血府逐瘀汤联合雷火灸对下肢骨折术后肢体疼痛、肿胀及血清疼痛介质的影响

〔摘 要〕 目的：观察血府逐瘀汤加减联合雷火灸对下肢骨折术后肢体疼痛、肿胀及血清疼痛介质的影响。 方法：选取郑州中医骨伤病医院 2022 年 1 月至 2022 年 12 月期间收治的 75 例单侧闭合性下肢骨折且实施手术治疗后的患者，随机分为观察组（38 例）和对照组（37 例）。对照组患者给予头孢呋辛钠注射液治疗，观察组患者在对照组治疗基础上增加血府逐瘀汤加减联合雷火灸治疗。观察两组患者治疗前、治疗 1 周及治疗 2 周的疼痛评分、肿胀评分及治疗前后的血清疼痛介质［P 物质（SP）、前列腺素 E2（PGE2）和 5– 羟色胺（5–HT）］水平，比较两组患者肿胀消退时间、疼痛消退时间和平均住院时间。 结果：与同组治疗前比较，在治疗 1 周及治疗 2 周两组患者视觉模拟评分法（VAS）评分均有不同程度下降，且治疗 1 周及治疗 2 周观察组患者 VAS 评分低于对照组，差异具有统计学意义（P ＜ 0.05）。与同组治疗前比较，在治疗 1 周及治疗 2 周两组患者肿胀评分均有不同程度下降，且治疗 1 周及治疗2 周观察组患者肿胀评分低于对照组，差异具有统计学意义（P ＜ 0.05）。治疗后，观察组患者肿胀消退时间、疼痛消退时间和平均住院时间明显短于对照组，差异具有统计学意义（P ＜ 0.05）。与同组治疗前比较，在治疗后两组患者血清 SP、PGE2 和 5–HT 水平均有不同程度下降，且治疗后观察组患者血清 SP、PGE2 和 5–HT 水平均低于对照组，差异具有统计学意义（P ＜ 0.05）。两组患者均未发生明显药物不良反应，观察组患者悬灸处皮肤均没有出现红肿、瘙痒、破溃等。 结论：血府逐瘀汤加减联合雷火灸可有效缓解下肢骨折术后肢体肿胀，降低疼痛介质水平，缓解疼痛程度，有效缩短肿胀、疼痛消退时间和平均住院时间。

Effect of Xuefu Zhuyu Decoction Combined with Thunder-fire Moxibustion on Limb Pain, Swelling and Serum Pain Mediators after Lower Limb Fracture

〔Abstract〕　Objective To observe the effects of Xuefu Zhuyu decoction combined with thunder-fire moxibustion on limb pain, swelling and serum pain mediators after lower limb fracture. Methods A total of 75 patients with unilateral closed lower extremity fracture admitted to Zhengzhou Hospital of Traditional Chinese Medicine from January 2022 to December 2022 after surgical treatment were randomly divided into the observation group (38 cases) and the control group (37 cases). The control group was treated with cefuroxime sodium injection, and the observation group was treated with Xuefu Zhuyu decoction combined with thunder-fire moxibustion on the basis of control group. The pain score, swelling score and serum pain mediators [Substance P (SP), prostaglandin E2 (PGE2) and 5-hydroxytryptamine (5-HT)] levels before and after treatment were observed in the two groups before and after treatment, and the duration of swelling resolution, pain resolution and average length of hospital stay were compared between the two groups. Results Compared with the same group before treatment, visual analogue scale (VAS) scores of the two groups were decreased to varying degrees at 1 week and 2 weeks of treatment, and the VAS scores of the observation group were lower than those of the control group at 1 week and 2 weeks of treatment, the differences were statistically significant (P < 0.05). Compared with the same group before treatment, the swelling scores of the two groups were decreased to varying degrees after 1 week and2 weeks of treatment, and the swelling scores of the observation group were lower than those of the control group after 1 week and 2 weeks of treatment, the differences were statistically significant (P < 0.05). The swelling regression time, pain regression time and average length of hospital stay in the observation group were significantly shorter than those in the control group, and the differences were statistically significant (P < 0.05). Compared with the same group before treatment, the serum levels of SP, PGE2 and 5-HT of the two groups were decreased to varying degrees after treatment, and the serum levels of SP, PGE2 and 5-HT of the observation group were lower than those of the control group after treatment, the differences were statistically significant (P < 0.05). No obvious adverse drug reactions occurred in the two groups, and the skin in the observation group did not appear red, swollen, pruritus, or ulceration. Conclusion Xuefu Zhuyu decoction combined with thunder-fire moxibustion can effectively relieve limb swelling after lower limb fracture, reduce the level of pain mediators, relieve pain degree, effectively shorten swelling, pain resolution time and average length of hospital stay.