【摘要】：目的：觀察加味桃紅四物湯治療上頸椎骨折術(shù)后早期頸部疼痛的臨床療效。方法：選取2014年11月至2015年12月發(fā)生上頸椎骨折就診于南京軍區(qū)福州總醫(yī)院的病例43例(其中3例脫落),隨機(jī)分成2組：試驗(yàn)組(口服中藥,n=22)和對(duì)照組(空白對(duì)照,n=21)。試驗(yàn)組自術(shù)后2d起在上頸椎骨折術(shù)后常規(guī)治療基礎(chǔ)上,開(kāi)始口服中藥加味桃紅四物湯,7天為1療程,共2個(gè)療程；對(duì)照組不服用加味桃紅四物湯,其余術(shù)后治療同試驗(yàn)組,分別于術(shù)后2d、術(shù)后9d、術(shù)后16d后對(duì)兩組患者進(jìn)行疼痛VAS評(píng)分；檢測(cè)血沉及C-反應(yīng)蛋白水平指標(biāo)；采用日常生活能力量表(Modified Barthel Index, MBI)評(píng)估患者術(shù)后日常生活能力。所有數(shù)據(jù)在SPSS17.0統(tǒng)計(jì)軟件下分析。結(jié)果：1.一般資料比較：兩組患者在年齡、性別、上頸椎骨折程度及骨折損傷節(jié)段、術(shù)后鎮(zhèn)痛藥物(包括鎮(zhèn)痛泵、口服止痛藥物等)使用情況比較無(wú)顯著性差異(P0.05),具有可比性。2.疼痛評(píng)分(VAS)比較：術(shù)后2d,兩組患者比較無(wú)顯著性差異(P0.05)。術(shù)后9d,試驗(yàn)組改善水平好于對(duì)照組(P0.05)；術(shù)后16d,試驗(yàn)組較對(duì)照組疼痛改善更為明顯(P0.05)。3.血沉和C-反應(yīng)蛋白指標(biāo)比較：術(shù)后2d,兩組患者血沉及C-反應(yīng)蛋白指標(biāo)比較,均無(wú)明顯統(tǒng)計(jì)學(xué)差異(P0.05)。術(shù)后9d,兩組C-反應(yīng)蛋白和血沉指標(biāo)比較有顯著統(tǒng)計(jì)學(xué)差異(P0.05)；術(shù)后16d,兩組C-反應(yīng)蛋白和血沉指標(biāo)有明顯差異(P0.05)。4.日常生活能力(MBI)評(píng)分比較：術(shù)后2d,兩組患者日常生活能力評(píng)分無(wú)顯著差異(P0.05)。治療9d后,試驗(yàn)組日常生活能力優(yōu)于對(duì)照組,有顯著統(tǒng)計(jì)學(xué)差異(P0.05)。術(shù)后16d與對(duì)照組比較,試驗(yàn)組日常生活能力提高更明顯,有顯著性差異(P0.05)。5.疼痛療效評(píng)價(jià)：術(shù)后2d,兩組患者疼痛療效比較,無(wú)顯著性統(tǒng)計(jì)學(xué)差異(P0.05)；術(shù)后9d,試驗(yàn)組疼痛療效好于對(duì)照組,有顯著性差異(P0.05)；術(shù)后16d,試驗(yàn)組療效優(yōu)于對(duì)照組(P0.05)。結(jié)論：加味桃紅四物湯能夠緩解上頸椎骨折患者術(shù)后早期頸部疼痛,對(duì)炎癥有一定抑制作用,更有利于患者早期功能鍛煉,盡早康復(fù),值得臨床推廣應(yīng)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.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R274.9

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