揿针结合冰硝散在踝关节骨折患者围手术期中的应用效果

doi:10.3760/cma.j.issn.1007-1245.2024.03.019

国际医药卫生导报 ›› 2024, Vol. 30 ›› Issue (3): 443-448.DOI: 10.3760/cma.j.issn.1007-1245.2024.03.019

揿针结合冰硝散在踝关节骨折患者围手术期中的应用效果

徐海霞罗海霞卓冬砚李亚伟周迎光

南京中医药大学连云港附属医院连云港市中医院骨伤科，连云港　222004

收稿日期:2023-06-09 出版日期:2024-02-01 发布日期:2024-03-06
通讯作者: 周迎光，Email：47494535@qq.com
基金资助:
连云港市卫生科技项目（202017）；连云港市中医院“赵化南”青年科技基金项目（lygq2103）

Effect of thumbtack needles combined with Bingxiao San for patients with ankle fractures during perioperative period

Xu Haixia, Luo Haixia, Zhuo Dongyan, Li Yawei, Zhou Yingguang

Department of Orthopedics and Traumatology, Lianyungang Hospital Affiliated to Nanjing University of Chinese Medicine, Lianyungang Hospital of Traditional Chinese Medicine, Lianyungang 222004, China

Received:2023-06-09 Online:2024-02-01 Published:2024-03-06
Contact: Zhou Yingguang, Email: 47494535@qq.com
Supported by:
Project of Health Science and Technology in Lianyungang (202017); Project Supported by Zhao Huanan Scientific and Technological Fund for Youths at Lianyungang Hospital of Traditional Chinese Medicine (lygq2103)

摘要/Abstract

摘要：

目的　观察揿针联合冰硝散在踝关节骨折患者围手术期中的应用效果。方法　选取2021年12月至2023年3月连云港市中医院骨伤科踝关节骨折住院手术患者60例进行随机对照试验。采用随机数字表法将患者分为治疗组和对照组，各30例。治疗组男15例，女15例，年龄（50.70±17.57）岁；患侧左16例，右14例；内踝骨折2例，外踝骨折6例，双踝骨折14例，三踝骨折8例。对照组男14例，女16例，年龄（51.87±19.43）岁；患侧左14例，右16例；内踝骨折2例，外踝骨折5例，双踝骨折16例，三踝骨折7例。所有患者均予踝关节骨折切开复位内固定术，术后常规治疗。治疗组除上述治疗外，另予揿针针刺内关、合谷穴结合冰硝散外敷，疗程1周。记录待手术天数，术后第1、7天测定患者视觉模拟量表（Visual Analogue Scale，VAS）评分、踝围、中医证候积分、局部皮肤温度、踝关节活动度及恶心呕吐发生次数。采用χ²检验、t检验和Wilcoxon秩和检验。结果　治疗组待手术天数少于对照组［（3.57±2.14）d比（5.00±2.08）d］，差异有统计学意义（P<0.05）。术后第1天，治疗组VAS评分、踝围、肤温、跖屈角度、背屈角度、中医证候评分分别为（6.70±0.84）分、（59.23±2.06）cm、（36.34±0.14）℃、（11.30±1.12）°、（9.03±1.13）°、（16.03±2.61）分，对照组分别为（6.67±0.96）分、（59.17±1.93）cm、（36.30±0.10）℃、（11.53±1.33）°、（9.40±1.07）°、（15.77±2.27）分，差异均无统计学意义（均P>0.05）。术后第7天，治疗组VAS评分、踝围、肤温、中医证候评分均低于对照组［（2.30±0.75）分比（3.03±0.89）分、（56.23±1.74）cm比（57.33±1.97）cm、（36.07±0.08）℃比（36.13±0.09）℃、（7.30±2.37）分比（9.07±2.15）分］，跖屈角度、背屈角度均高于对照组［（28.77±1.07）°比（25.40±1.40）°、（18.30±1.95）°比（15.67±1.40）°］，差异均有统计学意义（均P<0.05）。治疗组有效率高于对照组［93.3%（28/30）比80.0%（24/30）］，差异有统计学意义（P<0.05）。治疗组患者恶心呕吐次数2次，对照组4次，差异无统计学意义（P>0.05）。结论　揿针联合冰硝散能够有效减轻踝关节骨折患者术后踝部肿痛、发热症状，改善活动功能及临床症状，促进患者术后恢复，提高患者生活质量。

关键词:

踝关节骨折, 揿针, 冰硝散, 围手术期, 中医护理

Abstract:

