隴中消腫止痛合劑治療骨筋膜室綜合征臨床研究

申建軍 陳志偉 方鵬飛 張富龍 馮康虎 王久夏 田繼東

摘要：目的 ?觀察隴中消腫止痛合劑對骨筋膜室綜合征（OCS）患者視覺模擬評分法（VAS）評分及相關實驗室指標的影響。方法 ?采用隨機數(shù)字表法將100例OCS患者分為對照組和治療組各50例。對照組予20%甘露醇250 mL，七葉皂苷鈉20 mg+生理鹽水250 mL，均每日1次，靜脈滴注。治療組在對照組基礎上予隴中消腫止痛合劑，每次50 mL，每日3次，口服。均1周為1個療程，連續(xù)治療2個療程。比較2組治療前及治療3、7、14 d VAS評分及血清肌酸激酶（CK）、乳酸脫氫酶（LDH）、天冬氨酸氨基轉(zhuǎn)移酶（AST）水平。結果 ?與本組治療前比較，2組治療3、7、14 d VAS評分明顯降低（P<0.05）;2組治療后比較，治療組治療3、7 d VAS評分明顯低于對照組（P<0.05）。與本組治療前比較，治療3、7、14 d，2組血清CK、LDH、AST水平明顯降低（P<0.01）;2組治療7、14 d比較，治療組CK、LDH、AST水平改善明顯優(yōu)于對照組（P<0.05）。結論 ?隴中消腫止痛合劑治療OCS患者可有效止痛，降低患者血清CK、LDH、AST水平。

關鍵詞：骨筋膜室綜合征;肌酸激酶;乳酸脫氫酶;天冬氨酸氨基轉(zhuǎn)移酶

中圖分類號：R274.9 ???文獻標識碼：A ???文章編號：1005-5304（2019）05-0037-04

DOI：10.3969/j.issn.1005-5304.2019.05.008 開放科學（資源服務）標識碼（OSID）：

Abstract： Objective To observe the effects of Longzhong Xiaozhong Zhitong Mixture on VAS score and related laboratory indicators in patients with osteofascial compartment syndrome （OCS）. Methods Totally 100 patients with OCS were divided into two groups according to random number table method， with 50 cases in each group. The control group was given 20% mannitol 250 mL， sodium aescinate 20 mg + physiological saline 250 mL once daily， intravenously. On the basis of the control group， the treatment group was given Longzhong Xiaozhong Zhitong Mixture， 50 mL each time， 3 times a day， orally. One week was one treatment course， two courses successively. The VAS scores， serum creatine kinase （CK）， lactate dehydrogenase （LDH）， and glutamate aminotransferase （AST） levels were compared before treatment and at 3， 7， and 14 days of treatment. Results Compared with before treatment， the VAS scores of the two groups at 3， 7 and 14 days of treatment were significantly lower （P<0.05）; After treatment， the VAS scores of the treatment group at 3 and 7 days of treatment were significantly lower than those of the control group （P<0.05）. Compared with before treatment， the levels of serum CK， LDH and AST in the two groups significantly decreased 3， 7 and 14 day of treatment （P<0.01）; Compared with the control group， the improvement of CK， LDH and AST levels in the treatment group was significantly better than those in the control group 7 and 14 day of treatment （P<0.05）. Conclusion Longzhong Xiaozhong Zhitong Mixture is effective in relieving pain， reducing levels of CK， LDH and ASK in patients with OCS.

Keywords： osteofascial compartment syndrome; creatine kinase; lactic dehydrogenase; glutamate aminotransferase

骨筋膜室綜合征（osteofascial compartment syndrome，OCS）是由于急性創(chuàng)傷及骨折導致肢體骨筋膜室內(nèi)肌肉腫脹、出血、疼痛，波及血管神經(jīng)，甚至出現(xiàn)肌肉、軟組織壞死等一系列癥狀、體征。早期診斷與治療及預防嚴重并發(fā)癥尤為重要。隴中消腫止痛合劑為甘肅省中醫(yī)院院內(nèi)制劑，具有活血化瘀、消腫止痛之功，治療各種創(chuàng)傷所致的軟組織腫脹、疼痛療效顯著[1-3]。本研究采用隴中消腫止痛合劑治療OCS，觀察治療前后患者視覺模擬評分法（VAS）評分及相關實驗室指標變化，現(xiàn)報道如下。