加味桃红四物汤治疗上颈椎骨折术后早期颈部疼痛的临床研究

发布时间：2018-09-09 13:09

【摘要】：目的：观察加味桃红四物汤治疗上颈椎骨折术后早期颈部疼痛的临床疗效。方法：选取2014年11月至2015年12月发生上颈椎骨折就诊于南京军区福州总医院的病例43例(其中3例脱落),随机分成2组：试验组(口服中药,n=22)和对照组(空白对照,n=21)。试验组自术后2d起在上颈椎骨折术后常规治疗基础上,开始口服中药加味桃红四物汤,7天为1疗程,共2个疗程；对照组不服用加味桃红四物汤,其余术后治疗同试验组,分别于术后2d、术后9d、术后16d后对两组患者进行疼痛VAS评分；检测血沉及C-反应蛋白水平指标；采用日常生活能力量表(Modified Barthel Index, MBI)评估患者术后日常生活能力。所有数据在SPSS17.0统计软件下分析。结果：1.一般资料比较：两组患者在年龄、性别、上颈椎骨折程度及骨折损伤节段、术后镇痛药物(包括镇痛泵、口服止痛药物等)使用情况比较无显著性差异(P0.05),具有可比性。2.疼痛评分(VAS)比较：术后2d,两组患者比较无显著性差异(P0.05)。术后9d,试验组改善水平好于对照组(P0.05)；术后16d,试验组较对照组疼痛改善更为明显(P0.05)。3.血沉和C-反应蛋白指标比较：术后2d,两组患者血沉及C-反应蛋白指标比较,均无明显统计学差异(P0.05)。术后9d,两组C-反应蛋白和血沉指标比较有显著统计学差异(P0.05)；术后16d,两组C-反应蛋白和血沉指标有明显差异(P0.05)。4.日常生活能力(MBI)评分比较：术后2d,两组患者日常生活能力评分无显著差异(P0.05)。治疗9d后,试验组日常生活能力优于对照组,有显著统计学差异(P0.05)。术后16d与对照组比较,试验组日常生活能力提高更明显,有显著性差异(P0.05)。5.疼痛疗效评价：术后2d,两组患者疼痛疗效比较,无显著性统计学差异(P0.05)；术后9d,试验组疼痛疗效好于对照组,有显著性差异(P0.05)；术后16d,试验组疗效优于对照组(P0.05)。结论：加味桃红四物汤能够缓解上颈椎骨折患者术后早期颈部疼痛,对炎症有一定抑制作用,更有利于患者早期功能锻炼,尽早康复,值得临床推广应用。
[Abstract]:Objective: to observe the clinical effect of Jiawei Taohong Siwu decoction on early neck pain after upper cervical vertebra fracture. Methods: from November 2014 to December 2015, 43 cases of upper cervical vertebra fracture occurred in Fuzhou General Hospital of Nanjing military region were selected and randomly divided into two groups: the experimental group (treated with oral Chinese medicine Pian 22) and the control group (control group). On the basis of routine treatment of upper cervical vertebra fracture from 2 days after operation, the experimental group began to take orally modified Taohong Siwu decoction for 7 days as a course of treatment, and the control group did not take Jiawei Taohong Siwu decoction. Pain VAS scores were measured at 2 days, 9 days after operation and 16 days after operation. ESR and C-reactive protein levels were measured. ADL was evaluated by ADL (Modified Barthel Index, MBI). All the data are analyzed under the SPSS17.0 statistical software. The result is 1: 1. Comparison of general data: there was no significant difference between the two groups in age, sex, degree of fracture of upper cervical vertebrae, fracture injury level, postoperative analgesic drugs (including analgesic pump, oral analgesic drugs, etc.) (P0.05). Pain score (VAS) comparison: 2 days after operation, there was no significant difference between the two groups (P0.05). On the 9th day after operation, the level of improvement in the trial group was better than that in the control group (P0.05), and the pain in the experimental group was better than that in the control group on the 16th day after operation (P0.05). 3. ESR and C- reactive protein index comparison: 2 days after operation, there was no significant difference in ESR and C- reactive protein between the two groups (P0.05). After 9 days, the two groups of C- reactive protein and erythrocyte sedimentation rate were significantly different (P0.05), 16 days after surgery, the two groups of C- reactive protein and ESR were significantly different (P0.05). 4. Comparison of (MBI) score of ADL: there was no significant difference in ADL score between the two groups 2 days after operation (P0.05). After 9 days of treatment, the ADL of the experimental group was better than that of the control group (P0.05). After 16 days compared with the control group, the test group increased the ability of daily living more significantly, there was significant difference (P0.05) .5. Pain efficacy evaluation: 2 days after surgery, there was no significant difference between the two groups of pain efficacy (P0.05); 9 days after surgery, the trial group was better than the control group, there was significant difference (P0.05); 16 days after surgery, the experimental group was better than the control group (P0.05). Conclusion: Jiawei Taohong Siwu decoction can relieve early neck pain in patients with upper cervical vertebrae fracture and inhibit inflammation. It is also beneficial to early functional exercise and early recovery of patients. It is worth popularizing and applying in clinic.
【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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