五方散外敷结合中药内服及功能锻炼治疗无神经损伤胸腰椎骨折的疗效评价

目的评价五方散外敷结合中药内服及功能锻炼等治疗无神经损伤胸腰椎骨折的疗效。方法根据统一纳入及排除标准对2008-09—2010-08收治的225例无神经损伤胸腰椎骨折患者采用不同中医药疗法的治疗效果进行回顾性分析。治疗分为五方散外敷配合中药内服及功能锻炼组（简称外敷组）、腰背部药熨法配合中药内服及功能锻炼组（简称药熨组）和五方散外敷结合腰背部药熨法和中药内服及功能锻炼组（简称综合组），分别评价三种不同中医药疗法治疗无神经损伤胸腰椎骨折的疗效。结果治疗后3d与7d外敷组与综合组组间腰背部肿胀及腹胀减轻程度比较差异有统计学意义（P〈0．05或P〈0．01），但治疗后10d组间比较差异无统计学意义（P〉0．05）；药熨组与综合组治疗后各时段组间比较差异均有统计学意义（P〈0．05或P〈0．01）．外敷组与药熨组组间比较差异无统计学意义（P〉0．05）。三组治疗有效率均达90％以上，外敷组与药熨组组间疗效比较差异无统计学意义（P〉0．05），综合组与外敷组及药熨组组间疗效比较差异有统计学意义（／9〈0．05或／9〈0．01）。各组均有患者出现皮肤过敏症状，外敷组出现率最高，药熨组较低，而综合组最低，但组间比较差异无统计学意义（P〉0．05）。结论五方散外敷结合中药内服、腰背部中药熨烫及功能锻炼治疗无神经损伤胸腰椎骨折的疗效较好，但存在一定的并发症。

Effect of wufangsan plaster therapy combined with herbal oral administration, TCM hot medicated compress and functional exercise in the treatment of thoracolumbar fracture without neurologic deficit

Objective To evaluate the curative effect of wufangsan plaster therapy combined with herbal oral administration,TCM hot medicated compress of the back and functional exercise in the treatment of thoracolumbar fracture without neurologic deficit. Methods Two hundred and twenty-five patients with thoracolumbar fracture with- out neurologie deficit treated in our hospital from September 2008 to August 2010 were divided into three groups ac- cording to different treatments, including plaster therapy group（47 cases）, TCM（ Traditional Chinese Medicine） hot medicated compress group （43 cases）, and combined therapy group （135 cases）, then the curative effectiveness was compared by the same evaluation criteria. Results About improvement of the back pain, there was significant differ- ence between plaster therapy group and combined therapy group on 3rd and 7th day after treatment（P 〈 0.05 or P 〈 0. 01）,but there was no significant difference on 10th day after treatment（P 〉 0. 05）; and there was significant difference between TCM Hot medicated compress group and combined therapy group at every time points （P 〈 0. 05 or P 〈 0. 01 ） but no significant difference between plaster therapy group and TCM hot medicated compress group （ P 〉 0.05 ）. The clinical effect was obvious difference between combined therapy group and plaster therapy group or TCM hot medicated compress group（P 〈 0.05 or P 〈 0. 01 ）. Some patients in 3 groups suffered fi＇om skin allergies but there was no significant difference between combined modality therapy group and plaster therapy group or TCM hot medicated compress group （P 〉 0. 05 ）. Conclusion As for thoracolumbar fracture without neurologie, the curative effect of traditional Chinese combined therapy is better than that of plaster therapy or TCM hot medicated compress therapy, but some patients may suffer from skin allergies.