摘要
目的:分析黄芪桂枝五物汤对附带神经移植的游离足背静脉皮瓣术后感觉功能恢复的临床效果,为临床游离足背皮瓣移植术患者优选康复方案提供参考。方法:选取2019年2月—2021年1月我院收治的手外伤患者70例,所有患者均符合附带神经移植的游离足背静脉皮瓣术指征,并成功完成手术。按照术后康复方案不同分为对照组和观察组,每组35例。对照组术后予以甲钴胺片治疗;观察组在对照组治疗基础上再予以黄芪桂枝五物汤治疗。两组患者均连续治疗8周为1个疗程,均随访观察至少6个月。对两组患者术后1、3、6个月的皮瓣外形和皮肤质地进行评估,同时测量移植皮瓣两点辨别觉并评价皮瓣感觉功能恢复效果。对两组患者行康复治疗前后的中医症候、体征进行测评,比较两组中医证候疗效。结果:1)两组患者术后1、3、6个月的皮瓣外形和质地优良率呈上升趋势,且观察组优良率均高于对照组,差异有统计学意义(P<0.05);2)两组患者术后1、3、6个月的皮瓣感觉功能优良率呈上升趋势,且观察组高于对照组,差异有统计学意义(P<0.05);3)治疗8周后,观察组患者中医证候总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论:黄芪桂枝五物汤用于附带神经移植的游离足背静脉皮瓣术患者术后康复治疗,可有效提升患者术后皮瓣外形、质地及感觉功能恢复,提升患者临床疗效,对促进患者术后各项指标恢复质量具有较大的临床价值。
Objective To analyze the clinical effect of Huangqi Guizhi Wuwu Decoction on the recovery of sensory function after free dorsal foot vein flap with nerve transplantation,so as to provide reference for the selection of rehabilitation scheme for patients with free dorsal foot flap transplantation.Methods 70 cases of hand and foot surgery patients in our hospital from February 2019 to January 2021 were selected as the research objects.All patients met the indications of free dorsal foot vein flap with nerve transplantation,and successfully completed the operation.The patients were divided into control group and observation group according to different rehabilitation programs,which 35 cases in each group.The control group was treated with Mecobalamin tablets after operation;the observation group was treated with Huangqi Guizhi Wuwu Decoction on the basis of the control group.Two groups of patients were treated for 8 weeks as a course of treatment.Both groups were followed up for at least 6 months.The shape and texture of the flaps were evaluated at 1,3,and 6 months after operation.The two-point discrimination of the flaps was measured and the effect of sensory function recovery was evaluated.The TCM symptoms and signs of the two groups before and after rehabilitation treatment were evaluated,and the curative effect of TCM syndromes was evaluated according to the results of the two evaluations,and the comparison between the two groups was made.The above indexes were compared between groups.Results 1)The excellent and good rate of skin flap appearance and texture in the two groups increased at 1 month,3 months and 6 months after operation,and the excellent and good rate in the observation group was higher than that in the control group at different stages (P <0.05);2) The excellent and good rate of skin flap sensory function in the two groups showed an upwardtrend, and the excellent and good rate of the observation group was higher than that of the control group (P <0.05);3) After 8 weeks of treatment, the total effective rate of TCM syndromes in the observation group was significantlyhigher than that in the control group (P <0.05). Conclusion Huangqi Guizhi Wuwu decoction can effectivelyimprove the shape, texture and sensory function of the patients after the operation, and promote the recovery ofvarious indicators of patients after operation. It has great clinical value.
作者
王琳
凌李
周佳鑫
WANG Lin;LING Li;ZHOU Jia-xin(Department of Hand and Foot Surgery,Keqiao District Hospital of Traditional Chinese Medicine,Shaoxing 312030,China)
出处
《中国中西医结合外科杂志》
CAS
2021年第2期237-241,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
黄芪桂枝五物汤
附带神经移植
游离足背静脉皮瓣术
手创伤
皮瓣感觉功能
Huangqi Guizhi Wuwu Decoction
collateral nerve transplantation
free dorsal foot vein flap
hand trauma
skin flap sensory function
