[1]张东阳,尚立林,李程锦,等.解毒祛腐汤联合负压引流治疗骨髓炎临床研究*[J].陕西中医杂志,2019,(2):233-236.
　ZHANG Dongyang,SHANG Lilin,LI Chengjin,et al.Treatment of osteomyelitis by Jiedu Qufu decoction combined with negative pressure drainage[J].,2019,(2):233-236.
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解毒祛腐汤联合负压引流治疗骨髓炎临床研究*
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《陕西中医》杂志[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年2期
页码:
233-236
栏目:
临床研究
出版日期:
2019-02-05

文章信息/Info

Title:
Treatment of osteomyelitis by Jiedu Qufu decoction  combined with negative pressure drainage
文章编号:
DOI: 10.3969/j.issn.10007369.2019.02.028
作者:
张东阳1 ; 尚立林1 ; 李程锦1; 郭 豪2; 刘大旭1
1.河南省南阳市第二人民医院 (南阳 473000);2.河南省漯河协荣骨病医院 (漯河462000)
Author(s):
ZHANG Dongyang; SHANG Lilin; LI Chengjin; et al.
Department of Orthopaedics，Nanyang Second People Undefineds Hospital( nanyang 473000)
关键词:
创伤性骨髓炎; 负压封闭引流; 红细胞沉降率; 血清C反应蛋白; 肿瘤坏死因子α; 白细胞介素6
Keywords:
Key words Traumatic osteomyelitis;  Negative pressure closed drainage;  ESR; CRP; TNFα; IL6
分类号:
R737.31
文献标志码:
A
摘要:
摘 要 目的：观察自拟解毒祛腐汤联合负压引流治疗骨髓炎的疗效及对临床症状与血清指标的改善作用。方法：选取92例创伤性骨髓炎患者作为观察对象，入组患者均分为分别纳入对照组与观察组，对照组采取常规负压封闭引流（VSD）治疗，观察组在对照组的基础上联合应用本院自拟解毒祛腐汤治疗；治疗后30d时评估两组临床疗效，观察两组患者红细胞沉降率（ESR）及血清C反应蛋白（CRP）、肿瘤坏死因子α（TNFα）、白细胞介素6（IL6）的变化情况；随访一年，观察两组患者各项临床症状康复时间，评估两组患者的生活质量。结果：观察组临床总有效率为93.48%，对照组临床总有效率为69.57%；观察组临床疗效优于对照组（P＜0.05）。观察组患者骨折愈合时间、肉芽覆盖创面时间、创口愈合时间、肿胀消退时间、疼痛消失时间均少于对照组（P＜0.05）。治疗后，两组ESR、CRP、TNFα、IL6均较治疗前改善组内对比差异有统计学意义，且观察组优于对照组，组间对比差异有统计学意义。随访1年，观察组患者生理功能、社会功能、躯体疼痛、精神健康均较对照组患者理想（P＜0.05）。结论：解毒祛腐汤联合钢材引流治疗骨髓炎疗效理想，并且缩短治疗周期，使相关临床症状尽早康复。
Abstract:
Abstract Objective：To observe the curative effect of the Jiedu Qufu decoction in treating osteomyelitis and the improvement of clinical symptoms and serum index. Methods：92 patients with traumatic osteomyelitis were selected as observation subjects. Into the group，patients were divided into into control group and observation group，control group treated with conventional closed negative pressure drainage (VSD)，the observation group in the control group on the basis of the joint used Jiedu Qufu decoction; 30 d after treatment，two groups of clinical curative effect，observe two groups of patients' erythrocyte sedimentation rate (ESR) and serum C  reactive protein (CRP)，tumor necrosis factor alpha (TNFα)，interleukin 6 (IL6) changes; The patients were followed up for one year to observe the clinical symptoms recovery time of the two groups，and to evaluate the quality of life of the two groups. Results：The total effective rate was 93.48% in the observation group and 69.57% in the control group. The clinical efficacy of the observation group was better than that of the control group(P＜0.05). In the observation group，the time of fracture healing，the time of the granulation of the granulation，the time of wound healing，the time of the swelling and the disappearance of the pain were all less than that of the control group(P＜0.05). After treatment，both groups of ESR，CRP，TNFαand IL6 were compared with those in the pretreatment group，and the observation group was better than that of the control group( P＜0.05). The patients were followed up for one year，and their physiological function，social function，physical pain and mental health were all better than those in the control group(P＜0.05). Conclusion：Jiedu Qufu decoction is ideal for treating osteomyelitis and shortening the treatment cycle，so as to make the relevant clinical symptoms recover as soon as possible.

参考文献/References:

\[1\] 罗建军,顾 峰,王家威.抗菌药物药珠植入术与闭合灌洗引流术治疗胫骨慢性骨髓炎疗效对比[J] .中华医院感染学杂志,2014,24(13):32083210.
[2] 孙玉芝,张朝晖,马 静.糖尿病合并慢性骨髓炎诊疗进展[J] .辽宁中医杂志,2015,42(11):22492251.
[3] 史永安,杜全红,马秉珺,等.创伤性骨髓炎的分型及治疗经验[J] .中国矫形外科杂志,2016,24(11):10481050.
[4] Xie B，Tian J，Jing YF，et al. Early effect of induced membrane technique for the reconstruction of chronic osteomyelitis defects in limbsof adult patients[J] . Zhongguo Gu Shang,2015,28(1):4347.
[5] Huang JW，Lin YY，Wu NY，et al. A novel endoscopicassisted harvesting of pedicled freestyle fasciocutaneous flaps[J] .Medicine(Baltimore),2015,94(8):e592e592.
[6] Wirbel R，Hermans K.Surgical treatment of chronic osteomyelitis inchildren admitted from developing countries [J] . Afr J Paediatr Surg,2014,11(4):297303.
[7] 胥少汀,葛宝丰,徐印坎.实用骨科学\[M\].4版.北京:人民军医出版社,2014：33243328.
[8] 孙传兴.临床疾病诊断依据治愈好转标准\[M\].2版.北京:人民军医出版社,2002：140143.
[9] 沈永义.加味五味消毒饮治疗慢性化脓性骨髓炎40例效果分析[J] .临床合理用药,2018,11(1B):6465.〖ZK)〗
[10] Ali AM，Maya E，Lakhoo K. Challenges in managing paediatric osteomyelitis in the developing world：analysis of cases presenting to atertiary referral centre in Tanzania [J] .Afr J Paediatr Surg，2014,11(4):308311.
[11] Wilkenf,harrasser n，pohlig f，et al. Surgical technique：reconstruction of deficient extensor apparatus of the kneeacase report[J] .Z Orthop Unfall,2015,153(2):209211.
[12] Hui C,Ooi A，Tan TE，et al.Rectus sparing approach to left ventricular assist device exchange and use of the omental flap for coverage[J] .J Plast Reconstr Aesthet Surg,2015,68(2):278280.
[13] 梁 晖,李兴华,黄海东.VSD持续负压引流技术治疗慢性骨髓炎[J] .辽宁医学杂志,2015,29(2):130130.
[14] 窦浚峰,张景义,王 勤,等.封闭式负压引流联合植骨术治疗胫骨创伤性骨髓炎[J] .中国矫形外科杂志,2018,26(1):4347.
[15] 张自强,于继岗,祁文兵.五味消毒饮在成人慢性胫骨骨髓炎治疗中的应用[J] .陕西中医,2015,36(8):991992.

备注/Memo

备注/Memo:
*河南省科技攻关项目（0324420006）
更新日期/Last Update: 2019-03-13