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活血化瘀法治疗气滞血瘀型反射性交感神经营养不良的临床对照试验
Hits: 2569   Download times: 1741   Received:July 28, 2009    
作者Author单位UnitE-Mail
徐瑞生 XU Rui-sheng 无锡市第三人民医院骨科,江苏 无锡 214041 Department of Orthopaedics Surgery,the No.3 People's Hospital of Wuxi,Wuxi 214041,Jiangsu,China xuruisheng@medmail.com.cn 
宗序华 ZONG Xu-hua 无锡市第三人民医院骨科,江苏 无锡 214042 Department of Orthopaedics Surgery,the No.3 People's Hospital of Wuxi,Wuxi 214042,Jiangsu,China  
李小钢 LI Xiao-gang 无锡市第三人民医院骨科,江苏 无锡 214043 Department of Orthopaedics Surgery,the No.3 People's Hospital of Wuxi,Wuxi 214043,Jiangsu,China  
期刊信息:《中国骨伤》2009年22卷,第12期,第920-922页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:观察活血化瘀法治疗气滞血瘀型反射性交感神经营养不良的临床效果。

方法:将临床表现为“皮肤暗红,温度高于健侧,排汗较多而皮肤湿润和肢端水肿,伴随中等程度疼痛”的患者归为气滞血瘀型。自2006年至2008年,58例气滞血瘀型反射性交感神经营养不良患者随机分为治疗组30例和对照组28例,治疗组口服活血行气滋养筋骨的中药方(苏木10 g,川芎6 g,乳香6 g,当归10 g,红花6 g,没药6 g,地鳖虫10 g,参三七3 g,赤芍10 g,陈皮5 g ,落得打15 g,炮山甲10 g,延胡索10 g,骨碎补15 g).每日1剂,分2次口服,10 d为1个疗程。同时,配合中药煎汤熏洗,采用舒筋活血方(伸筋草10 g,秦艽10 g,独活10 g,当归10 g,钩藤10 g,乳香6 g,没药6 g,红花6 g).该方泡浸汤液经抽水,干燥制成颗粒剂。使用时加热水冲成汤药熏洗,每日1剂,熏洗2次,每次30 min,10 d为1个疗程。对照组给予安慰剂,为相同颜色的口服汤药和熏洗用的颗粒剂,给药时间、方法、疗程同治疗组。观察比较两组治疗前后疼痛VAS评分和患肢肿胀(体积)改变的情况,并30 d后进行疗效评定。

结果:疼痛VAS评分:治疗组平均降低(3.8±0.8)分,对照组平均降低(1.0±0.3)分,差异有统计意义(P<0.01).治疗组软组织体积减少(21.8±2.5) ml,对照组减少(10.3±2.1) ml,差异有统计学意义(P<0.01).两组疗效差异有统计学意义,治疗组疗效优于对照组。

结论:活血化瘀法治疗气滞血瘀型反射性交感神经营养不良可减轻疼痛,具有良好的疗效。
[关键词]:反射性交感神经营养障碍  中药疗法  活血祛瘀  气滞血瘀  疼痛  临床对照试验
 
Controlled clinical trials of therapeutic effects of Chinses herbs promoting blood circulation and removing blood stasis on the treatment of reflex sympathetic dystrophy with type of stagnation of vital energy and blood stasis
Abstract:

Objective: To observe clinical results of Chinese herbs promoting blood circulation and removing blood stasis on the treatment of reflex sympathetic dystrophy(RSD) with type of stagnation of vital energy and blood stasis.

Methods: RSD with type of stagnation of vital energy and blood stasis was distinguished as erubescence,high temperature, perspiration,damp and acro-edema, with middle level pain. From 2006 to 2008,58 patients with RSD of stagnation of vital energy and blood stasis were randomly divided into the treatment group(30 cases) and the control group(28 cases). The former were treated with Chinese medicine to activate blood circulation and improve bone and muscle nourishment. Chinese medicine includes:Caesalpinia Sappan 10 g,Ligusticum Chuanxiong 6 g,Frankincense 6 g,Angelica 10 g,Safflower 6 g,Myrrh 6 g, Ground Beetle 10 g,Araliaceae 3 g,Radix Paeoniae Rubra 10 g,Pericarpium Citri Reticulatae 5 g,Lawn Pennywort Herb 15g,Manis Pentadactyla 10 g,Corydalis Yanhusuo 10 g,Rhizoma Drynariae 15 g,which were boiled into decoction and the patients were take orally everyday with a course of treatment for 10 days,together with the boiled Chinese traditional medicine of stretching muscle and activating blood circulation to fume and wash the limbs twice everyday. The compatibility of medicines in prescription includes:Lycopodium Japanicum Grass 10 g,Gentiana Macrophylla Pall 10 g,Radix Angelicae Pubescentis 10 g,Angelica 10 g,Uncaria 10 g,Frankincense 6 g,Myrrh 6 g,Safflower 6 g. Control group were treated with a placebo of the same color for oral use and external application. The delivery times,method and the time of therapy were all the same as the treatment group. After 30 days' treatment,the effective indexes of VAS pain score and swelling condition were observed in both groups.

Results: VAS pain score:the treatment group decreased(3.8 ± 0.8) points and the control group decreased(1.0 ± 0.3) points,the difference between the two groups was significantly(P<0.01). There was significantly difference in volume decrease of the swelling limb between treatment group(21.8 ± 2.5) ml and the control group(10.3 ± 2.1) ml(P<0.01). The efficiency difference between treatment group and control group was significantly(P<0.01).

Conclusion: With the different treatment based on different syndrome and emphasis on the nourishment of bone and soft tissue, treated by Chinese medicine to promote blood circulation and remove blood stasis in stagnation of vital energy and blood stasis,RSD get a favorable result.
KEYWORDS:Reflex sympathetic dystrophy  Drug therapy  Blood act stasis remov  Qi stagnation blood stasis  Pain  Controlled clinical trials
 
引用本文,请按以下格式著录参考文献:
中文格式:徐瑞生,宗序华,李小钢.活血化瘀法治疗气滞血瘀型反射性交感神经营养不良的临床对照试验[J].中国骨伤,2009,22(12):920~922
英文格式:XU Rui-sheng,ZONG Xu-hua,LI Xiao-gang.Controlled clinical trials of therapeutic effects of Chinses herbs promoting blood circulation and removing blood stasis on the treatment of reflex sympathetic dystrophy with type of stagnation of vital energy and blood stasis[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(12):920~922
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