五苓散合当归补血汤治疗骨折四肢肿胀的效果

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摘要目的探讨五苓散合当归补血汤治疗骨折四肢肿胀的效果。方法选取2019年12月至2021年1月期间于武汉市蔡甸区中医医院就诊的150 例骨折四肢肿胀患者作为研究对象，按照随机数字表法分为对照组（75 例）与观察组（75 例），对照组给予常规治疗，观察组给予五苓散合当归补血汤治疗。比较两组患者治疗前后临床症状评分[视觉模拟评分（VAS）、四肢肿胀程度、临近关节活动度评分]，骨代谢指标水平[骨钙素（BGP）、血清碱性磷酸酶（ALP）、Ⅰ型前胶原羧基端肽（PICP）和骨形态发生蛋白-2（BMP-2）]，骨痂生长情况[骨痂密度、骨痂量、骨痂边缘、断端边缘生长情况]和临床疗效。结果治疗前，两组患者的VAS评分、四肢肿胀程度和临近关节活动度评分比较，差异无统计学意义（P＞0.05）；治疗后，两组患者的VAS评分、四肢肿胀程度和临近关节活动度评分均低于本组治疗前，差异有统计学意义（P＜0.05）；治疗后，观察组患者VAS评分、四肢肿胀程度和临近关节活动度评分均低于对照组，差异具有统计学意义（P＜0.05）。治疗前，两组患者的BGP、ALP、PICP、BMP-2 水平比较，差异无统计学意义（P＞0.05）；治疗后，两组患者的BGP、ALP、PICP、BMP-2 水平均高于本组治疗前，差异有统计学意义（P＜0.05）；治疗后，观察组患者的BGP、ALP、PICP、BMP-2 水平比较均高于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的骨痂密度、骨痂量、骨痂边缘、断端边缘生长评分比较，差异无统计学意义（P＞0.05）；治疗后，两组患者的骨痂密度、骨痂量、骨痂边缘、断端边缘生长评分均高于本组治疗前，差异有统计学意义（P＜0.05）；治疗后，观察组患者的骨痂密度、骨痂量、骨痂边缘、断端边缘生长评分均高于对照组，差异有统计学意义（P＜0.05）。观察组临床治疗总有效率93.33%（70/75）高于对照组81.33%（61/75），差异有统计学意义（P＜0.05）。结论给予骨折四肢肿胀患者五苓散合当归补血汤治疗可有效减轻肿胀、疼痛症状，改善骨代谢水平并促进骨痂生长，有利于骨折愈合。

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	王大光

关键词 ：五苓散, 当归补血汤, 骨折, 四肢肿胀, 临床疗效

Abstract：Objective To investigate the effect of Wuling Powder and Danggui Buxue Decoction in the treatment of swelling of limbs.Methods A total of 150 patients with fractured limbs and swelling who were treated at the Caidian District Hospital of Traditional Chinese Medicine in Wuhan City from December 2019 to January 2021 were selected as the research objects,according to the random number table method,they were divided into control group (75 cases) and observation group (75 cases).The control group was given routine treatment.The observation group was treated with Wuling Powder and Danggui Buxue Decoction.The clinical symptom scores of the two groups were compared before and after treatment (visual analogue scale[VAS],limb swelling degree,adjacent joint range of motion score),bone metabolism index level (osteocalcin[BGP],serum alkaline phosphatase[ALP],type I procollagen carboxy-terminal peptide[PICP]and bone morphogenetic protein-2[BMP-2]),bone callus Growth condition[callus density,callus volume,callus edge,growth condition of stump edge]and clinical efficacy.Results Before treatment,there was no significant difference in the VAS score,the degree of swelling of limbs and the range of motion of adjacent joints between the two groups (P＞0.05).The scores were lower than those before treatment in this group,and the differences were statistically significant (P＜0.05).After treatment,the VAS score,the degree of swelling of the limbs and the range of motion of adjacent joints in the observation group were lower than those in the control group,and the differences were statistically significant (P＜0.05).Before treatment,there was no significant difference in the levels of BGP,ALP,PICP and BMP-2 between the two groups (P＞0.05).After treatment,the levels of BGP,ALP,PICP and BMP-2 in the two groups were higher than before treatment,the differences were statistically significant in this group (P＜0.05).After treatment,the levels of BGP,ALP,PICP and BMP-2 in the observation group were higher than those in the control group,and the differences were statistically significant (P＜0.05).Before treatment,there was no significant difference in the callus density,callus volume,callus edge and fracture edge growth score between the two groups (P＞0.05).The volume,callus edge,and fracture edge growth scores of the patients in the observation group were higher than those before treatment,and the differences were statistically significant (P＜0.05).The end-edge growth scores were higher than those in the control group,and the differences were statistically significant (P＜0.05).The total effective rate of clinical treatment in the observation group was 93.33% (70/75) higher than that in the control group,which was 81.33% (61/75),and the difference was statistically significant (P＜0.05).Conclusion The treatment of Wulingsan combined with Danggui Buxue Decoction for patients with swelling of fractured limbs can effectively reduce the symptoms of swelling and pain,improve the level of bone metabolism and promote the growth of callus,which is beneficial to fracture healing.

Key words： Wulingsan Danggui Buxue Decoction Fractures Swelling of limbs Clinical efficacy

引用本文:

王大光. 五苓散合当归补血汤治疗骨折四肢肿胀的效果 [J]. 中国当代医药, 2022, 29(7): 126-129.
WANG Daguang. Effect of Wuling Powder and Danggui Buxue Decoction in treating swelling of limbs with fractures. 中国当代医药, 2022, 29(7): 126-129.

链接本文:

https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I7/126

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