| 通脉汤对股骨骨折围手术期TNF-α、IL-6的影响 |
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投稿时间：2010-02-05
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| 作者 | Author | 单位 | Address | E-Mail |
| 吴征杰 |
WU Zheng-jie |
佛山市中医院骨伤科，广东 佛山 528000 |
Department of Orthopaedics and Trauma tology,Foshan Hospita1 of Traditional Chinese Medicine,Foshan 528000,Guangdong,China |
fswjz2009@163.com |
| 赵王林 |
ZHAO Wang-lin |
佛山市中医院骨伤科，广东 佛山 528000 |
Department of Orthopaedics and Trauma tology,Foshan Hospita1 of Traditional Chinese Medicine,Foshan 528000,Guangdong,China |
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| 曾焰辉 |
ZENG Yan-hui |
佛山市中医院骨伤科，广东 佛山 528000 |
Department of Orthopaedics and Trauma tology,Foshan Hospita1 of Traditional Chinese Medicine,Foshan 528000,Guangdong,China |
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| 朱永展 |
ZHU Yong-zhan |
佛山市中医院骨伤科，广东 佛山 528000 |
Department of Orthopaedics and Trauma tology,Foshan Hospita1 of Traditional Chinese Medicine,Foshan 528000,Guangdong,China |
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| 区锦燕 |
OU Jin-yan |
佛山市中医院骨伤科，广东 佛山 528000 |
Department of Orthopaedics and Trauma tology,Foshan Hospita1 of Traditional Chinese Medicine,Foshan 528000,Guangdong,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第7期，第500-503页 |
| DOI：10.3969/j.issn.1003-0034.2010.07.008 |
| 基金项目:广东省中医药管理局课题（编号：2007275） |
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中文摘要:
目的：探讨通脉汤对创伤骨折围手术期肿瘤坏死因子-α、白介素-6血浆浓度的影响，研究通脉汤对创伤所致的炎症因子改变的有效性，为临床运用提供一定的理论依据。
方法：选择2007年10月至2009年5月入院，股骨闭合性骨折ASA评分在Ⅰ～Ⅱ级的患者共60例，性别不限，分为A、B、C组。A组（田七丸组）20例，年龄20～45岁，平均（32.00±7.33）岁；男13例，女7例；病程2.0～26.0 h,平均（9.51±6.61） h.B组（田七丸+可塞风组）20例，年龄23～42岁，平均（31.00±6.92）岁；男12例，女8例；病程3.5～25.0 h,平均（13.56±7.27） h.C组（田七丸+可塞风+通脉汤组）20例，年龄21～44岁，平均（31.50±8.20）岁；男14例，女6例；病程4.6～29.0 h,平均（13.31±6.23）h.42例行股骨带锁髓内钉固定，18例行股骨锁定钢板固定，在此基础上，A组加用田七丸口服，每次4 g,每日2次；B组口服田七丸每次4 g,每日2次，同时肌肉注射可塞风注射液，每次8 mg,每日1次；C组在B组的基础上，同时口服通脉汤水煎液，每次200 ml,每日2次。上述药物均在入院第2天开始应用，3组患者于入院后2、7 d（术前）及8、14 d（术后）清晨6:40于静脉输液前采取外周静脉血，运用免疫度量法分别测定促炎症细胞因子TNF-α、IL-6在血清中的含量，所测TNF-α、IL-6不同时间点的数据采用SPSS 17.0统计学软件进行统计处理。
结果：入院第2天、术后第2天，3组周围血清TNF-α、IL-6的含量比较，差异无统计学意义（P>0.05）;入院第7天，3组周围血清TNF-α、IL-6的含量比较，差异有统计学意义（P<0.05）;术后第7天，3组周围血清TNF-α、IL-6的含量比较，差异有统计学意义（P<0.05,P<0.01）.入院第7天、术后第7天与入院第2天周围血清TNF-α、IL-6含量比较，差异有统计学意义，F=3.87及3.16（P<0.01）.入院第7天及术后第7天周围血清TNF-α、IL-6的含量，C组与A组比较（P<0.01）,C组与B组比较（P<0.05）差异均有统计学意义。
结论：股骨骨折围手术期内患者血清中TNF-α、IL-6增高，通脉汤对抑制创伤后致炎症因子大量释放，减少创伤后早期并发症有一定的作用。 |
| 【关键词】股骨骨折 中药疗法 活血祛瘀 手术期间 肿瘤坏死因子α |
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| Effects of Tongmai decoction（通脉汤）on the perioperative changes of plasma TNF-α andIL-6 in patients with femoral fractures |
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ABSTRACT
Objective: To explore the effects of Tongmai decoction(通脉汤) on the perioperative changes of serum concentrations of tumor necrosis factor alpha (TNF-α) and interleukin(IL)-6 in patients with femoral fractures,and conform the effectiveness of Tongmai decoction(通脉汤)on inflammatory factors in patients with femoral fractures,providing the theoretical evidence for the clinical use of Tongmai decoction(通脉汤).
