芒硝外敷对黄体酮肌注所致局部炎症疗效观察

发布时间：2018-03-30 15:15

本文选题：黄体酮　切入点：硬结　出处：《河北医科大学》2016年硕士论文

【摘要】：目的:芒硝具有清热解毒、泻热软坚、散积消肿的作用,非常适用于热实积滞之证。外用贴敷可消炎去肿。黄体酮长期肌肉注射导致局部炎性反应,严重者可导致人工脂膜炎。本次实验选择接受黄体酮肌肉注射的患者为研究对象,比较芒硝外敷与硫酸镁湿敷对治疗黄体酮肌注所致局部不良反应的疗效观察,以期对临床护理做出指导。方法:1选择2015年3月-2015年12月到河北省中医院妇科门诊、病房的72例需要进行长期肌注黄体酮注射液的先兆流产患者,年龄22~40岁,要求符合先兆流产的诊断标准,肌注黄体酮注射液(40mg),每天1次,采用剂型20mg/ml,两侧臀部交替注射,直到妊娠4~8周后缓慢减量至最后停止用药。2分组:本次研究采用的是病例自身对照研究的方法。按照注射部位分为对照组和观察组:(1)对照组(右侧臀部、奇数次注射):Z型手法预冲少量空气肌肉注射黄体酮2小时后,将50%硫酸镁溶液浸透纱布外敷在注射部位,每日1次,每次持续2小时,湿敷期间,保持纱布湿润;(2)观察组(左侧臀部、双数次注射):Z型手法预冲少量空气肌注黄体酮2小时后,取装有芒硝碎屑的药袋一个,外敷于肌肉注射部位,并适当固定,同样每日1次,每次外敷2小时。3疗效判断指标:以每次肌肉注射前评估前一天辅助治疗情况并记录。(1)肌肉注射部位的不同程度炎性反应发生情况。(2)注射部位体表温度。(3)肌肉注射部位皮下硬结出现时间。(4)患者注射时的疼痛指数。(5)患者在药物外敷过程中舒适度指数。4统计学分析:数据处理采用SPSS13.0统计软件包,结果等级资料采用秩和检验,计量资料采用t检验,计数资料采用x2检验。结果:1两种外敷方法在辅助治疗黄体酮肌注所致局部炎症的治疗和预防方面有统计学意义(P0.01),芒硝外敷组治疗效果显著优于硫酸镁湿敷组。2两组患者肌肉注射部位体表温度有统计学意义(P0.01),芒硝外敷组治疗效果显著优于硫酸镁湿敷组。3两组患者肌肉注射部位皮下硬结出现时间有统计学意义(P0.01),芒硝外敷组治疗效果显著优于硫酸镁湿敷组。4在外敷治疗过程舒适度方面两组数据比较,芒硝外敷的使用效果与硫酸镁湿敷也占较大优势(P0.01),有统计学意义。外敷时不仅不会污染敷料,而且不太受体位的限制,大大提高病人的依从性。5两种外敷治疗方法对改善肌肉注射的疼痛程度方面无统计学意义。6在治疗过程中,两组患者均没有出现不良反应,该治疗安全可靠。结论:芒硝外敷对于预防和治疗由于黄体酮长期肌肉注射所致的局部炎症效果优于硫酸镁湿敷。芒硝外敷与硫酸镁湿敷相比较具有舒适度较高的优点,而且安全可靠。作为治疗和预防黄体酮所致局部炎症的辅助方法芒硝外敷具有值得推广的意义。对于肌肉注射时疼痛的观察有待于进一步研究。
[Abstract]:Objective: mirabilite has the function of clearing heat and detoxifying, reducing heat soft and strong, spreading heat and reducing swelling, which is very suitable for the syndrome of heat accumulation and stagnation. Topical application can reduce inflammation and remove swelling. Long term intramuscular injection of progesterone leads to local inflammatory reaction. Severe cases may lead to artificial panniculitis. In this experiment, patients receiving intramuscular injection of progesterone were selected as study subjects to compare the efficacy of topical application with magnesium sulfate in the treatment of local adverse reactions caused by intramuscular injection of progesterone. Methods from March 2015 to December 2015, 72 patients with threatened abortion, aged 22 to 40 years, who needed long-term intramuscular injection of progesterone, were selected to go to the gynecological clinic of Hebei Provincial Hospital of traditional Chinese Medicine. According to the diagnostic criteria of threatened abortion, 40 mg of progesterone injection was injected intramuscularly, once a day, with 20 mg / ml dosage form, alternately injected on both sides of the buttocks. After 4 weeks of gestation, the drug was gradually reduced to the final withdrawal of medication. 2 groups: this study was conducted using a case-control study. It was divided into two groups according to the injection site: the control group and the observation group: the control group (right buttocks), the right buttocks, the right buttocks. After 2 hours of intramuscular injection of progesterone, 50% magnesium sulfate solution was immersed in gauze at the injection site, once a day for 2 hours, during wet compress. The observation group (left buttocks, double times injection: Z type manipulation pre-flushing a small amount of air intramuscular injection of progesterone 2 hours later, take a medicine bag containing mirabilite crumbs, apply it to the intramuscular injection site and fix it properly, again once a day, Outcome measures of external application for 2 hours: the adjuvant therapy was evaluated one day before each intramuscular injection and the incidence of different degree of inflammatory reaction at the intramuscular injection site was recorded. 2) body surface temperature (SST) of the injection site. 3) intramuscular injection. The pain index at the time of injection. 5) the comfortableness index of the patients in the course of drug application was analyzed statistically: the data was processed by SPSS13.0 software package. Results Rank sum test was used for grade data and t test was used for measurement data. Results there was significant difference in the treatment and prevention of local inflammation caused by intramuscular injection of progesterone by using the two methods of external application. The curative effect of the application group of mirabilite was better than that of the wet compress group of magnesium sulfate (.2%) in the treatment and prevention of local inflammation caused by intramuscular injection of progesterone. There was significant difference in the body surface temperature of the two groups of patients with intramuscular injection site (P 0.01). The curative effect of the external application group was significantly better than that of the magnesium sulfate wet compress group. 3. There was significant difference in the time of subcutaneous hardening of the intramuscular injection site between the two groups. The therapeutic effect of the group was significantly better than that of the group of magnesium sulfate wet compress (group 4), and compared with the data of the two groups in terms of comfort in the course of external application. The application effect of external application of mirabilite and the wet application of magnesium sulfate also have a great advantage. There is statistical significance. Not only does it not pollute dressing, but also it is not restricted by body position. There was no significant difference between the two methods of external application in improving the pain degree of intramuscular injection. During the course of treatment, there were no adverse reactions in both groups. Conclusion: the effect of external application of glauberite on prevention and treatment of local inflammation caused by long-term intramuscular injection of progesterone is better than that of wet compress of magnesium sulfate. As an auxiliary method for the treatment and prevention of local inflammation induced by progesterone, it is worth popularizing the application of glauberite. The observation of pain during intramuscular injection needs further study.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R248.3

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