Objective　To observe the effect of thumbtack needles combined with Bingxiao San for patients with ankle fractures during perioperative period. Methods　From December 2021 to March 2023, 60 patients with ankle fractures treated at Department of Orthopedics and Traumatology, Lianyungang Hospital of Traditional Chinese Medicine were selected for the randomized controlled trial. The patients were divided into a treatment group and a control group by the random number table method, with 30 cases in each group. In the treatment group, there were 15 males and 15 females who were (50.70 ± 17.57) years old; there were 16 cases of left ankle fractures and 14 cases of right ankle fractures; there were 2 cases of medial malleolus fractures, 6 cases of lateral malleolar fractures, 14 cases of bimalleolar fractures, and 8 cases of trimalleolus fractures. In the control group, there were 14 males and 16 females who were (51.87±19.43) years old; there were 14 cases of left ankle fractures and 16 cases of right ankle fractures; there were 2 cases of medial malleolus fractures, 5 cases of lateral malleolar fractures, 16 cases of bimalleolar fractures, and 7 cases of trimalleolus fractures. Open reduction and internal fixation of ankle fractures was given to all the patients, and they were treated routinely after the surgery. In addition to the above-mentioned treatments, the treatment group were acupunctured Neiguan and Hegu by thumbtack needles and took Bingxiao San for a course of 1 week. The number of days to be operated on was recorded. The patients' score of Visual Analogue Scale (VAS), ankle circumference, score of traditional Chinese medicine syndromes, local skin temperature, ankle mobility, and the number of episodes of nausea and vomiting were measured 1 and 7 days after the surgery. χ², t, and Wilcoxon rank-sum tests were used. Results　The number of days to undergo surgery in the treatment group was less than that in the control group [(3.57±2.14) d vs. (5.00±2.08) d], with a statistical difference (P<0.05). One day after the surgery, the VAS score, ankle circumference, skin temperature, plantar flexion angle, dorsiflexion angle, and score of traditional Chinese medicine symptoms in the treatment group were (6.70±0.84), (59.23±2.06) cm, (36.34±0.14) ℃, (11.30±1.12)°, (9.03±1.13)°, and (16.03±2.61), and those in the control group were (6.67±0.96), (59.17±1.93) cm, (36.30±0.10) ℃, (11.53±1.33)°, (9.40±1.07)°, and (15.77±2.27), respectively, with no statistical differences (all P>0.05). Seven days after the surgery, the VAS score, ankle circumference, skin temperature, and score of traditional Chinese medicine symptoms in the treatment group were lower than those in the control group [(2.30±0.75) vs. (3.03±0.89), (56.23±1.74) cm vs. (57.33±1.97) cm, (36.07±0.08) ℃ vs. (36.13±0.09) ℃, and (7.30±2.37) vs. (9.07±2.15)], and the plantar flexion angle and dorsiflexion angle in the treatment group were higher than those in the control group [(28.77±1.07)° vs. (25.40±1.40)° and (18.30±1.95)° vs. (15.67±1.40)°], with statistical differences (all P<0.05). The effective rate of the treatment group was higher than that of the control group [93.3% (28/30) vs. 80.0% (24/30)], with a statistical difference (P<0.05). Nausea and vomiting occurred twice in the treatment group, and 4 times in the control group, with no statistical difference (P>0.05). Conclusion　Thumbtack needles combined with Bingxiao San for patients with ankle fractures after surgery can effectively reduce the occurrence of ankle pain and local heating, and improve their activity function, clinical symptoms, postoperative recovery, and quality of life.

Key words:

Ankle fractures, Thumbtack needles, Bingxiao San, Perioperative period, Traditional Chinese medicine nursing

徐海霞罗海霞卓冬砚李亚伟周迎光.

揿针结合冰硝散在踝关节骨折患者围手术期中的应用效果 [J]. 国际医药卫生导报, 2024, 30(3): 443-448.

Xu Haixia, Luo Haixia, Zhuo Dongyan, Li Yawei, Zhou Yingguang.

Effect of thumbtack needles combined with Bingxiao San for patients with ankle fractures during perioperative period [J]. International Medicine and Health Guidance News, 2024, 30(3): 443-448.

