05), and there were significant differences between the two groups in VAS score and circumference difference before and after treatment (P 0.05).The statistical analysis of rank sum test showed that there was no significant difference in pain degree, swelling and ecchymosis between the two groups before treatment, but there was significant difference on the 7th day after treatment.The results of t test showed that there were significant differences between the two groups before treatment and 7 days after treatment, but there was no significant difference between the two groups in the levels of WBC and CRP before and after treatment.All the patients in the treatment group had no allergic reactions such as rash, skin rash and itching.Conclusion: Xiaozhongzhitong ointment has a good effect on relieving swelling and analgesia after operation of intertrochanteric fracture in the elderly, and can significantly improve the degree of swelling and pain of local soft tissue without adverse reactions.The advantages of traditional Chinese medicine in rehabilitation treatment of fracture after operation are fully brought into play, and it is worth popularizing in clinic.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9
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本文编号：1705833