Methods: From October 2007 to May 2009,60 patients with closed traumatic femoral fractures were selected according to the inclusion criterias and exclusion criterias. All the patients were randomly divided into three groups (group A,group B and group C). Twenty patients in group A(Tpanax Notoginseng pill group),13 patients were male and 7 patients were female;ranging in age from 20 to 45 years,averaged 32.0 years;the disease course ranged from 2.0 to 26.0 h,with an average of 9.5 h. Twenty patients in group B(Tpanax Notoginseng pills and Lornoxicam injection group),12 patients were male and 8 patients were female;ranging in age from 23 to 42 years,averaged 31.0 years;the disease course ranged from 3.5 to 25.0 h,with an average of 13.6 h. Twenty patients in group C (Tpanax Notoginseng pill,Lornoxicam injection and Tongmai decoction group),14 patients were male and 6 patients were female;ranging in age from 21 to 44 years,averaged 31.5 years;the disease course ranged from 4.6 to 29.0 h,with an average of 13.3 h. Among all the patients,42 patients with fractures were fixed with femoral intramedullary nailing,and other 18 patients with femoral locking plate fixation. The patients in group A took Tpanax Notoginseng pills orally,4 g each time and twice daily;the patients in group B took Tpanax Notoginseng pills orally as group A,and at the same time received intramuscular injection of Lornoxicam,8 mg each time and once daily;the patients in group C took Tpanax Notoginseng pills orally and received intramuscular injection of Lornoxicam as group B,and at the same time took Tongmai decoction(通脉汤)orally,200 ml each time and twice daily. The above medications were administered to the three groups on the second day after admission to hospital. Peripheral blood samples were taken for determination of pro-inflammatory cytokines of TNF-α and IL-6 in blood serum on the 2nd and 6th days before operation and on the 8th and 13th days after operation. And all the patients were evaluated liver and kidney function at the 2nd and 7th days after admission. Analysis of variance and least significant difference-test were done with the help of SPSS 17.0 statistic software.
Results: The differences among three groups of TNF-α and IL-6 in blood serum at the 2nd day after admission and 2 days after operation had no statistical significance(P>0.05). The TNF-α and IL-6 levels among 3 groups had statistical differences at the 7th day after admission and at the 7th day after operation(P<0.05,P<0.01). There were significant differences of TNF-α and IL-6 levels between the 7th day after admission and the 2nd day after admission,the 7th day after operation and the 2nd day after admission(P<0.01). There were also significant differences of TNF-α and IL-6 levels between group C compared with group A and B at the 7th day after admission and the 7th day after operation(P<0.05,P<0.01).
Conclusion: The serum concentrations of TNF-α and IL-6 level significantly increased in perioperative period. The results indicate that the Tongmai decoction(通脉汤)may play an important role in inhibiting the release of TNF-α and IL-6 into the blood stream and decreasing the incunabula complication at early traumatic stage. |
| KEY WORDS Femoral fractures Drug therapy（TCD） Blood act stasis remov Intraoperative period Tumor necrosis fractor-alpha |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吴征杰,赵王林,曾焰辉,朱永展,区锦燕.通脉汤对股骨骨折围手术期TNF-α、IL-6的影响[J].中国骨伤,2010,23(7):500~503 |
| 英文格式: | WU Zheng-jie,ZHAO Wang-lin,ZENG Yan-hui,ZHU Yong-zhan,OU Jin-yan.Effects of Tongmai decoction（通脉汤）on the perioperative changes of plasma TNF-α andIL-6 in patients with femoral fractures[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(7):500~503 |
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