参考文献

[1] 刘松. 踝关节骨折流行病学及成人踝关节骨折手术部位感染危险因素研究[D]. 石家庄:河北医科大学, 2019.
[2] 魏代好,马腾,杨海波. 切开复位内固定术治疗复杂踝关节骨折的手术时机选择[J]. 宁夏医科大学学报,2020,42(11):1169-1172. DOI:10.16050/j.cnki.issn1674-6309. 2020.11.020.
[3] 王竞,周文犁,周延安.2012～2018年我国内地甘露醇注射液严重不良反应文献源病例分析[J].药物流行病学杂志,2019,28(11):769-772. DOI:10.19960/j.cnki.issn1005- 0698. 2019.11.015.
[4] 王乃堃,陈雯奕,张晓燕,等. 复方阿片类镇痛药在疼痛治疗中的应用[J]. 实用药物与临床,2018,21(7):725-727. DOI:10.14053/j.cnki.ppcr.201807001.
[5] 陈波翰,刘莉,刘橙橙,等. 中医外治法治疗骨折术后肿胀临床研究进展[J]. 实用中医药杂志,2022,38(11):2033-2035.
[6] 曹华生. 中医外治法在骨伤科疼痛性疾病中的实施效果分析研究[J/CD]. 中西医结合心血管病电子杂志,2020,8(34):189.
[7] 唐家威,谢芳. 揿针疗法的临床应用研究进展[J]. 中医研究,2023,36(1):92-96. DOI:10.3969/j.issn.1001-6910. 2023.01.24.
[8] 温彬. 冰硝散外敷治疗人工全膝关节置换术后肿胀的疗效观察[D]. 济南:山东中医药大学,2022.
[9] 王亦璁,姜保国. 骨与关节损伤[M]. 北京: 人民卫生出版社, 2012: 1160.
[10] 郑筱萸,任德权. 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社, 2002: 340-342.
[11] 刘媛媛,周兴华,郭德立,等. 刺络放血联合红光照射治疗踝关节周围骨折术前局部肿胀疼痛效果观察[J]. 现代中西医结合杂志,2022,31(6):799-802. DOI:10.3969/j.issn. 1008-8849.2022.06.015.
[12] Myles PS, Myles DB, Galagher W, et al. Measuring acute postoperative pain using the Visual Analog Scale: the minimal clinically important difference and patient acceptable symptom state [J]. Br J Anaesth, 2017, 118(3): 424-429. DOI: 10.1093/bja/aew466.
[13] 李润香,李颖芳,郑建娣. 金黄膏配合玉红粉外敷治疗下肢骨折张力性水疱的临床研究[J]. 中国中医药现代远程教育,2018,16(3):87-89. DOI:10.3969/j.issn.1672-2779. 2018.03.040.
[14] 宋江博. 养血止痛丸联合推拿按摩对踝关节骨折术后康复的影响[J]. 实用中医药杂志,2022,38(12):2076-2078.
[15] 彭怡芳,杨碧花. 疼痛护理对踝关节骨折手术治疗患者疼痛程度、骨折愈合的影响[J]. 微量元素与健康研究, 2022, 39(6): 94-95.
[16] 荆文慧. 七叶皂苷钠所致不良反应文献概述[J]. 中国药物滥用防治杂志,2019,25(3):184-186. DOI:10.15900/j.cnki.zylf1995.2019.03.018.
[17] 刘树兴. 冰硝散对双踝关节骨折肿胀的临床疗效观察[D]. 济南:山东中医药大学,2020.
[18] 王凤铭,张宏健,陈彦华,等. 加减桃红四物汤联合冰硝散外敷对尺桡骨骨干双骨折术前肿胀及炎性因子的影响[J]. 中国中医急症,2022,31(5):851-854. DOI:10.3969/j.issn. 1004-745X.2022.05.026.
[19] 国家卫生健康委加速康复外科专家委员会骨科专家组,中国研究型医院学会骨科加速康复专业委员会,中国康复技术转化及促进会骨科加速康复专业委员会. 骨科加速康复围手术期疼痛管理专家共识[J]. 中华骨与关节外科杂志,2022,15(10):739-745. DOI:10.3969/j.issn.2095-9958. 2022.10.04.
[20] 宋晓琦. 强化疼痛护理对急诊创伤骨科患者疼痛程度和满意度的影响[J]. 中国医药指南, 2020, 18(27): 152-153.DOI:10.15912/j.cnki.gocm.2020.27.074.
[21] 蔡雪娇,闵永华,钱新洪. 穴位按摩联合揿针预防全麻手术后患者自控镇痛所致恶心呕吐临床研究[J]. 新中医, 2023, 55(2): 157-159. DOI:10.13457/j.cnki.jncm.2023.02.037.
[22] 张嘉怡. 中医护理缓解骨科患者术后疼痛的效果观察[J]. 云南中医中药杂志, 2018, 39(6): 90-91. DOI:10.16254/j.cnki.53-1120/r.2018.06.038.
[23] 吴菊,张君烨,丁施思. 揿针疗法在分娩镇痛中的应用[J]. 光明中医, 2023, 38(6): 1109-1112. DOI:10.3969/j.issn. 1003-8914.2023.06.031.
[24] 邓福华,邓天好. 基于文献计量的针灸治疗癌痛研究热点及趋势分析[J]. 江西中医药, 2021, 52(6): 52-57.
[25] 陈晓锋. 祛风通痹汤联合温针灸治疗风湿寒性关节痛的临床效果及有效率影响观察[J]. 世界最新医学信息文摘, 2019, 19(45): 181-183. DOI:10.19613/j.cnki.1671-3141. 2019.45.123.
[26] 陈敏,陈金兰,朱锐,等. 腕踝针联合吴茱萸热熨疗法改善PCNL术后疼痛的效果观察[J]. 国际医药卫生导报, 2022, 28(23): 3316-3320. DOI:10.3760/cma.j.issn.1007-1245. 2022.23.015.
[27] 陈生娥. 揿针互动式埋针联合康复疗法治疗膝骨关节炎的临床效果观察[J]. 中外医学研究, 2023, 21(6): 140-143.DOI:10.14033/j.cnki.cfmr.2023.06.035.

