补中益气汤促进跟骨骨折术后切口愈合的临床研究

发布时间：2018-04-30 17:13

本文选题：补中益气汤 + 跟骨骨折　；参考：《福建中医药大学》2016年硕士论文

【摘要】：目的：通过观察补中益气汤对跟骨骨折术后手术切口愈合的影响,评价其临床疗效,以期寻求一种应用中医药促进跟骨切口愈合的新方案。方法：自2014年6月至2015年6月,依据纳入标准、排除标准收集86例患者作为研究对象,按照入院时间顺序进行编号,采用随机数字表分为对照组和试验组。对照组44例,2例患者入组后发现合并糖尿病故予剔除,1例失访。试验组42例,1例因无法接受中药口感,要求退出试验。最终共有82例患者获得随访,对照组41例46足,试验组41例47足。术前对患者的性别、年龄、Sanders分型、皮肤损伤AO分型、受伤至手术时间进行记录。所有患者均行石膏托固定5～12天,并予抬高患肢促进肿胀消退,出现皮肤“褶皱征”后,采用跟骨外侧“L”形切口进行切开复位钢板内固定手术。对照组术后予常规抗炎、换药治疗加服用安慰剂,试验组术后予常规抗炎、换药治疗加服补中益气汤。记录两组患者的手术时间、术中出血量、切口干燥时间、切口愈合时间、切口健康等级、切口并发症分级以及术后8个月Maryland足部功能评分等指标,并应用统计学软件对采集的数据进行统计学分析。结果：两组患者的性别、年龄、Sanders分型、皮肤损伤AO分型、受伤至手术时间等术前资料行均衡性检验,差异均无统计学意义(P0.05),两组病例比较具有可比性。两组患者的手术时间、术中出血量、术后8个月患足Maryland功能评分差异无统计学意义(P0.05)。对照组的切口干燥时间平均为(6.57±1.54)天,试验组平均为(4.94±1.40)天,差异有统计学意义(P0.05)。对照组的切口愈合时间平均为(17.83±3.60)天,试验组平均(15.70±2.54)天,差异有统计学意义(P0.05)。切口健康等级优良率对照组为63.0%,试验组为85.1%,差异有统计学意义(P0.05)。切口并发症发生率对照组为17.4%,试验组为4.3%。结论：跟骨骨折术后患者口服补中益气汤可有效促进切口愈合,减少术后切口并发症发生率。
[Abstract]:Objective: to observe the effect of Buzhong Yiqi decoction (BYQD) on the healing of calcaneal incision after operation, and to evaluate its clinical effect in order to seek a new scheme of applying Chinese medicine to promote the healing of calcaneal incision. Methods: from June 2014 to June 2015, 86 patients were divided into control group and experimental group by random digital table according to inclusion criteria and exclusion criteria. In the control group, 44 patients with diabetes were found to be complicated with diabetes and 1 case was excluded. 42 cases in the trial group, 1 case was unable to accept the taste of traditional Chinese medicine, asked to withdraw from the test. A total of 82 patients were followed up. The control group (41 cases, 46 feet) and the experimental group (41 cases, 47 feet) were followed up. Preoperative gender, age and Sanders classification, AO classification of skin injury, injury to surgery time were recorded. All the patients were treated with plaster fixation for 5 to 12 days. The patients were treated with open reduction and internal fixation with the L shape incision of the lateral calcaneus after the swelling of the affected limb was promoted and the skin "fold sign" appeared. The control group was treated with routine anti-inflammatory therapy, the control group was treated with routine anti-inflammatory therapy, the experimental group was given routine anti-inflammatory therapy, and the treatment group was treated with Buzhong Yiqi decoction. The operative time, intraoperative bleeding volume, incision dry time, incision healing time, incision health grade, incision complication grade and Maryland foot function score at 8 months after operation were recorded. Statistical software is used to analyze the collected data. Results: there was no significant difference between the two groups in sex, age Sanders classification, AO classification of skin injury, time between injury and operation, etc. There was no significant difference between the two groups (P 0.05), and the comparison between the two groups was comparable. There was no significant difference between the two groups in the time of operation, the amount of intraoperative bleeding and the score of Maryland function at 8 months after operation (P 0.05). The average incision drying time was 6.57 卤1.54 days in the control group and 4.94 卤1.40 days in the experimental group. The difference was statistically significant (P 0.05). The average healing time of incision was 17.83 卤3.60 days in the control group and 15.70 卤2.54 days in the experimental group. The difference was statistically significant (P 0.05). The excellent and good rate of incision health grade was 63.0 in the control group and 85.1 in the experimental group. The difference was statistically significant (P 0.05). The incidence of incision complications was 17.4 in the control group and 4.3 in the experimental group. Conclusion: oral Buzhong Yiqi decoction can effectively promote wound healing and reduce the incidence of postoperative incision complications in patients with calcaneal fracture.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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