本文選題：消腫止痛膏　切入點：股骨轉(zhuǎn)子間骨折　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:研究消腫止痛膏對老年轉(zhuǎn)子間骨折術(shù)后局部軟組織疼痛、腫脹的影響,通過分析臨床觀察結(jié)果評價消腫止痛膏的臨床療效及安全性,為中醫(yī)外治法在骨折術(shù)后腫痛的應(yīng)用提供客觀的臨床依據(jù)。方法:選取2016年4月至2017年1月期間在廣東省中醫(yī)院骨二科行手術(shù)治療的老年股骨轉(zhuǎn)子間骨折患者為研究對象,將納入研究的患者按照隨機分配的方法分為治療組(常規(guī)治療+消腫止痛膏組)和對照組(常規(guī)治療組)。治療組在常規(guī)治療的基礎(chǔ)上于術(shù)后第1天給予消腫止痛膏外敷,對照組僅常規(guī)治療而不給予任何藥物外敷,療程1周。觀察并記錄治療前及治療后7天的肢體周徑差,疼痛評分,疼痛、腫脹及瘀斑程度;檢測并記錄治療前后的白細胞計數(shù)及hs-CRP水平,并觀察有無藥物不良反應(yīng),然后進行數(shù)據(jù)分析并評價消腫止痛膏對老年轉(zhuǎn)子間骨折術(shù)后腫痛的臨床療效。結(jié)果:本研究共納入60例老年轉(zhuǎn)子間骨折患者(治療組30例,對照組30例),其中男性患者18例(治療組8例,對照組10例),女性患者42例(治療組22例,對照組20例),平均年齡為83.97 ± 5.09,最小年齡為68歲,最大年齡為94歲。通過統(tǒng)計對比兩組患者年齡、性別比例、骨折部位、AO分型、手術(shù)耗時、麻醉方法等基本資料,兩組基線均衡(P0.05)。經(jīng)組間比較獨立樣本t檢驗,組內(nèi)比較配對樣本t檢驗統(tǒng)計分析,治療前兩組患者VAS評分及周徑差組間比較無明顯差異(P0.05);治療后7天,治療前后的VAS評分差值及周徑差差值均有明顯差異(P0.05);組內(nèi)比較兩組患者VAS評分及周徑差在治療前后均有顯著差異(P0.05)。經(jīng)秩和檢驗統(tǒng)計分析,兩組患者疼痛程度、腫脹及瘀斑程度方面在治療前無明顯差異(P0.05),而在治療后7天均有顯著差異(P0.05)。對于炎癥指標(biāo)的監(jiān)測情況,經(jīng)t檢驗對比分析,治療前及治療后7天兩組組內(nèi)差異均有統(tǒng)計學(xué)意義(P0.05),而組間對比WBC與CRP水平在治療前后均無統(tǒng)計學(xué)意義(P0.05)。全部治療組患者均沒有出現(xiàn)紅疹、皮膚疹癢等過敏反應(yīng)。結(jié)論:消腫止痛膏在老年轉(zhuǎn)子間骨折術(shù)后的消腫鎮(zhèn)痛方面有著良好的療效,可顯著改善局部軟組織的腫痛程度,且無不良反應(yīng),充分發(fā)揮了中醫(yī)藥在骨折術(shù)后康復(fù)治療中的優(yōu)勢,值得在臨床上大力推廣。
[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 鹵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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R274.9
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本文編號：1705833