揿针结合冰硝散在踝关节骨折患者围手术期中的应用效果

Effect of thumbtack needles combined with Bingxiao San for patients with ankle fractures during perioperative period

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 13

编辑推荐

Metrics

[1]	甘喆李桂贤董寒星. 基于双相交流的健康宣教干预在ERCP患者围手术期护理中的应用 [J]. 国际医药卫生导报, 2024, 30(4): 670-673.
[2]	李玉秋叶晓芳. 血栓弹力图指导的输血应用于体外循环心脏手术围手术期的效果 [J]. 国际医药卫生导报, 2023, 29(9): 1268-1271.
[3]	周伟君田天照施敏蔡迎峰周剑鹏. MIS-TLIF围手术期中西医结合外科快速康复理念的实践运用 [J]. 国际医药卫生导报, 2023, 29(8): 1127-1131.
[4]	林健吕丽琼吴玉玲唐香马燕琼蔡如意. 揿针疗法干预癌痛患者阿片类药物相关性便秘的效果观察 [J]. 国际医药卫生导报, 2023, 29(24): 3686-3690.
[5]	徐莹莹崔莹莹. 循证理论的手术室责任制护理在甲状腺手术患者中的应用效果 [J]. 国际医药卫生导报, 2023, 29(24): 3585-3589.
[6]	熊辉强潘鸿桂曹小青甘文鹉. 加速康复外科在耳内镜下鼓膜修补术围手术期的应用研究 [J]. 国际医药卫生导报, 2023, 29(23): 3399-3402.
[7]	孔敏靳欣王宗霞. 改良早期预警评分管理在胰十二指肠患者围手术期的应用效果 [J]. 国际医药卫生导报, 2023, 29(22): 3284-3287.
[8]	孙红梅项招妮孙兆莲李明鑫刘昀李文亮. AOFAS量化康复训练对踝关节骨折患者术后康复效果的影响 [J]. 国际医药卫生导报, 2023, 29(22): 3301-3305.
[9]	程建兰丁丽袁红梅. 杵针联合穴位贴敷在颈性眩晕患者中医护理中的应用研究 [J]. 国际医药卫生导报, 2023, 29(21): 3099-3102.
[10]	朱晓彤毛小燕李萍朱腊梅严静雯. 经口腔前庭入路腔镜甲状腺手术患者的围手术期护理 [J]. 国际医药卫生导报, 2023, 29(21): 3116-3120.
[11]	王慧温桂香谷云青蚁淳杨丽陈星星. 突出中医护理核心能力培养临床护生带教模式的探索与实践 [J]. 国际医药卫生导报, 2023, 29(21): 3143-3147.
[12]	刘荣娇郑玲玲. 折叠式人工玻璃体球囊植入术患者的围手术期护理 [J]. 国际医药卫生导报, 2023, 29(15): 2200-2203.
[13]	李芸香成丽敏霍雪臣. 高压氧联合揿针对跟骨骨折患者疼痛的影响 [J]. 国际医药卫生导报, 2023, 29(11): 1608-1611.