摘要
目的:观察基于祛瘀生新原则应用复元活血汤对手指软组织缺损皮瓣移植修复效果的影响。方法:60例患者按随机数字表法分为2组各30例,均急诊或择期行手指软组织缺损皮瓣移植修复术,对照组术后给予常规治疗,观察组在对照组治疗方案的基础上口服复元活血汤,比较2组治疗效果,比较其纤维蛋白原(Fb)、红细胞沉降率(ESR)、血栓素B2(TXB2)、血管内皮生长因子(VEGF)水平,应用视觉模拟评分法(VAS)、拇/手指再造功能评定表、健康调查简表(SF-36)评价2组疼痛度、手指功能、生活质量改善情况,同时观察其并发症。结果:总有效率观察组93.33%,对照组73.33%,2组比较,差异有统计学意义(P<0.05),观察组优于对照组。治疗后,2组Fb、ESR、TXB2均较同组治疗前降低,而VEGF均高于同组治疗前,差异均有统计学意义(P<0.05);且观察组治疗后Fb、ESR、TXB2较对照组低,VEGF水平较对照组高,差异均有统计学意义(P<0.05)。2组VAS评分均降低,而手指功能评分、SF-36评分均增加,差异均有统计学意义(P<0.05);且观察组治疗后VAS评分低于对照组,手指功能评分、SF-36评分高于对照组,差异均有统计学意义(P<0.05)。观察组出现耐药菌株1例,肝肾功能异常2例;对照组出现血管危象及耐药菌株各1例。观察组并发症发生率10.00%与对照组6.67%比较,差异均无统计学意义(P>0.05)。结论:依据祛瘀生新原则应用复元活血汤可提高手指软组织缺损皮瓣移植修复效果,同时改善患者血流变指标,降低疼痛,且并发症少。
Objective： To observe the effect of Fuyuan Huoxue tang on repair effect of flap graft for soft tissue defect of finger based on principle of removing blood stasis for promoting tissue regeneration. Methods： Divided 60 patients into two groups being 30 cases in each according to the random table method. The two groups were received emergency treatment or selective surgery of flap graft for soft tissue defect of finger. After operation, the control group was given routine antibiotics for anti-infection, while the observation group was given oral Fuyuan Huoxue tang based on the treatment of the control group.Compared curative effect, level of fibrinogen（Fb）, sedimentation rate（ESR）, thromboxane B2（TXB2）, vascular endothelial growth factor（VEGF） of the two groups, and evaluated improvement pain degree, finger function and quality of life in both groups with visual analogue scale（VAS）, functional assessment of finger reconstruction and SF-36 health survey（SF-36）.Results： Total effective rate was 93.33% in the observation group, and was 73.33% in the control group, the difference being significant（P〈0.05）, and the effective rate of the observation group was better than that of the control group. After treatment,Fb, ESR and TXB2 of both groups were lower than that those before treatment, while the VEGF level was higher than that before treatment, differences being significant（P〈0.05）. Fb, ESR and TXB2 of the observation group were lower than those of the control group, while the VEGF level was higher than that of the control group, the difference being significant（P〈0.05）. VAS score of both groups was lower than that before treatment, while score of finger function and SF-36 score were both increased, differences being significant（P〈0.05）. After treatment, VAS score of the observation group was lower than that of the control group, and score of finger function as well as SF-36 score of the observation group were higher than that those of the control group, differences being significant（P〈0.05）. There being one case of multiple drug resistance（MDR）, two cases of renal and liver insufficiency appeared in the observation group while there was one case of MDR and vascular crisis appeared in the control group. The complication rate was 10.00% in the observation group, and was 6.67% in the control group, the difference being not statistically significant（P〈0.05）. Conclusion： Based on principle of removing blood stasis for promoting tissue regeneration, applying Fuyuan huoxue tang can improve repair effect of flap graft for soft tissue defect of finger, improve hemorheological parameters in the meanwhile, reduce pain and has less complication.
出处
《新中医》
CAS
2017年第9期63-66,共4页
New Chinese Medicine
关键词
手指软组织缺损
皮瓣移植修复
祛瘀生新
活血化瘀
中药
血流变指标
手指再造功能评定表
健康调查简表(SF-36)
Soft tissue defect of finger
Removing blood stasis for promoting tissue regeneration
Invigorate blood and dissolve stasis
Chinese medicine
Hemorheological parameters
Functional assessment of finger reconstruction
SF-36 health survey（SF-36）
