| 穴位按压联合活血散瘀方用于跟骨骨折早期消肿的临床观察 |
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投稿时间：2019-02-11
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| 作者 | Author | 单位 | Address | E-Mail |
| 王金法 |
WANG Jin-fa |
湖州市南浔区人民医院骨科, 浙江 湖州 313009 |
Department of Orthopaedics, People's Hospital of Nanxun of Huzhou, Huzhou 313009, Zhejiang, China |
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| 姬强明 |
JI Qiang-ming |
湖州市南浔区人民医院骨科, 浙江 湖州 313009 |
Department of Orthopaedics, People's Hospital of Nanxun of Huzhou, Huzhou 313009, Zhejiang, China |
25588314@qq.com |
| 费红良 |
FEI Hong-liang |
湖州市南浔区人民医院骨科, 浙江 湖州 313009 |
Department of Orthopaedics, People's Hospital of Nanxun of Huzhou, Huzhou 313009, Zhejiang, China |
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| 石盛生 |
SHI Sheng-sheng |
湖州市南浔区人民医院骨科, 浙江 湖州 313009 |
Department of Orthopaedics, People's Hospital of Nanxun of Huzhou, Huzhou 313009, Zhejiang, China |
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| 童培建 |
TONG Pei-jian |
浙江省中医院, 浙江 杭州 310006 |
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| 期刊信息：《中国骨伤》2019年，第32卷，第11期，第982-986页 |
| DOI：10.3969/j.issn.1003-0034.2019.11.002 |
| 基金项目:湖州市科技计划项目（编号：2016GY50） |
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中文摘要:
目的：观察穴位按压联合活血散瘀方口服治疗跟骨骨折早期肿胀的临床疗效。
方法：自2016年6月至2018年4月将78例闭合性跟骨骨折患者分为观察组和对照组。其中观察组39例，男36例，女3例；年龄28~61（41.7±13.3）岁；高处坠落伤20例，车祸伤10例，其他伤9例；受伤至就诊时间0.5~10.5（4.6±3.2）h；SandersⅡ型15例，Ⅲ型17例，Ⅳ型7例；入院后即开始按压血海、三阴交和足三里3穴至手术日当天为止，每穴按压10 min，每天3次，同时口服活血散瘀方5 d，每天1剂，分两次口服。对照组39例，男34例，女5例；年龄26~62（43.3±12.3）岁；高处坠落伤19例，车祸伤12例，其他伤8例；受伤至就诊时间1~11（4.4±3.7）h；SandersⅡ型15例，Ⅲ型18例，Ⅳ型6例；入院后即予20%甘露醇针静滴5 d，每天2次，每次125 ml。两组患者入院5 d后每天用水溢出法测量并计算出患侧足踝部的肿胀度，比较治疗前和治疗后第1、2、3、4天的肿胀度；观察两组术前患侧足踝部首次出现皮肤褶皱征阳性所需时间及发生张力性水泡的例数。
结果：观察组患者足踝部的肿胀度在治疗后第1、2、3、4天分别为（12.67±0.82）%、（11.87±0.88）%、（10.65±0.92）%、（9.47±0.96）%，低于对照组的（13.31±0.98）%、（13.51±0.84）%、（12.22±0.94）%、（11.38±1.01）%，差异有统计学意义（P<0.05）；观察组首次出现皮肤褶皱征阳性时间为（6.41±1.74）d，少于对照组的（8.15±2.01）d，差异有统计学意义（P<0.01）；观察组3例发生张力性水泡，对照组9例，差异无统计学意义（P>0.05）。
结论：在跟骨骨折早期采用穴位按压联合活血散瘀方口服可加快足踝部肿胀的消退，缩短首次皮肤褶皱征阳性出现所需时间，减少足踝部张力性水泡的发生，可缩短患者的手术等待时间，使患者可以尽早手术治疗。 |
| 【关键词】跟骨骨折 穴位按压 中草药 肿胀 |
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| Acupressure with activating blood and dissipating blood stasis prescription for early swelling of calcaneal fractures |
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ABSTRACT
Objective: To observe clinical effects of acupressure combined with activating blood and dissipating blood stasis prescription for the treatment of early swelling of calcaneal fractures.
Methods: From June 2016 to April 2018,78 patients with calcaneus were divided into observation group and control group. There were 39 patients in observation group,including 36 males and 3 females aged from 28 to 61 years old with an average of(41.7±13.3) years old;20 patients were caused by falling down,10 patients were caused by traffic accident and 9 patients were caused by other injuries;The time from injury to medical treatment ranged from 0.5 to 10.5 h with an average of(4.6±3.2) h;15 patients were typeⅡ,17 patients were type Ⅲ and 7 patients were type Ⅳ according to Sanders classification;the patients began to be pressed the three points of "Xuehai(SP 10)" "Sanyinjiao(SP 6)" "Zusanli(ST 36)" for 10 min from the day of hospital admission to the day of operation,3 times a day,and taken prescription of activating blood and dissipating blood stasis prescription orally for 5 days,one dose per day and twice a day. There were 39 patients in control group,including 34 males and 5 females aged from 26 to 62 years old with an average of (43.3±12.3) years old;19 patients were caused by falling down,12 patients were caused by traffic accident and 8 patients were caused by other injuries;the time from injury to medical treatment ranged from 1 to 11 h with an average of (4.4±3.7) h;15 patients were typeⅡ,18 patients were type Ⅲ and 6 patients were type Ⅳ according to Sanders classification; patients were given 20% mannitol intravenously for 5 days,twice a day,125 ml each time from hospital admission. During the 5 days of admission,the degree of swelling of the affected ankle was measured and calculated by water spillover method every day. The result which was measured and calculated on the first day of admission without treatment was the degree of swelling before treatment,compared degree of swelling before operation and 1st,2nd,3rd and 4th day after treatment;the time needed for the first positive skin fold sign in the affected ankle and the number of cases of tension blisters between two groups before operation were observed.
Results: The swelling of the affected ankle on the1st,2nd,3rd and 4th day after treatment in the observation group separately were(12.67±0.82)%,(11.87±0.88)%,(10.65±0.92)%,(9.47±0.96)%,and lower than control group which separately were(13.31±0.98)%,(13.51±0.84)%,(12.22±0.94)%,(11.38±1.01)%;The time for the first appearance of the skin fold sign was (6.41±1.74) days in the observation group was earlier than that of the control group (8.15±2.01) days;There was no significant difference in occurrence of tension blisters between observation group(3 patients) and control group(9 patients).
Conclusion: Acupressure combined with activating blood and dissipating blood stasis prescription for the treatment of early swelling of calcaneal fractures could accelerate the decline of swelling of the affected ankle,shorten the time of the first skin fold sign,reduce the incidence of tension blisters in the ankle,shorten the waiting time of operation,and the surgical treatment as soon as possible. |
| KEY WORDS Calcaneal fracture Acupoint pressing Drugs,Chinese herbal Swelling |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王金法,姬强明,费红良,石盛生,童培建.穴位按压联合活血散瘀方用于跟骨骨折早期消肿的临床观察[J].中国骨伤,2019,32(11):982~986 |
| 英文格式: | WANG Jin-fa,JI Qiang-ming,FEI Hong-liang,SHI Sheng-sheng,TONG Pei-jian.Acupressure with activating blood and dissipating blood stasis prescription for early swelling of calcaneal fractures[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(11):982~986 |
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