首页|改良桃红四物汤辅助治疗对创伤性四肢骨折术后患肢末梢循环及血栓素B2、前列腺素I2水平的影响

改良桃红四物汤辅助治疗对创伤性四肢骨折术后患肢末梢循环及血栓素B2、前列腺素I2水平的影响

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目的 评价改良桃红四物汤辅助治疗对创伤性四肢骨折患者术后患肢末梢循环及血栓素B2(TXB2)、前列腺素I2(PGI2)水平的影响.方法 随机对照试验研究.选择2020年2月-2023年2月本院70例行切开复位内固定术的创伤性四肢骨折患者作为观察对象,按住院顺序分对照组34例、观察组36例.对照组行常规治疗,观察组在对照组基础上予改良桃红四物汤辅助治疗.2组均治疗2周.分别于治疗前后进行中医证候评分;采用多普勒血流探测仪测量踝肱指数(ABI),彩色多普勒超声仪检测血管内径、血流量及患肢深静脉;采用ELISA法检测TXB2、PGI2水平,评价临床疗效.结果 观察组总有效率为91.67%(33/36)、对照组为73.53%(25/34),2组比较差异有统计学意义(x2=4.05,P=0.044).观察组治疗后气血凝滞[(2.13±0.43)分比(3.61±0.96)分,t=5.85]、筋骨损伤[(1.62±0.41)分比(2.74±0.58)分,t=9.37]、肿胀瘀斑[(1.15±0.31)分比(2.28±0.52)分,t=11.12]、肝肾不足[(1.52±0.24)分比(2.15±0.36)分,t=8.66]积分低于对照组(P<0.001);观察组治疗后 ABI[(0.83±0.03)比(0.74±0.02),t=14.68]、血管内径[(0.48±0.13)mm 比(0.42±0.11)mm,t=2.08]、血流速度[(60.24±15.46)cm/s 比(52.15±12.11)cm/s,t=2.41]高于对照组(P<0.01 或P<0.05).观察组治疗后血清TXB2水平[(140.76±16.64)ng/L 比(168.39±25.28)ng/L,t=5.37]及 TXB2/PGI2 比值[(6.67±1.24)比(9.33±1.69),t=7.54]低于对照组(P<0.01);PGI2水平[(21.27±2.24)ng/L 比(18.71±1.79)ng/L,t=5.26]高于对照组(P<0.01).观察组治疗后深静脉血栓发生率为19.44%(7/36)、对照组为44.12%(15/34),2组比较差异有统计学意义(x2=4.94,P=0.026).结论 改良桃红四物汤辅助治疗可提高创伤性四肢骨折患者切开复位内固定术后临床疗效、减轻临床症状、改善患肢末梢循环状态、减轻术后高凝状态并预防深静脉血栓形成.
Effects of modified Taohong Siwu Decoction on postoperative affected limb peripheral circulation and serum levels of TXB2 and PGI2 in patients with traumatic limb fractures
Objective To observe the effects of modified Taohong Siwu Decoction on peripheral circulation status of affected limbs and serum thromboxane B2(TXB2)and prostacyclin(PGI2)levels in patients with traumatic limb fractures after open reduction and internal fixation.Methods Randomized controlled trial study was conducted.70 patients with traumatic limb fractures who underwent open reduction and internal fixation in the hospital from February 2020 to February 2023 were set as observation subjects and divided into control group(34 cases)and observation group(36 cases)according to the order of hospitalization.The control group was given conventional method for treatment,and the observation group was given modified Taohong Siwu Decoction adjuvant therapy on the basis of the control group.The treatment for both groups lasted for 2 weeks.TCM symptoms scores were evaluated before and after treatment.Ankle brachial index(ABI)was detected using a Doppler blood flow detector.Color Doppler ultrasound was used to detect the inner diameter,blood flow,and deep veins of the affected limb;serum levels of TXB2 and PGI2 were detected by ELISA.Results After treatment,the total effective rate of clinical efficacy was 91.67%(33/36)in observation group and 73.53%(25/34)in control group,with statistical significance(P<0.05).After treatment,the observation group had lower scores for qi and blood stasis(2.13±0.43 vs.3.61±0.96,t=5.85),tendon and bone injury(1.62±0.41 vs.2.74±0.58,t=9.37),swelling and ecchymosis(1.15±0.31 vs.2.28±0.52,t=1.12),and liver and kidney deficiency(1.52±0.24 vs.2.15±0.36,t=8.66)compared to the control group(P<0.001);after treatment,the ABI(0.83±0.03 vs.0.74±0.02,t=14.68),vascular diameter[(0.48±0.13)mm vs.(0.42±0.11)mm,t=2.08],and blood flow velocity[(60.24±15.46)cm/s vs.(52.15±12.11)cm/s,t=2.41]in the observation group were higher than those in the control group(P<0.01 or P<0.05).After treatment,the serum TXB2 levels[(140.76±16.64)ng/L vs.(168.39±25.28)ng/L,t=5.37]and TXB2/PGI2(6.67±1.24 vs.9.33±1.69,t=7.54)in the observation group were lower than those in the control group(P<0.01);the level of PGI2[(21.27±2.24)ng/L vs.(18.71±1.79)ng/L,t=5.26]was higher in the control group(P<0.01).The incidence of deep vein thrombosis after treatment in the observation group was 19.44%(7/36),while in the control group it was 44.12%(15/34),with statistical significance(x2=4.94,P=0.026).Conclusion Modified Taohong Siwu Decoction adjuvant therapy can enhance the clinical efficacy of patients with traumatic limb fractures after open reduction and internal fixation,relieve the TCM symptoms,improve the peripheral circulation status of affected limbs,reduce the postoperative hypercoagulability and prevent the deep venous thrombosis formation.

Fractures,boneTao Hong Si Wu TangPeripheral circulationThromboxane B2Prostaglandin I2

白志林、周熙、撒忠秋

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昆山市中西医结合医院骨科,昆山 215300

骨折 桃红四物汤 末梢循环 血栓素B2 前列腺素I2

昆山市科技局科技计划项目

KSZ2117

2024

国际中医中药杂志
中华医学会,中国中医科学院中医药信息研究所

国际中医中药杂志

CSTPCD
影响因子:0.411
ISSN:1673-4246
年,卷(期):2024.46(8)
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